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 HDR brachytherapy.Objective: Purpose of this study is to evaluate the role of in vivo dosimetry in HDR brachytherapy and to compare actual doses delivered to OAR’ s with those calculated during treatment planning.Material and Methods: In this retrospective study, 50 patients of cervical carcinoma were treated by 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 bladder and rectum was done on TPS & in vivo dosimetry was performed using portable MOSFET.Results: Calibration factors calculated for both 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. Deviation between TPS-calculated dose and 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 small size MOSFET dosimeter is an efficient method for accurately measuring doses in high-dose gradient fields typically seen in brachytherapy. Therefore, to reduce the risk of large errors in dose delivery, in vivo dosimetry can be done in addition to TPS computations.