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Is it important to define skin sub-volumes in breast brachytherapy?

Published online by Cambridge University Press:  02 October 2020

Tabassum Wadasadawala Open the ORCID record for Tabassum Wadasadawala [Opens in a new window] ,
Sabheen Bushra ,
Lavanya Gurram ,
Libin Scaria ,
Reena Phurailatpam ,
Pallavi Rane  and
Rajiv Sarin
Tabassum Wadasadawala*
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
Sabheen Bushra
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
Lavanya Gurram
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
Libin Scaria
Affiliation:
Department of Medical Physics, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
Reena Phurailatpam
Affiliation:
Department of Medical Physics, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
Pallavi Rane
Affiliation:
Department of Medical Statistics, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
Rajiv Sarin
Affiliation:
Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
*
Author for correspondence: Dr Tabassum Wadasadawala, Department of Radiation Oncology, Advanced Center for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, CISF Road, Near Central Park, Kharghar, Navi Mumbai410210, India. Tel: +91 22 27405079. Fax: +91 22 27405061. E-mail: twadasadawala@actrec.gov.in, drtabassum2004@rediffmail.com
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Abstract

Aim:

To evaluate clinically pertinent skin dose and volume parameters for the development of toxicities following accelerated partial breast irradiation (APBI).

Methods:

Three skin structures of various thicknesses inside the body (2 mm, 3 mm, 4 mm) were contoured over the treated breast retrospectively in a cohort of 62 women who underwent APBI using multi-catheter interstitial brachytherapy. The correlation statistics between the various skin structures and acute and late skin sequelae were evaluated using the Mann–Whitney U test and receiver-operating characteristic analysis. A p-value of <0·05 was considered significant.

Results:

At a median follow-up period of 54 months (range: 28–86), a significant correlation was seen between dose received by 0·2 (D0·2) cc of skin 4 mm inside the body as well as volume receiving 100% dose (V100) of skin 3 mm inside the body with cosmesis at 2 years and at last follow-up. The threshold for the two parameters for prediction of excellent or good cosmesis was 90% of the prescribed dose and 0·05 cc, respectively. No significant dosimetric or volumetric correlation was seen with other sequelae like wound dehiscence, fat necrosis, telangiectasia and atrophy.

Conclusion:

The results of this study support the use of dose and volumetric indices of the sub-volumes of the skin for correlation with clinical endpoints. However, the same should be validated prospectively in a larger cohort of women undergoing breast brachytherapy.

Keywords

accelerated partial breast irradiationcosmesismulti-catheter interstitial brachytherapyskin dose
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 1 , March 2022 , pp. 68 - 73
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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