Dosimetric Comparison of Brachytherapy Intravaginal Vendor Applicator with Indigenously Developed Improvised Intravaginal Wax Applicator with 100% Dose Coverage at the Vaginal Vault Region: A Pilot Study

A BSTRACT Introduction: Intravaginal-based brachytherapy treatment is highly useful in the treatment of gynecological malignancies. A common challenge to come across in intravaginal application is achieving 100% of dose prescribed in vaginal vault region during the brachytherapy treatment course. In the superior part of the intravaginal applicator, the vaginal vault area receives a lesser dose as compared to the vaginal walls due to the dip in the 100% dose coverage in the vault region. This could be a potential factor contributing to the vaginal vault recurrence in cervical cancer and endometrial cancer. Aim: The aim of this study is to improve the dose coverage of the vaginal vault area using an indigenously developed improvised intravaginal wax applicator. Materials and Methods: Dental wax is melted and made a replica of the company-provided applicator. The dose is measured using film dosimetry, and dose distribution is studied at distal end of the applicator (vaginal vault region). Results and Discussion: The applicator is able to produce uniform dose coverage around the distal end and along the sides at 5 mm from the applicator surface. This study shows that the under dosage at the vaginal vault area can be rectified using this indigenously developed improvised intravaginal wax applicator. The process explained here is economically affordable, and the materials used are easily available. Conclusion: With the help of indigenously developed improvised intravaginal wax applicator, 100% dose is achieved with much lesser radio toxicity.