Assessment of rectal dose with thermoluminescent in vivo dosimetry in high-dose-rate cobalt-60 intracavitary brachytherapy for cervical cancer: A two-arm cohort study using orthogonal images planning

采用热释光体内剂量测定法评估宫颈癌高剂量率钴-60腔内近距离放射治疗中的直肠剂量:一项使用正交图像计划的双臂队列研究

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Abstract

PURPOSE: High-dose-rate intracavitary brachytherapy delivers high radiation doses to tumors while minimizing exposure to surrounding normal cells. However, inappropriate administration can lead to radiation-induced toxicity by overdosing organs at risk. This study evaluated and compared the rectum doses planned by treatment planning system and measured using a thermoluminescent dosimeter. MATERIAL AND METHODS: Thermoluminescent dosimeters (TLD) were employed to measure radiation dose to the rectum across two patient groups: one treated using first fraction-based planning (FFP), and the other with each fraction planned individually (EFP). RESULTS: The mean dose measured by TLD (3.99 ±1.63 Gy) was higher than the mean dose planned by TPS (3.23 ±1.16 Gy, p < 0.001). The mean dose difference was higher in second fraction (0.87 ±1.89 Gy) for first fraction-based planning group; however, the differences between first and second fractions were not statistically significant in either group. CONCLUSIONS: For patients transferred from a brachytherapy couch to a hospital stretcher during applicator insertion and dose delivery, first fraction-based planning is feasible. However, caution is needed to minimize applicator shifts, as these changes can alter the geometric position between fractions.

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