APBI 2016

Dose to ribs

Brashears et al. Late chest wall toxicity after MammoSite breast brachytherapy. Brachytherapy 2009;8:19–25 .

Five treatment related rib fractures were reported after treating 105 patients with MammoSite breast brachytherapy. They evaluated the original treatment plans and found that the average D0.1 cm3 and D1 cm3 to ribs were 45.6 Gy ( 134% ) and 34.8 Gy ( 102% ).

Brown et al. Factors associated with chest wall toxicity after accelerated partial breast irradiation using high-dose-rate brachytherapy. Int J Radiat Oncol Biol Phys 2012;83:801–5. Direct correlation was found between total dose received and volume of rib irradiated. They conclude that the dose to ribs and chest wall have to be kept as low as possible , and they suggest limiting the chest wall dose preferably less than 132% of the PD at a volume of 0.008 cm 3 .