Evaluation of rectal radiation dose during intracavitary brachytherapy for uterine cervical cancer using in vivo dosimetry.
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Date
2025-04
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NM-AIST
Abstract
High-dose-rate intracavitary brachytherapy is a crucial part of cervical cancer treatment, delivering high doses to the tumor while minimizing exposure to normal tissues. However, improper administration can lead to radiation-induced damage. In vivo dosimetry is essential for verifying that the planned treatment dose matches the radiation delivered doses. This study utilized Thermoluminescent dosimeters (TLDs) to measure the radiation dose
delivered to the rectum in two patient groups: one with first fraction-based planning (FFP) and the other with each fraction planned individually (EFP). Applicator and probe positions from the treatment planning system (TPS) were used to assess the shift between treatment fractions. The median dose measured by TLDs (3.85 Gy, IQR = 2.23) exceeded the planned dose by TPS (3.37 Gy, IQR = 1.54), with a p-value < 0.001. The interquartile range (IQR) of dose difference
was higher in the second fraction, 1.92 Gy, in the FFP group, and the dose differences between the first and second fractions were not statistically significantly different for either group. The applicator position shows a minimal shift between the first and second fraction compared to a rectal probe. Generally, it is best practice to plan each fraction independently to minimize potential risks. In scenarios such as when patients are transferred from a brachytherapy couch to a stretcher, separate imaging and planning each fraction is not necessary.
Sustainable Development Goals
SDG-3:Good Health and Well-being
SDG-5:Gender Equality (through its focus on cervical cancer care).
SDG-9:Industry, Innovation and Infrastructure