CPB Ljubljana 2018 course book

Breast cancer CT (closed cavity): 3.4 Gy to volume

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

34 Gy in 10 fractions was prescribed as the minimum dose anywhere within the prescription volume

27% developed clinically evident fat necrosis

fat necrosis no fat necrosis V100 234.4 cc 147.7 cc (p<0.03) V150 69.0 cc 36.2 cc (p<0.01) DNR 0.29 0.24

Baglan WBH Budrakkar Mumbai (85%) 216 cc 124cc 26 cc 30cc 18% fat necrosis 0.12 0.24

The volume of the implant, the volume of dose “hotspots” V150 and V200, and the dose homogeneity of the implant DNR 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