title: A three-dimensional computed tomography-assisted Monte Carlo evaluation of ovoid shielding on the dose to the bladder and rectum in intracavitary radiotherapy for cervical cancer.
abstract: OBJECTIVE
  To determine the effects of Fletcher Suit Delclos ovoid shielding on dose to the bladder and rectum during intracavitary radiotherapy for cervical cancer.
  
  
  METHODS
  The Monte Carlo method was used to calculate the dose in 12 patients receiving low-dose-rate intracavitary radiotherapy with both shielded and unshielded ovoids. Cumulative dose-difference surface histograms were computed for the bladder and rectum. Doses to the 2-cm(3) and 5-cm(3) volumes of highest dose were computed for the bladder and rectum with and without shielding.
  
  
  RESULTS
  Shielding affected dose to the 2-cm(3) and 5-cm(3) volumes of highest dose for the rectum (10.1% and 11.1% differences, respectively). Shielding did not have a major impact on the dose to the 2-cm(3) and 5-cm(3) volumes of highest dose for the bladder. The average dose reduction to 5% of the surface area of the bladder was 53 cGy. Reductions as large as 150 cGy were observed to 5% of the surface area of the bladder. The average dose reduction to 5% of the surface area of the rectum was 195 cGy. Reductions as large as 405 cGy were observed to 5% of the surface area of the rectum.
  
  
  CONCLUSIONS
  Our data suggest that the ovoid shields can greatly reduce the radiation dose delivered to the rectum. We did not find the same degree of effect on the dose to the bladder. To calculate the dose accurately, however, the ovoid shields must be included in the dose model.
authors.affiliation: Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. kagifford@mail.mdanderson.org
authors.forename: Kent A
authors.initials: KA
authors.lastname: Gifford
authors.forename: John L
authors.initials: JL
authors.lastname: Horton
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Pelloski
authors.forename: Anuja
authors.initials: A
authors.lastname: Jhingran
authors.forename: Laurence E
authors.initials: LE
authors.lastname: Court
authors.forename: Firas
authors.initials: F
authors.lastname: Mourtada
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Eifel
mesh_terms: D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D009010:Monte Carlo Method; D010865:Pilot Projects; D011446:Prospective Studies; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000295:instrumentation* / Q000379:methods; D012007:Rectum / Q000528:radiation effects*; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000528:radiation effects*; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*