A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh
Purpose: The report presents an extraordinary synthesis of customer acceptance procedures (CAP), quality assurance tests (QA) in the treatment of cervical cancer patients, using the first Co-60 Multisource Unit® in Bangladesh. The QA and commissioning required measurements and emergency tests verify...
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| Format: | Article |
| Language: | English |
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Termedia Publishing House
2011-07-01
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| Series: | Journal of Contemporary Brachytherapy |
| Subjects: | |
| Online Access: | http://www.termedia.pl/Preliminary-Reports-A-comprehensive-study-on-HDR-brachytherapy-treatments-of-cervical-cancers-using-the-first-Co-60-BEBIG-Multisource-Unit-in-Bangladesh,54,16926,1,1.html |
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| author | Naheed Rukhsana Parvin A. Banu Sadiq R. Malik |
| author_facet | Naheed Rukhsana Parvin A. Banu Sadiq R. Malik |
| author_sort | Naheed Rukhsana |
| collection | DOAJ |
| description | Purpose: The report presents an extraordinary synthesis of customer acceptance procedures (CAP), quality assurance tests (QA) in the treatment of cervical cancer patients, using the first Co-60 Multisource Unit® in Bangladesh. The QA and commissioning required measurements and emergency tests verifying the functional limits of parameters acceptable for the new HDR afterloader. Acceptable limits were: 1) the deviation between specified and measured source strength: ± 3%; 2) the positional accuracy and uniformity: ± 1 mm; 3) the temporal accuracy (i.e. timer error and linearity and end error): ± 1% or 30 sec.; 4) treatment planning system (digitizer and localization software): ± 3% or 1 mm; 5) the distance from line to first dwell position and all the others: 5 mm and 10 mm (± 1 mm). Material and methods: Till February 2011, 47 patients were treated with HDR with more than 140 insertions applied. Amongst them, 12 patients were in stage IIB and IIIB, 22 were postoperative (IA and IB) while the remaining 13 patients were with unknown stage. All the cases with stage IIB and IIIB received concurrent chemo-radiation and brachytherapy. Postoperative patients received EBRT (50 Gy and HDR) according to the institutional protocol. CT scans were completed before HDR-plus planning with a good reproducibility (± 2%) and were documented in repeating the plan for the same set up of a patient. Absorbed dose (Gy) to a point P, at a distance of “r” in centimeters from a source of the Reference Air Kerma Rate (RAKR) has been utilized for the QA of the source, where source strength measurement was accomplished. Results: All methods and analysis applicable to the QA and commissioning of Co-60 have been investigated and systematically analyzed, measured and documented before the treatment of a patient. Studies and safety requirements of this HDR remote afterloader were carried out. Acceptance and the QA were imperative to justify functionality and dependability in delivering the treatment. Implications of these studies were described in detail in this paper, where equipments and guidelines of measurement parameters are enunciated. Conclusions: We noted that contouring structures from CT images, prescription points for dose delivery, optimization, isodose evaluation, DVH, dwell times and a 3-D Dose reconstructed images, etc. followed by a final verification after delivering the treatment at the console, are well prepared in the new planning software. We present our material as an early preliminary report. |
| first_indexed | 2024-12-18T14:41:41Z |
| format | Article |
| id | doaj.art-63179268c1f743f993a4e76e66332bd4 |
| institution | Directory Open Access Journal |
| issn | 1689-832X 2081-2841 |
| language | English |
| last_indexed | 2024-12-18T14:41:41Z |
| publishDate | 2011-07-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Journal of Contemporary Brachytherapy |
| spelling | doaj.art-63179268c1f743f993a4e76e66332bd42022-12-21T21:04:22ZengTermedia Publishing HouseJournal of Contemporary Brachytherapy1689-832X2081-28412011-07-013296105A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in BangladeshNaheed RukhsanaParvin A. BanuSadiq R. MalikPurpose: The report presents an extraordinary synthesis of customer acceptance procedures (CAP), quality assurance tests (QA) in the treatment of cervical cancer patients, using the first Co-60 Multisource Unit® in Bangladesh. The QA and commissioning required measurements and emergency tests verifying the functional limits of parameters acceptable for the new HDR afterloader. Acceptable limits were: 1) the deviation between specified and measured source strength: ± 3%; 2) the positional accuracy and uniformity: ± 1 mm; 3) the temporal accuracy (i.e. timer error and linearity and end error): ± 1% or 30 sec.; 4) treatment planning system (digitizer and localization software): ± 3% or 1 mm; 5) the distance from line to first dwell position and all the others: 5 mm and 10 mm (± 1 mm). Material and methods: Till February 2011, 47 patients were treated with HDR with more than 140 insertions applied. Amongst them, 12 patients were in stage IIB and IIIB, 22 were postoperative (IA and IB) while the remaining 13 patients were with unknown stage. All the cases with stage IIB and IIIB received concurrent chemo-radiation and brachytherapy. Postoperative patients received EBRT (50 Gy and HDR) according to the institutional protocol. CT scans were completed before HDR-plus planning with a good reproducibility (± 2%) and were documented in repeating the plan for the same set up of a patient. Absorbed dose (Gy) to a point P, at a distance of “r” in centimeters from a source of the Reference Air Kerma Rate (RAKR) has been utilized for the QA of the source, where source strength measurement was accomplished. Results: All methods and analysis applicable to the QA and commissioning of Co-60 have been investigated and systematically analyzed, measured and documented before the treatment of a patient. Studies and safety requirements of this HDR remote afterloader were carried out. Acceptance and the QA were imperative to justify functionality and dependability in delivering the treatment. Implications of these studies were described in detail in this paper, where equipments and guidelines of measurement parameters are enunciated. Conclusions: We noted that contouring structures from CT images, prescription points for dose delivery, optimization, isodose evaluation, DVH, dwell times and a 3-D Dose reconstructed images, etc. followed by a final verification after delivering the treatment at the console, are well prepared in the new planning software. We present our material as an early preliminary report.http://www.termedia.pl/Preliminary-Reports-A-comprehensive-study-on-HDR-brachytherapy-treatments-of-cervical-cancers-using-the-first-Co-60-BEBIG-Multisource-Unit-in-Bangladesh,54,16926,1,1.htmlHDR brachytherapycervical cancerCo-60MultiSource® |
| spellingShingle | Naheed Rukhsana Parvin A. Banu Sadiq R. Malik A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh Journal of Contemporary Brachytherapy HDR brachytherapy cervical cancer Co-60 MultiSource® |
| title | A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh |
| title_full | A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh |
| title_fullStr | A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh |
| title_full_unstemmed | A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh |
| title_short | A comprehensive study on HDR brachytherapy treatments of cervical cancers: using the first Co-60 BEBIG Multisource Unit in Bangladesh |
| title_sort | comprehensive study on hdr brachytherapy treatments of cervical cancers using the first co 60 bebig multisource unit in bangladesh |
| topic | HDR brachytherapy cervical cancer Co-60 MultiSource® |
| url | http://www.termedia.pl/Preliminary-Reports-A-comprehensive-study-on-HDR-brachytherapy-treatments-of-cervical-cancers-using-the-first-Co-60-BEBIG-Multisource-Unit-in-Bangladesh,54,16926,1,1.html |
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