Publication: A comprehensive 3D dosimetric analysis of the vienna ring applicator in high-dose-rate (HDR) brachytherapy for cervical cancer treatment: TLD measurement
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Date
2024
Authors
Sivaprakasam, Pugalya
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Abstract
Introduction: Intracavitary brachytherapy is the most common approach used for gynecological cancers which happens to be the cancer with highest occurrence among women. Intracavitary-interstitial (IC/IS) brachytherapy is an approach that is developed, and various applicators are utilised in this treatment method such as the Vienna Ring applicator. However, a comprehensive understanding on the dosimetric behavior of Vienna Ring applicator is required for efficient use in brachytherapy for cervical cancer. Purpose: This study aims to experimentally analyse the dosimetric performance of Vienna Ring applicator in aspects of target coverage, organ at risk (OAR) sparing and ability to deliver the planned dose during treatment. Methods and Materials: A Vienna Ring applicator was assembled in a pelvic phantom with Thermoluminescence Dosimeters (TLD-100) chips were attached to the OARs (bladder and rectum) to act as markers. Computed Tomography (CT) images were obtained for treatment planning. 7Gy was prescribed for irradiation and the treatment was planned for the assessment of dose received by target, OAR and the TLDs at 8 points. The dose measured by the TLD-100 chips during the irradiation and dose calculated by treatment planning system (TPS) on the TLD points were compared. Results: The dose received by target, bladder and rectum are 7.1 Gy, 2.4 Gy and 7.4 Gy respectively as obtained from TPS. Out of 8 TLDs, 7 TLDs have dose deviation less than 20% while 1 TLD (F7) have dose deviation of 31.03% between measured and calculated dose. Conclusion: The dose distribution of Vienna ring applicator to GTV is not homogenous but has high degree of conformity. The Vienna ring applicator was able to spare the bladder and deliver optimum dose to tumour. The Vienna ring applicator can deliver planned dose during treatment delivery due to 90% of the dose deviation was below 20%. Therefore, the applicator can be categorised as a reliable applicator in brachytherapy for cervical cancer.
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Keywords
brachytherapy , cervical cancer