Optimization of high dose-rate cervix brachytherapy; Part I: Dose distribution

Pavel V. Houdek, James G. Schwade, Andre A. Abitbol, Vincent Pisciotta, Xiaodong Wu, Christopher F. Serago, Arnold M. Markoe, Alan A. Lewin, Hervy E. Averette, Bernd Uwe Sevin, Alfred H. Brandon, Jeffrey A. Fiedler, Andrew M. Cohen, Fahed Fayad

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Computer controlled high dose-rate (HDR) brachytherapy afterloading machines are equipped with a single, miniaturized, high activity Ir-192 source that can be rapidly moved in fine increments among several channels. Consequently, by appropriate programming of source dwell positions and times, the dose distribution can be optimized as desired. We have explored the optimization potential of this new technology for two applications: (a) cervix brachytherapy, and (b) transvaginal irradiation. Cervix brachytherapy with a gynecologic ring applicator was simulated by 48 sources of relative activities ranging from 0.17 to 1.00 that were equally distributed between the tandem and the ring. The results confirmed that the optimized distribution of physical doses are superior to those achievable with standard brachytherapy sources and applicators. For example, with five-point optimization, the relative dose-rate in the rectum was only 47% of that in point A; for standard application the dose rate was 47% higher. For transvaginal application 27 sources of relative activities between 0.07-0.79 were placed in the ring and a single source of unit strength in the tandem. Using dose distribution homogeneity as an optimization criterion, the results (2.5 %) were again superior to those obtained for commonly used double ovoid (±15%), linear cylinder (±27%), or a "T" source (31%).

Original languageEnglish (US)
Pages (from-to)1621-1625
Number of pages5
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume21
Issue number6
DOIs
StatePublished - Nov 1991

Keywords

  • Brachytherapy
  • High dose-rate
  • Optimization
  • Ring applicator

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

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    Houdek, P. V., Schwade, J. G., Abitbol, A. A., Pisciotta, V., Wu, X., Serago, C. F., Markoe, A. M., Lewin, A. A., Averette, H. E., Sevin, B. U., Brandon, A. H., Fiedler, J. A., Cohen, A. M., & Fayad, F. (1991). Optimization of high dose-rate cervix brachytherapy; Part I: Dose distribution. International Journal of Radiation Oncology, Biology, Physics, 21(6), 1621-1625. https://doi.org/10.1016/0360-3016(91)90341-Z