Rectal and Bladder Dose Measurements in the Intracavitary Applications of Cervical Cancer Treatment with HDR Afterloading System: Comparison of TPS Data with MOSFET Detector.

Abstract

Background: Intracavitary brachytherapy plays a major role in management of cervical carcinoma. Assessment of dose received by OAR’s therefore becomes crucial for the estimation of radiation toxicities in high dose rate brachytherapy. Objective: The purpose of this study is to evaluate the role of in vivo dosimetry in HDR brachytherapy and to compare the actual doses delivered to OAR’s with those calculated during treatment planning. Materials and Methods: A total of 50 patients were treated with Microselectron HDR. Out of 50 patients, 26 were treated with a dose of 7 Gy and 24 with a dose of 9 Gy, prescribed to point A. Brachytherapy planning and evaluation of dose to the bladder and rectum was done on TPS & in vivo dosimetry was performed using portable MOSFET. Results: The calibration factors calculated for both the dosimeters are almost equal and are 0.984 cGy/mV and 1.0895 cGy/mV. For bladder, dose deviation was found to be within +/- 5% in 28 patients, +/- 5-10% in 14 patients, +/- 10-15% in 4 patients. The deviation between the TPS-calculated dose and the dose measured by MOSFET for rectum was within +/- 5% in 31 patients, +/- 5–10% in 8 patients, and +/- 10–15% in 7 patients. Conclusion: TPS calculated doses were slightly higher than that measured by MOSFET. The use of a small size of MOSFET dosimeter is an efficient method for accurately measuring doses in high-dose gradient fields typically seen in brachytherapy. Therefore, to reduce risk of large errors in the dose delivery, in vivo dosimetry can be done in addition to TPS computations.