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A novel device for intravaginal electronic brachytherapy.

Frank Schneider¹, Holger Fuchs, Friedlieb Lorenz

¹Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany. frank.schneider@umm.de

International Journal of Radiation Oncology, Biology, Physics

|June 24, 2009

Summary

This study demonstrates that a kilovolt X-ray source can create a homogeneous cylindrical dose distribution for endometrial carcinoma brachytherapy, offering a potential alternative to traditional iridium-192 high-dose rate afterloading.

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Area of Science:

Medical Physics
Radiation Oncology
Gynecologic Oncology

Background:

Postoperative intravaginal brachytherapy for endometrial carcinoma commonly uses iridium-192 (192Ir) high-dose rate (HDR) afterloading.
A novel approach involves a 50kV X-ray point source, offering a steep dose gradient due to its low energy.

Purpose of the Study:

To develop and assess a homogeneous cylindrical energy deposition pattern around a newly designed vaginal applicator using a kilovolt X-ray source.
To evaluate the feasibility of electronic brachytherapy as an alternative to 192Ir HDR afterloading.

Main Methods:

A cylindrical plastic vaginal applicator was used with the INTRABEAM system, moving the X-ray source in steps to create layered dose distributions.
Film dosimetry (Gafchromic EBT) in a solid water phantom measured dose distributions, analyzed using Mathematica 5.2 and OmniPro-I'mRT 1.6.
Results were compared to a 192Ir HDR afterloading plan at multiple sampling points.

Main Results:

Three distinct dose distributions with lengths of 3.9-7.3 cm were successfully created.
Irradiation times ranged from 19 to 38 minutes for delivering 5/7 Gy at a 5 mm tissue depth.
Dose measurements showed comparable distributions between the kilovolt X-ray source and 192Ir HDR, with deviations under 7%.

Conclusions:

A homogeneous cylindrical dose distribution, mimicking 192Ir HDR afterloading, can be achieved by superimposing multiple spherical dose distributions from a stepped kilovolt point source.
This technique presents a viable alternative for endometrial carcinoma brachytherapy.