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Physics of APBI

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Short Course Breast Radiotherapy

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Abstract

APBI (accelerated partial-breast irradiation) treatments can be delivered using external beam or brachytherapy techniques. Interstitial brachytherapy using LDR (low-dose rate) Ir-192 seeds was historically the first modality used for APBI and consequently has the longest follow-up. More recently, external beam treatment has been used, either as photon, proton beams, or highly collimated electron beams, the latest being more often associated with intraoperative techniques relatively popular in Europe. New brachytherapy sources have been developed, including a miniature low-energy (~50 kV) electronic brachytherapy source and existent sources (e.g., Pd-103) commonly used as permanent seed implants for PBI, i.e., prostate cancer [47, 54, 56]. However, more commonly, APBI brachytherapy is associated with HDR (high-dose rate) treatment using Ir-192. The relatively high-energy source (~380 keV) at the tip of a thin wire is placed, using a computer-controlled afterloader device, in precisely specified positions for time intervals determined during the planning phase. Given the fact that the treatment is delivered very fast compared with the average half-time of cellular repair processes, one can establish equivalence between multiple sources loaded simultaneously (LDR) and one source, as is the basis for the HDR paradigm. Utilizing a planned combination of dwell positions, the single HDR source being successively placed in specified positions along applicators, and dwell times, and the specified time, the single HDR source remains at that position. Thus, after combining a well-determined target, a specified applicator, and a given strength of an Ir-192 source, an HDR treatment plan is generated through specifying dwell positions and their associated dwell times. The highly radioactive source cannot be placed in direct contact with tissues, and therefore, various devices or “applicators” are used to both contain and to guide the source in the desired positions.

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Authors and Affiliations

  1. Department of Radiation Oncology, School of Medicine, Virginia Commonwealth University, 401 College St, PO Box 980058, Richmond, VA, 23298, USA

    Dorin A. Todor

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  1. Dorin A. Todor
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Correspondence to Dorin A. Todor .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, Virginia Commonwealth Univ Sch. Medicine Department of Radiation Oncology, RICHMOND, Virginia, USA

    Douglas W Arthur

  2. Michigan Healthcare Professionals, 21st Century Oncology Michigan Healthcare Professionals, Farmington Hills, Michigan, USA

    Frank A. Vicini

  3. Dept. Rad Oncol, Tufts Univ. School Med, Alpert Medical School Brown University Dept. Rad Oncol, Tufts Univ. School Med, BOSTON, Massachusetts, USA

    David E. Wazer

  4. Dept. of Radiation Oncology, Rutgers Can State Univ. New Jer Sch. Med Dept. of Radiation Oncology, NEW BRUNSWICK, New Jersey, USA

    Atif J. Khan

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© 2016 Springer International Publishing Switzerland

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Todor, D.A. (2016). Physics of APBI. In: Arthur, D., Vicini, F., Wazer, D., Khan, A. (eds) Short Course Breast Radiotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-24388-7_14

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  • DOI: https://doi.org/10.1007/978-3-319-24388-7_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24386-3

  • Online ISBN: 978-3-319-24388-7

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