Advanced Radiotherapy Consulting

Mammosite

Mammosite is a catheter balloon used as a HDR brachy breast applicator

Rx Dose = 10 fx at 340 cGy/fx for a total dose of 34 Gy delivered BID

Rx Point is 1 cm from balloon

Used for early stage breast cancer (preferably node negative)

Protocol allows for 3 (+) nodes

Physics Notes
o Total Dose = 34 Gy
o Symmetry of Balloon < 2mm asymmetric
o Min distance to skin is (should be 7mm; shall be 5mm)
o PTV_Eval 95% Volume covering 90% Dose
o Max skin dose: 145%
o Tissue Volume V150 <50cc
o Tissue Volume V200 <10cc
o Uninvolved Normal Breast: <60% receives >50% Rx Dose

Contouring Notes
o
o
o
o

Subtract balloon volume from breast volume

PTV_eval = PTV 5mm from skin pectoral muscle
Breast Volume based on external tangential fields
Evaluate Air Pockets vs Volume

Advanced Radiotherapy Consulting

3D PBI

3D Partial Breast Irradiation used in leau of Mammosite

Rx Dose = 10 fx at 385 cGy/fx for a total dose of 38.5 Gy delivered BID

Rx Point Volume is PTV_eval

Used for early stage breast cancer (preferably node negative)

Protocol allows for 3 (+) nodes

Physics Notes
o Total Dose = 38.5 Gy
o PTV_Eval 90% Volume covering 90% Dose
o Max Dose in Plan: < 120%
o Heart Dose: <5%V 5% Dose (right sided lesions)
o Heart Dose: <40%V 5% Dose (left sided lesions)
o Thyroid Max: <3%
o Ipsilateral Lung Dose: <15%V 30% Rx Dose
o Contralateral Lung Dose: <15%V 5% Rx Dose
o Whole Breast Reference Volume

<60%V at 50% Rx Dose

<35%V at Rx Dose

Contouring Notes
o Subtract balloon volume from breast volume
o PTV_eval = PTV 5mm from skin pectoral muscle
o Breast Volume based on external tangential fields