Initial radiation experience evaluating early tolerance and toxicities in patients undergoing accelerated partial breast irradiation using the Contura Multi-Lumen Balloon breast brachytherapy catheter.
OBJECTIVE
We reviewed our institution's experience treating patients with the Contura Multi-Lumen Balloon (SenoRx, Inc., Irvine, CA) breast brachytherapy catheter to deliver accelerated partial breast irradiation.


METHODS
Forty-one patients treated with breast-conserving therapy received adjuvant radiation using the Contura catheter (34Gy in 3.4Gy fractions). Thirteen patients had Stage 0, 21 had Stage I, and 7 had Stage II breast cancer. Median followup was 8 months (range, 1-17).


RESULTS
Median, minimum skin spacing was 10mm (range, 2-17). Median, maximum skin doses (% of prescribed dose [PD]) were 99.7 (range, 57.1-124.1). Eight patients were treated with a skin spacing <or=5mm and 2 had a spacing of 2mm. Median, maximum rib doses were 102.6% of PD (10.0-187.7), and the median percentage of the planning target volume for evaluation (PTV_EVAL) receiving 95% of the PD was 98.8 (range, 79.4-107.4). The median volume receiving 200% of the PD was 5.7cc (range, 1.3-9.9). The percentage of patients with excellent/good cosmetic results at 6 months (n=15) and 12 months (n=12) was 100%. Patient tolerance was assessed on a scale 0-10 (0=no pain, 10=requiring narcotic analgesics). In 37 out of 38 patients, pain was graded <or=3 at the time of catheter insertion. Four breast infections (11%) and one transient symptomatic seroma (3%) developed.


CONCLUSIONS
Adjuvant accelerated partial breast irradiation using the Contura Multi-Lumen Balloon catheter exhibited similar toxicities to standard single lumen balloon brachytherapy with improvements in dosimetric capabilities (i.e., reduced skin and rib doses and improved PTV_EVAL coverage).
Brown
Sheree
S
Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, GA.
McLaughlin
Mark
M
Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, GA. Electronic address: mmclaughlin0823@msn.com.
Pope
Keith
K
Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, GA.
Haile
Kenneth
K
Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, GA.
Hughes
Laurie
L
Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, GA.
Israel
Philip Z
PZ
The Breast Center, Marietta, GA.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001918:Brachytherapy / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D002404:Catheterization; D004307:Dose-Response Relationship, Radiation; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011836:Radiation Tolerance / Q000528:radiation effects*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome