Dosimetric comparison of 60Co and 192Ir high dose rate source used in brachytherapy treatment of cervical cancer

• Published in: Journal of cancer research and therapeutics 2019-10, Vol.15 (6), p.1212-1215
• Main Authors: Shukla, Arvind, Jangid, Pawan, Rajpurohit, Vikram, Verma, Atul, Dangayach, Suresh, Gagrani, Vaibhav, Rathore, Narendra
• Format: Article
• Language: English
• Subjects: Advantages; Bladder; Cervical cancer; Dosimetry; Optimization techniques; Patients; Planning; Radiation therapy
• ISSN: 0973-1482; 1998-4138
• DOI: 10.4103/jcrt.JCRT_372_19

Purpose: The study purpose included dosimetric comparison of cobalt 60 (60Co) and iridium 192 (192Ir) high dose rate (HDR) source used in brachytherapy treatment of cervical cancer. Materials and Methods: Computed tomography (CT) scans for 15 patients of carcinoma of uterine cervix using 3-mm slice thickness were considered for the study The contouring of high-risk clinical target volume (HRCTV), bladder, and rectum on CT images was done as per the GEC ESTRO guidelines with the help of magnetic resonance imaging images in the treatment planning system. All parameters were kept the same for 60Co (3.5 mm active length, 0.5 mm active dia, Bebig) and 192Ir (3.5 mm active length, 0.6 mm active dia, Bebig) HDR source with 2.5-mm step size and dose prescription to Point A. As per the International Commission on Radiation Unit (ICRU)-89 guidelines, the dose-volume parameters such as D50(Gy), D90(Gy), and D98(Gy) for HRCTV and D0.1cc (Gy), D1cc (Gy), D2cc (Gy), and D5cc (Gy) to the bladder and rectum were calculated for both the HDR sources. Results: The difference in dose-volume histogram parameters such as D50,D90,and D98 of HRCTV was 3.19%, 1.13%, and 0.50%, respectively, for the two radioisotopes. The difference in dose values of D0.1cc, D1cc, D2cc, D5cc, and ICRU reference points of bladder was -0.58%, -0.67%, -0.99%, -0.94%, and -1.75%, respectively. On the other hand, dose difference for D0.1cc, D1cc, D2cc, D5cc, and ICRU reference points of rectum was 0.67%, 0.26%, 0.56%, 0.63%, and -0.33%, respectively. Conclusions: The present study results show that all the dose parameters of HRCTV, bladder, and rectum with 60Co were comparable with those of 192Ir HDR source. The isodose distribution is more bulge out for 60Co in cranial-caudal direction compared to that of 192Ir. However, these differences can be reduced by treatment planning optimization techniques. The clinical plan evaluation in each slice and plane is necessary to explore the logistic and financial benefits of miniaturized 60Co source over 192Ir HDR source.