title: A Contura catheter offers dosimetric advantages over a MammoSite catheter that increase the applicability of accelerated partial breast irradiation.
abstract: OBJECTIVE
  The purpose of this study was to determine whether a Contura catheter (SenoRx, Inc, Aliso Viejo, CA) can increase the applicability of accelerated partial breast irradiation.
  
  
  METHODS
  One hundred eighty-two women with early stage breast carcinomas were treated with postlumpectomy brachytherapy using a Contura multilumen catheter (n=45) or a MammoSite single-lumen catheter (Cytyc Corp, Marlborough, MA) (n=137). Hypothetical MammoSite catheter treatment plans were created for the Contura patients. Treatment planning goals were to (1) avoid a radiation "hot spot" in the skin and (2) have only a small air/fluid pocket next to the balloon.
  
  
  RESULTS
  The median followup was 16 months. Eighty-nine percent (40 of 45) of Contura plans satisfied both treatment planning goals vs. only 36% (16 of 45) of MammoSite plans (p<0.0001). A Contura catheter did not require explantation in 16% (7 of 45) of patients where balloon-to-skin spacing was only 3-6mm and 11% (5 of 45) of patients where there was an air/fluid pocket >10% of the planning target volume for plan evaluation (PTV_EVAL). A MammoSite catheter was explanted in 10% of cases where the minimum balloon-to-skin distance was <7mm and in 13% of cases where there was a large air/fluid pocket next to the balloon. Our incidence rates of acute toxicity with a Contura catheter were similar to those with a MammoSite catheter.
  
  
  CONCLUSIONS
  A Contura catheter provides important dosimetric advantages over a MammoSite catheter and does not require explantation in cases where balloon-to-skin spacing is only 3-6mm or an air/fluid pocket next to the balloon is >10% of PTV_EVAL.
authors.affiliation: Cancer Center of Irvine, Irvine, CA, USA. richardbwilder@yahoo.com
authors.forename: Richard B
authors.initials: RB
authors.lastname: Wilder
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Curcio
authors.forename: Rajesh K
authors.initials: RK
authors.lastname: Khanijou
authors.forename: Martin E
authors.initials: ME
authors.lastname: Eisner
authors.forename: Jane L
authors.initials: JL
authors.lastname: Kakkis
authors.forename: Lucy
authors.initials: L
authors.lastname: Chittenden
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Agustin
authors.forename: Jessica
authors.initials: J
authors.lastname: Lizarde
authors.forename: Albert V
authors.initials: AV
authors.lastname: Mesa
authors.forename: John
authors.initials: J
authors.lastname: Ravera
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Tokita
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant