Monte Carlo dosimetry for 125I and 103Pd eye plaque brachytherapy

A Monte Carlo study of dosimetry for eye plaque brachytherapy is performed. BrachyDose, an EGSnrc user code which makes use of Yegin's multi-geometry package, is used to fully model 125I (model 6711) and 103Pd (model 200) brachytherapy seeds and the standardized plaques of the Collaborative Ocular Melanoma Study (COMS). Three-dimensional dose distributions in the eye region are obtained. In general, dose to water is scored; however, the implications of replacing water with eye tissues are explored. The effect of the gold alloy (Modulay) backing is investigated and the dose is found to be sensitive to the elemental composition of the backing. The presence of the silicone polymer (Silastic) seed carrier results in substantial dose decreases relative to water, particularly for 103Pd. For a 20 mm plaque with a Modulay backing and Silastic insert, fully loaded with 24 seeds, the dose decrease relative to water is of the order of 14% for 125I and 20% for 103Pd at a distance of 1 cm from the inner sclera along the plaque's central axis. For the configurations of seeds used in COMS plaques, interseed attenuation is a small effect within the eye region. The introduction of an air interface results in a dose reduction in its vicinity which depends on the plaque's position within the eye and the radionuclide. Introducing bone in the eye's vicinity also causes dose reductions. The dose distributions in the eye for the two different radionuclides are compared and, for the same prescription dose, 103Pd generally offers a lower dose to critical normal structures. BrachyDose is sufficiently fast to allow full Monte Carlo dose calculations for routine clinical treatment planning.