Investigation of Anisotropy Caused by Cylinder Applicator on Dose Distribution around Cs-137 Brachytherapy Source using MCNP4C Code

Introduction: Brachytherapy is a type of radiotherapy in which radioactive sources are used in proximity of tumors normally for treatment of malignancies in the head, prostate and cervix. Materials and Methods: The Cs-137 Selectron source is a low-dose-rate (LDR) brachytherapy source used in a remote afterloading system for treatment of different cancers. This system uses active and inactive spherical sources of 2.5 mm diameter, which can be used in different configurations inside the applicator to obtain different dose distributions. In this study, first the dose distribution at different distances from the source was obtained around a single pellet inside the applicator in a water phantom using the MCNP4C Monte Carlo code. The simulations were then repeated for six active pellets in the applicator and for six point sources.  Results: The anisotropy of dose distribution due to the presence of the applicator was obtained by division of dose at each distance and angle to the dose at the same distance and angle of 90 degrees. According to the results, the doses decreased towards the applicator tips. For example, for points at the distances of 5 and 7 cm from the source and angle of 165 degrees, such discrepancies reached 5.8% and 5.1%, respectively.  By increasing the number of pellets to six, these values reached 30% for the angle of 5 degrees. Discussion and Conclusion: The results indicate that the presence of the applicator causes a significant dose decrease at the tip of the applicator compared with the dose in the transverse plane. However, the treatment planning systems consider an isotropic dose distribution around the source and this causes significant errors in treatment planning, which are not negligible, especially for a large number of sources inside the applicator.