Radiation Oncology/Toxicity/Aorta

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Aorta RT Tolerance

  • Pittsburgh; 2008 PMID 18299113 -- "Tolerance of the aorta using intraoperative iodine-125 interstitial brachytherapy in cancer of the lung." (Trombetta MG, Brachytherapy. 2008 Jan-Mar;7(1):50-4.)
    • Retrospective. 278 patients who underwent intrathoracic I-125 brachythearpy. 29 had I-125 impregnated mesh (nomographically guided geometric array) that contacted >50% aorta. Mean prescribed dose 114 Gy (85-120) at 0.5 cm. Mean aortic volume receiving entire prescribed dose 17.2 cm3, mean surface 34.4 cm2. 5/29 received EBRT mediastinal boost. Median F/U 3.7 years
    • Outcome: 1/29 (3%) fatal hemorrhage from suspected great vessel rupture. Brachytherapy was supplemented with 45 Gy EBRT overlapping the implant volume over aorta. No other patients even minor events, no long term sequelae
    • Conclusion: Intrathoracic I-125 safe, may be used even in close proximity to aora. Tolerance of aorta may >120 Gy over lifetime of the implant. Overlapping EBRT should be avoided