Pacemaker/implantable cardioverter-defibrillator dose in balloon high-dose-rate brachytherapy for breast cancer treatment

Brachytherapy
Yongbok KimMark G Trombetta

Abstract

To retrospectively report pacemaker (PM)/implantable cardioverter-defibrillator (ICD) dose in balloon high-dose-rate (HDR) brachytherapy and provide distance-dose graph and table to approximately estimate the maximal device dose. For 3 patients (A, B, and C), PM/ICD was retrospectively contoured on planning computed tomography images and its maximal dose was extracted from a dose-volume histogram. The surface of 1cm expansion from balloon was prescribed to 34Gy and the inverse square law was dominant factor in dose calculation. Therefore, the maximal PM/ICD dose was approximately estimated from the distance-dose graph or table and compared with that of the treatment plan. The minimal device-balloon surface distance was 10.9, 18.4, and 4.3cm for patient A, B, and C, respectively. The maximal dose estimated from the proposed table/graph was 2.1 vs. 1.61Gy for patient A, 0.87 vs. 0.49Gy for patient B, and 8.9 vs. 9.14Gy for patient C compared with that from the treatment plan. Depending on the location of PM/ICD relative to the tumor bed, balloon HDR brachytherapy is feasible if the maximal dose is less than or equal to the dose limit. The proposed distance-dose graph and/or table enable to approximately predict the maximal device...Continue Reading

References

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Citations

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