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Verification of dose distribution by different material properties in intraoral mold irradiation

Published online by Cambridge University Press:  20 July 2023

Hiraku Fuse Open the ORCID record for Hiraku Fuse [Opens in a new window] ,
Fumihiro Tomita ,
Kenji Yasue ,
Hideaki Ikoma ,
Shin Miyakawa ,
Norikazu Kori ,
Tatsuya Fujisaki ,
Yoshiyuki Ishimori ,
Masahiko Monma  and
Toshiyuki Okumura
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Hiraku Fuse*
Affiliation:
Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
Fumihiro Tomita
Affiliation:
Graduate School of Health Sciences, Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
Kenji Yasue
Affiliation:
Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
Hideaki Ikoma
Affiliation:
Department of Radiation Technology, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
Shin Miyakawa
Affiliation:
Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
Norikazu Kori
Affiliation:
Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
Tatsuya Fujisaki
Affiliation:
Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
Yoshiyuki Ishimori
Affiliation:
Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
Masahiko Monma
Affiliation:
Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
Toshiyuki Okumura
Affiliation:
Department of Radiation Technology, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
Yoshio Tamaki
Affiliation:
Department of Radiation Oncology, Fukushima Rosai Hospital, Iwaki, Fukushima, Japan
*
Corresponding author: Hiraku Fuse; Email: fuseh@ipu.ac.jp
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Abstract

Background:

Brachytherapy is an effective local treatment for early-stage head and neck cancers. Mold irradiation is a method in which the source is placed in the oral cavity in sites where the soft tissue is thin and an irradiation source cannot be implanted. However, dose calculations based on TG-43 may be subject to uncertainty due to the heterogeneity of tissues and materials used for the irradiation of head and neck cancers.

Materials and Methods:

In this study, we investigated the basic physical properties of different materials and densities in the molds, retrospectively analysed patient plans and verified the doses of intraoral mold irradiation using a dose verification system with MC simulations specifically designed for brachytherapy, which was constructed independently.

Results and Discussion:

Dose–volume histograms were obtained with a treatment planning system (TG-43) and MC simulation and revealed a non-negligible difference in coverage of high-risk clinical target volume (HR-CTV) and organ at risk (OAR) between calculations using computed tomography values and those with density changes. The underdose was 10·6%, 3·7% and 5·6% for HR-CTV, gross tumour volume and OAR, respectively, relative to the treatment plan. The calculations based on the differences in the elemental composition and density changes in TG-43, a water-based calculation algorithm, resulted in clinically significant dose differences. The validation method was used only for the cases of complex small source therapy.

Conclusion:

The findings of this study can be applied to more complex cases with steeper density gradients, such as mold irradiation.

Keywords

mold brachytherapyintraoral brachytherapyMonte Carlo simulationsTG-43
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e71
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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