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Radiation protection of patients in epiescleral brachytherapy

Jesús María de Frutos, Gonzalo García de Casasola Sánchez, J Sendón, Andrés del Castillo, Ignacio Bejarano Hernando

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Abstract

Introduction. Choroidal melanoma and other ophthalmic tumors are treated with episcleral plaques. Optimisation and other criteria are necessary to avoid damage in eye and visual function preservation. Purpose. To study the dosimetric phases to apply radiation protection criteria. To determine procedures for quality assurance of applicators, sources and treatment prescription and planning. Method. We have revised treatment procedure. First, aspects shared for all the patients. Then treatment planning and applicator assembling. After that, we study insertion and treatment. Finally, we check the chart flow to modify, if necessary. It necessary consider normative and recommendations. Results and conclusions. Quality assurance of sources (calibration, autoradiography), applicator (effects, dose distribution) and treatment planning are revised. Appropriate patient data acquisition is essential due the special characteristics of tumor and eye. Treatment planning involves optimisation as a factor. Seed selection is very important to avoid misadministration. Next procedure is applicator assembling. We must care to choose the same as dosimetry and to carry out its verification. Sources insertion is a surgical procedure. It is essential in accurate placement. Desinsertion is also surgical, and must be adapted to dosimetry and prescription. Flow chart is modified adding two staff meetings to discuss about patient data and doses. (author)

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Introduction. Choroidal melanoma and other ophthalmic tumors are treated with episcleral plaques. Optimisation and other criteria are necessary to avoid damage in eye and visual function preservation. Purpose. To study the dosimetric phases to apply radiation protection criteria. To determine procedures for quality assurance of applicators, sources and treatment prescription and planning. Method. We have revised treatment procedure. First, aspects shared for all the patients. Then treatment planning and applicator assembling. After that, we study insertion and treatment. Finally, we check the chart flow to modify, if necessary. It necessary consider normative and recommendations. Results and conclusions. Quality assurance of sources (calibration, autoradiography), applicator (effects, dose distribution) and treatment planning are revised. Appropriate patient data acquisition is essential due the special characteristics of tumor and eye. Treatment planning involves optimisation as a factor. Seed selection is very important to avoid misadministration. Next procedure is applicator assembling. We must care to choose the same as dosimetry and to carry out its verification. Sources insertion is a surgical procedure. It is essential in accurate placement. Desinsertion is also surgical, and must be adapted to dosimetry and prescription. Flow chart is modified adding two staff meetings to discuss about patient data and doses. (author)

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Available abstract

Introduction. Choroidal melanoma and other ophthalmic tumors are treated with episcleral plaques. Optimisation and other criteria are necessary to avoid damage in eye and visual function preservation. Purpose. To study the dosimetric phases to apply radiation protection criteria. To determine procedures for quality assurance of applicators, sources and treatment prescription and planning. Method. We have revised treatment procedure. First, aspects shared for all the patients. Then treatment planning and applicator assembling. After that, we study insertion and treatment. Finally, we check the chart flow to modify, if necessary. It necessary consider normative and recommendations. Results and conclusions. Quality assurance of sources (calibration, autoradiography), applicator (effects, dose distribution) and treatment planning are revised. Appropriate patient data acquisition is essential due the special characteristics of tumor and eye. Treatment planning involves optimisation as a factor. Seed selection is very important to avoid misadministration. Next procedure is applicator assembling. We must care to choose the same as dosimetry and to carry out its verification. Sources insertion is a surgical procedure. It is essential in accurate placement. Desinsertion is also surgical, and must be adapted to dosimetry and prescription. Flow chart is modified adding two staff meetings to discuss about patient data and doses. (author)

Key concepts: Quality assurance, Radiation treatment planning, Dosimetry, Medical physics, Brachytherapy, Chart, Medicine, Medical prescription

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