Verification of absorbed dose using diodes in cobalt-60 radiation therapy.

The objective of this work was to enhance the quality and safety of dose delivery in the practice of radiation oncology. To achieve this goal, the absorbed dose verification program was initiated by using the diode in vivo dosimetry (IVD) system (for entrance and exit). This practice was implemented at BINO, Bahawalpur, Pakistan. Diodes were calibrated for making absorbed dose measurements. Various correction factors (SSD, dose non-linearity, field size, angle of incidence, and wedge) were determined for diode IVD system. The measurements were performed in phantom in order to validate the IVD procedure. One hundred and nineteen patients were monitored and 995 measurements were performed. For phantom, the percentage difference between measured and calculated dose for entrance setting remained within ±2% and for exit setting ±3%. For patient measurements, the percentage difference between measured and calculated dose remained within ±5% for entrance/open fields and ±7% for exit/wedge/oblique fields. One hundred and nineteen patients and 995 fields have been monitored during the period of 6 months. The analysis of all available measurements gave a mean percent deviation of ±1.19% and standard deviation of ±2.87%. Larger variations have been noticed in oblique, wedge and exit measurements. This investigation revealed that clinical dosimetry using diodes is simple, provides immediate results and is a useful quality assurance tool for dose delivery. It has enhanced the quality of radiation dose delivery and increased/improved the reliability of the radiation therapy practice in BINO.

Accuracy requirements in radiotherapy treatment planning.

Radiation therapy attempts to deliver ionizing radiation to the tumour and can improve the survival chances and/or quality of life of patients. There are chances of errors and uncertainties in the entire process of radiotherapy that may affect the accuracy and precision of treatment management and decrease degree of conformation. All expected inaccuracies, like radiation dose determination, volume calculation, complete evaluation of the full extent of the tumour, biological behaviour of specific tumour types, organ motion during radiotherapy, imaging, biological/molecular uncertainties, sub-clinical diseases, microscopic spread of the disease, uncertainty in normal tissue responses and radiation morbidity need sound appreciation. Conformity can be increased by reduction of such inaccuracies. With the yearly increase in computing speed and advancement in other technologies the future will provide the opportunity to optimize a greater number of variables and reduce the errors in the treatment planning process. In multi-disciplined task of radiotherapy, efforts are needed to overcome the errors and uncertainty, not only by the physicists but also by radiologists, pathologists and oncologists to reduce molecular and biological uncertainties. The radiation therapy physics is advancing towards an optimal goal that is definitely to improve accuracy where necessary and to reduce uncertainty where possible.

Verification of computerized treatment planning for HDR 192Ir brachytherapy for gynaecological cancer.

Treatment planning in both teletherapy and brachytherapy is time consuming practice but accurate determination of planning parameters is more important. This paper aims to verify the dose delivery time for the treatment of vaginal cancer, which is a vital parameter of High Dose Rate (HDR) brachytherapy treatment planning. Treatment time has been calculated by the computerized treatment planning system (ABACUS 3.1), and then it has been compared with the manually calculated time. The results obtained are in good agreement. Independent verification of nominal time by two different protocols assures the quality of treatment. This should always be practiced to increase the accuracy of treatment.