Sci-Sat AM: Brachy - 11: Improving treatment planning for I-125 lung brachytherapy using Monte Carlo methods

Medical Physics
J G H SutherlandR M Thomson

Abstract

(125) I brachytherapy used in conjunction with sublobar resection to treat stage I non-small cell lung cancer has been reported to improve disease-free and overall survival rates compared with resection alone. Treatments are planned intra-operatively using seed spacing nomograms or tables to achieve a prescription dose defined 5 mm above the implant plane. Dose distributions for patients treated with this technique at the Mayo Clinic Rochester were reanalyzed using a Monte Carlo (MC) calculation; significant differences were observed between the standard TG-43 dose calculations and the actual dose delivered as determined by MC. This work investigates differences between TG-43 calculated prescription doses and those calculated in more accurate models. Monte Carlo calculations are performed using the EGSnrc user-code BrachyDose with a number of lung tissue phantom models including patient CT-derived phantoms. Seed spacing nomograms using these models are recalculated by determining the dose to the prescription point using the activities per seed required to produce a prescription dose of 100 Gy with the TG-43 point source formalism. Models using nominal density lung or CT-derived density lung tissue result in a significant increa...Continue Reading

Citations

Apr 25, 2019·Journal of Applied Clinical Medical Physics·Xiaodong MaShude Chai

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