Journal of Medical Physics
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Year : 2002  |  Volume : 27  |  Issue : 2  |  Page : 51-57

A Physical Optimization Technique In High Dose Rate Brachytherapy For Cervical Carcinoma

Correspondence Address:
S S Sivakumar

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Source of Support: None, Conflict of Interest: None

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High dose rate remote after loaders become a viable alternative to the traditional low dose rate brachytherapy system in the treatment of carcinoma of cervix. Treatment optimization is an important breakthrough in the modern remote after loading brachytherapy system. The term optimization refers to achieving clinically intended dose distribution by modifying some parameters of the treatment, such as dwell weight and source step size. The aim of this study is to evaluate optimization possibility in the treatment of carcinoma of cervix in Micro Selectron high dose rate remote after loading brachytherapy system. 15 patients who have undergone intracavitary application for the treatment of carcinoma of cervix have been considered in this study. Orthogonal pelvic simulation films were taken for dose computation at Point A, Point B and rectum and bladder. Step size and dwell weights of the source in intrauterine tandem and vaginal ovoid were modified using PLAT0 Treatment Planning System and Microselectron unit. All evaluated parameters are found to decrease with decreasing dwell weights to vaginal ovoid. The variation in bladder dose for different dwell weights and step size is not considerable as compared with the rectal dose variation. The pear shape volume is mainly affected by the dwell weights and step size of vaginal ovoid. The percentage variation in evaluated parameters is found to vary from patient to patient. Optimization helps to produce desirable isodose distribution, which assures that dose to reference points are maintained, whilst reducing the dose to the critical organs. Interactive optimization is a useful tool to produce clinically intended dose distribution in the intracavitary irradiation of carcinoma of cervix.

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