1040 / 1609
34 Gy in 10 fractions was prescribed as the minimum
dose anywhere within the prescription volume
27% developed clinically evident fat necrosis
Wazer DE, et al. Clinically evident fat necrosis in women treated with HDR
brachytherapy alone for early-stage breast cancer. Int J Radiat Oncol Biol Phys
2001, 50:107–111
fat necrosis no fat necrosis Baglan WBH Budrakkar Mumbai (85%)
V100 234.4 cc 147.7 cc (p<0.03) 216 cc 124cc
V150 69.0 cc 36.2 cc (p<0.01) 26 cc 30cc
18% fat necrosis
DHI 0.82 0.85
0.87 0.74
The volume of the implant, the volume of dose “hotspots”
V150 and V200, and the dose homogeneity of the implant
DHI were strongly correlated with adverse outcome
.
Wazer DE et al. APBI: An analysis of variables associated with late toxicity and long-term cosmetic
outcome after HDR interstitial brachytherapy. Int J Radiat Oncol Biol Phys 2006; 64:489–495
Breast cancer CT (closed cavity): 3.4 Gy to volume