Dosimetric study to assess the feasibility of intraoperative radiotherapy with electrons

Purpose To report in-vivo dosimetry in the infraclavicular region, a potential site of a cardiac implantable electronic device (CIED) and to evaluate the absorbed dose from intraoperative radiotherapy with electrons (ELIOT). Methods 27 non-cardiopathic breast cancer (BC) patients without CIED receiv...

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Bibliographic Details
Published in:Breast cancer research and treatment 2018-10, Vol.171 (3), p.693
Main Authors: Galimberti, Viviana, Luraschi, Rosa, Colombo, Nicola, Rondi, Elena, Bazani, Alessia, Corso, Giovanni, Lazzari, Roberta
Format: Article
Language:English
Subjects:
Cancer patients
Cardiac patients
Care and treatment
Electrons
Lumpectomy
Medical research
Prostheses and implants
Radiotherapy
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Summary:Purpose To report in-vivo dosimetry in the infraclavicular region, a potential site of a cardiac implantable electronic device (CIED) and to evaluate the absorbed dose from intraoperative radiotherapy with electrons (ELIOT). Methods 27 non-cardiopathic breast cancer (BC) patients without CIED received quadrantectomy and ELIOT as partial breast irradiation. Before delivering ELIOT, two catheters, each containing eight thermoluminescent dosimeters (TLDs), were positioned in the infraclavicular region. TLDs internal catheter was located deep in the tumor bed while the external catheter was placed on patient's skin. Results Data were available for 24/27 patients. The absorbed doses were referred to the dose of 21 Gy. Values measured by the external catheter were low, although statistically significant higher doses were found close to the applicator (mean values 0.26-0.49 Gy). External TLD doses in proximity of the applicator were lower than those detected by their internal counterparts. Values measured by the internal catheter TLDs varied according to the distance from the applicator while no correlation with tumor site and beam energy was found. The distance from the applicator to deliver < 2 Gy to a CIED was 2 cm, while from 2.5 cm the dose measured in all the patients became negligible. Conclusions This dosimetric study provided data to support the clinical use of ELIOT in BC patients having CIEDs as long as the suggested minimum safe distance of 2.5 cm is taken from the RT field in case of ELIOT single dose of 21 Gy, in the energy range of 6-10 MeV.
ISSN:0167-6806
DOI:10.1007/s10549-018-4878-8