title: A comparison of skin and chest wall dose delivered with multicatheter, Contura multilumen balloon, and MammoSite breast brachytherapy.
abstract: OBJECTIVE
  Skin and chest wall doses have been correlated with toxicity in patients treated with breast brachytherapy . This investigation compared the ability to control skin and chest wall doses between patients treated with multicatheter (MC), Contura multilumen balloon (CMLB), and MammoSite (MS) brachytherapy.
  
  
  METHODS
  43 patients treated with the MC technique, 45 patients treated with the CMLB, and 83 patients treated with the MS were reviewed. The maximum doses delivered to the skin and chest wall were calculated for all patients.
  
  
  RESULTS
  The mean maximum skin doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.2 Gy per fraction (94% of prescription dose), respectively. Although the skin distances were similar (p = 0.23) for the two balloon techniques, the mean skin dose with the CMLB was significantly lower than with the MS (p = 0.05). The mean maximum rib doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.6 Gy per fraction (105% of prescription dose), respectively. Again, the mean rib dose with the CMLB was significantly lower than with the MS (p = 0.002).
  
  
  CONCLUSIONS
  The MC and CMLB techniques are associated with significantly lower mean skin and rib doses than is the MS. Treatment with the MS was associated with significantly more patients receiving doses to the skin or rib in excess of 125% of the prescription. Treatment with the CMLB may prove to yield less normal tissue toxicity than treatment with the MS.
authors.affiliation: Department of Radiation Oncology, Virginia Commonwealth University, Medical College of Virginia, Richmond, VA 23298, USA. lcuttino@mcvh-vcu.edu
authors.forename: Laurie W
authors.initials: LW
authors.lastname: Cuttino
authors.forename: Dorin
authors.initials: D
authors.lastname: Todor
authors.forename: Mihaela
authors.initials: M
authors.lastname: Rosu
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Arthur
mesh_terms: D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D011832:Radiation Injuries / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D012272:Ribs / Q000528:radiation effects; D012867:Skin / Q000528:radiation effects