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Estimation and comparison of integral dose to target and organs at risk in three-dimensional computed tomography image-based treatment planning of carcinoma uterine cervix with two high-dose-rate brachytherapy sources:60Co and192Ir


1 Department of Radiotherapy, Gandhi Medical College, Bhopal; Department of Physics, Rabindranath Tagore University, Raisen, Madhya Pradesh, India
2 Department of Radiotherapy, Gandhi Medical College, Bhopal, Madhya Pradesh, India
3 Department of Physics, Rabindranath Tagore University, Raisen, Madhya Pradesh, India
4 Department of Radiotherapy, Chirayu Medical College and Hospital, Bhopal, India
5 Department of Radiotherapy, Indraprastha Apollo Hospital, New Delhi, India

Correspondence Address:
Suresh Yadav,
Department of Radiotherapy, Gandhi Medical College, Bhopal - 462 001, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_199_19

Background: Iridium-192 (192 Ir) has been a widely accepted radioisotope for high-dose-rate (HDR) brachytherapy. Recently, Cobalt-60 (60 Co) radioisotope with a longer half-life (5.26 years) has been gaining popularity due to economic and logistical reasons as compared with the traditional192 Ir. Aim:This study aimed to evaluate and compare the integral dose (ID) to the target and organs at risk (OARs) with two HDR brachytherapy sources in brachytherapy treatment of carcinoma uterine cervix to find appropriate HDR radioisotopes for clinical benefit. Materials and Methods: This is a retrospective analysis of 52 computed tomography image-based brachytherapy plans of 52 patients who have received intracavitary treatment with192 Ir HDR source. For each patient plan, one additional set of plan was created using60 Co source in place of192 Ir source keeping the same dwell position, and again dose was optimized. The volume and mean dose for target, OARs, and volume structures of 400%, 200%, 150%, 100%, and 50% were recorded for the estimation and comparison of ID. Results: The mean ID to high-risk clinical target volume was significantly higher by 5.84% in60 Co plan than that in192 Ir plan. For OARs, the mean ID to the rectum was significantly higher by 2.60% in60 Co plan as compared to192 Ir plan, whereas for bladder and sigmoid colon, it was lower in60 Co plan than that in192 Ir plan. The mean ID of central dose volume structures of 400%, 200%, 150%, 100%, and 50% was higher by 12.97%, 9.77%, 8.16%, 6.10%, and 3.22%, respectively, in60 Co plan than that of192 Ir plan. Conclusion: The results of our study concluded that192 Ir HDR radioisotope should be preferred for intracavitary brachytherapy due to its ideal physical characteristics for better clinical outcomes.


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