A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy

Abstract

Purpose Over 20,000 patients have been treated with partial breast irradiation (PBI) using the MammoSite balloon brachytherapy applicator (IBB). Recently, a new form of balloon-based PBI, Xoft Axxent electronic brachytherapy (KVB), which uses a 50-kV x-ray source, has been introduced. This analysis was undertaken to dosimetrically compare the results of treatment using these two methods of PBI. Methods and Materials The study population consisted of 15 patients previously treated with IBB. The planning CT scans from these 15 patients were used to construct hypothetical treatment plans using the source characteristics of the KVB device. The plans were then compared using the dosimetric parameters discussed below. Results The mean % V 90 was 99.6% vs. 99.0% ( p = nonsignificant [ns]), the mean % V 100 was 96.5% vs. 96.5%, the mean % V 150 was 41.8% vs. 59.4% ( p < 0.05), the mean % V 200 was 11.3% vs. 32.0% ( p < 0.05), and the mean % V 300 was 0.4% vs. 6.7% ( p < 0.05) for the IBB and KVB methods, respectively. The mean ipsilateral breast % V 50 was 19.8% vs. 13.0% ( p < 0.05), the mean ipsilateral lung % V 30 was 3.7% vs. 1.1% ( p < 0.05), and the mean heart % V 5 was 59.2% vs. 9.4% ( p < 0.05) for the IBB and KVB methods, respectively. Conclusions The IBB and KVB methods of PBI offer comparable target volume coverage; however, the KVB method is associated with an increased volume of breast tissue in the high-dose regions and a decreased dose to the adjacent normal tissues.