open access

Vol 21, No 5 (2016)
Original research articles
Published online: 2016-09-01
Submitted: 2015-06-16
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Study of the dosimetric differences between Ir and Co sources of high dose rate brachytherapy for breast interstitial implant

Mourougan Sinnatamby, Vivekanandan Nagarajan, Reddy Kanipakam Sathyanarayana, Gunaseelan Karunanidhi, Vivekanandam Singhavajala
DOI: 10.1016/j.rpor.2016.03.005
·
Rep Pract Oncol Radiother 2016;21(5):453-459.

open access

Vol 21, No 5 (2016)
Original research articles
Published online: 2016-09-01
Submitted: 2015-06-16

Abstract

Aim

The study intends to compare 192Ir source against the 60Co source for interstitial breast metal implant in high dose rate brachytherapy.

Background

Few studies have been reported to compare 60Co and 192Ir on HDR brachytherapy in gynaecology and prostate cancer and very few with reference to breast cancer.

Materials and methods

Twenty patients who had undergone interstitial template guided breast implant were treated in HDR 192Ir brachytherapy unit. Plans were generated substituting 60Co source without changing the dwell positions and optimization. Cumulative dose volume histograms were compared.

Results

The reference isodose line enclosing CTV (CTVref) and the 2.34% difference seen in the volume enclosed by the reference isodose line (Vref) between the two isotopes show small but statistically significant difference (p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.05). In DHI, no difference was observed in the relative dose between the two sources (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.823). The over dose volume index showed 11% difference. The conformity index showed 2.32% difference compared to 192Ir (p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.05).

Dmean (%) and Dmax (%) for the heart, ipsilateral lung, ipsilateral ribs, skin presented very small difference. V5% and V10% of the heart shows 25% and 32% difference in dose. D2cc (%) and D0.1cc (%) for the contralateral breast, contralateral lung and D2cc (%) of the skin displayed significant difference (p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.05). However, D0.1cc (%) of the skin indicated no noteworthy difference with p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.343.

Conclusion

Based on the 3D dosimetric analysis of patient plans considered in this study, most of the DVH parameters showed statistically significant differences which can be reduced by treatment planning optimization techniques. 60Co isotope can be used as a viable alternative because of its long half-life, logistic advantages in procurement, infrequent need of source replacement and disposal of used source.

Abstract

Aim

The study intends to compare 192Ir source against the 60Co source for interstitial breast metal implant in high dose rate brachytherapy.

Background

Few studies have been reported to compare 60Co and 192Ir on HDR brachytherapy in gynaecology and prostate cancer and very few with reference to breast cancer.

Materials and methods

Twenty patients who had undergone interstitial template guided breast implant were treated in HDR 192Ir brachytherapy unit. Plans were generated substituting 60Co source without changing the dwell positions and optimization. Cumulative dose volume histograms were compared.

Results

The reference isodose line enclosing CTV (CTVref) and the 2.34% difference seen in the volume enclosed by the reference isodose line (Vref) between the two isotopes show small but statistically significant difference (p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.05). In DHI, no difference was observed in the relative dose between the two sources (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.823). The over dose volume index showed 11% difference. The conformity index showed 2.32% difference compared to 192Ir (p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.05).

Dmean (%) and Dmax (%) for the heart, ipsilateral lung, ipsilateral ribs, skin presented very small difference. V5% and V10% of the heart shows 25% and 32% difference in dose. D2cc (%) and D0.1cc (%) for the contralateral breast, contralateral lung and D2cc (%) of the skin displayed significant difference (p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.05). However, D0.1cc (%) of the skin indicated no noteworthy difference with p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.343.

Conclusion

Based on the 3D dosimetric analysis of patient plans considered in this study, most of the DVH parameters showed statistically significant differences which can be reduced by treatment planning optimization techniques. 60Co isotope can be used as a viable alternative because of its long half-life, logistic advantages in procurement, infrequent need of source replacement and disposal of used source.

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Keywords

[[ce:sup loc=" pre" ]]60Co; [[ce:sup loc=" pre" ]]192Ir; HDR; Breast; Interstitial implant

About this article
Title

Study of the dosimetric differences between Ir and Co sources of high dose rate brachytherapy for breast interstitial implant

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 21, No 5 (2016)

Pages

453-459

Published online

2016-09-01

DOI

10.1016/j.rpor.2016.03.005

Bibliographic record

Rep Pract Oncol Radiother 2016;21(5):453-459.

Keywords

[[ce:sup loc="pre"]]60Co
[[ce:sup loc="pre"]]192Ir
HDR
Breast
Interstitial implant

Authors

Mourougan Sinnatamby
Vivekanandan Nagarajan
Reddy Kanipakam Sathyanarayana
Gunaseelan Karunanidhi
Vivekanandam Singhavajala

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