A braquiterapia é a modalidade de tratamento radioterápico que utiliza fontes radioativas seladas a uma distância curta do tumor, diminuindo o risco de aplicação de uma dose indesejável em tecidos sadios adjacentes. Para que a braquiterapia seja confiável, é necessário estabelecer um programa de práticas dosimétricas visando a determinação da dose ideal de radiação para esta prática radioterápica. Neste trabalho apresenta a aplicação de duas metodologias destinadas à dosimetria utilizando filmes radiocrômicos. Medidas experimentais foram realizadas com filmes EBT3 em objetos simuladores composto de material homogêneo e heterogêneo (pulmão, osso e tecidos moles) construídos especialmente para medidas de dose em braquiterapia. Os processamentos e analises das imagens resultantes do procedimento experimental foram realizados com o software IMAGEJ e MATLAB. Os resultados foram avaliados a partir de comparações medidas experimentais de dose e obtidas por simulações pelo Método de Monte Carlo. / Brachytherapy is a radiotherapy treatment modality using radioactive sealed sources within walking distance of the tumor, reducing the risk of applying an unwanted dose to adjacent healthy tissues. For brachytherapy is reliable, it is necessary to establish a dosimetric practices program aimed at determining the optimal dose of radiation for this radiotherapy practice. This paper presents the application of two methodologies for the dosimetry using radiochromic movies. Experimental measurements were performed with EBT3 movies phantoms consisting of homogeneous and heterogeneous material (lung, bone and soft tissue) built especially for dose measurements in brachytherapy. The processing and analysis of the resulting images of the experimental procedure were performed with ImageJ software and MATLAB. The results were evaluated from comparisons dose of experimental measurements and simulations obtained by the Monte Carlo method.

A braquiterapia é a modalidade de tratamento radioterápico que utiliza fontes radioativas seladas a uma distância curta do tumor, diminuindo o risco de aplicação de uma dose indesejável em tecidos sadios adjacentes. Para que a braquiterapia seja confiável, é necessário estabelecer um programa de práticas dosimétricas visando a determinação da dose ideal de radiação para esta prática radioterápica. Neste trabalho apresenta a aplicação de duas metodologias destinadas à dosimetria utilizando filmes radiocrômicos. Medidas experimentais foram realizadas com filmes EBT3 em objetos simuladores composto de material homogêneo e heterogêneo (pulmão, osso e tecidos moles) construídos especialmente para medidas de dose em braquiterapia. Os processamentos e analises das imagens resultantes do procedimento experimental foram realizados com o software IMAGEJ e MATLAB. Os resultados foram avaliados a partir de comparações medidas experimentais de dose e obtidas por simulações pelo Método de Monte Carlo. / Brachytherapy is a radiotherapy treatment modality using radioactive sealed sources within walking distance of the tumor, reducing the risk of applying an unwanted dose to adjacent healthy tissues. For brachytherapy is reliable, it is necessary to establish a dosimetric practices program aimed at determining the optimal dose of radiation for this radiotherapy practice. This paper presents the application of two methodologies for the dosimetry using radiochromic movies. Experimental measurements were performed with EBT3 movies phantoms consisting of homogeneous and heterogeneous material (lung, bone and soft tissue) built especially for dose measurements in brachytherapy. The processing and analysis of the resulting images of the experimental procedure were performed with ImageJ software and MATLAB. The results were evaluated from comparisons dose of experimental measurements and simulations obtained by the Monte Carlo method.

Purpose: The aim of this study was to develop a method of measuring changes in the skin microcirculation and skin dose for mastectomy patients in connection with the radiation treatment. The distribution of the skin dose, its dependence on the energy of the beam, field geometry and bolus material and the accuracy of the given skin dose in the treatment planning system were studied. Finally, the correlation between the given dose and the changes in skin microcirculation was evaluated. Methods: Skin dose was measured using GafChromic EBT3 films. To evaluate the impact of different energies and field geometry measurements on a PMMA phantom were done. Dose measurements were done using an anthropomorphic phantom and in patients. The measured skin doses were compered to the doses calculated using the treatment planning system. Before and after treatment, skin blood perfusion was measured using laser speckle contrast imaging. In connection with the last measurement also methyl nicotinate was used to increase the perfusion for the measurement. Results: The measurements on the PMMA-phantom indicate that a larger photon energy results in a lower dose to the skin, but a higher exit dose. Furthermore a more oblique angle results in a higher skin dose and a larger field size also results in an increased skin dose. The patient measurements showed that the skin dose was significantly different in different areas of the irradiated field. The highest dose was measured in the area in which a bolus was applied. All patients showed a significant increase in skin blood of the perfusion within the irradiated area. The comparison between the measured doses and the doses calculated using the treatment planning system shows an underestimation of the skin dose by the treatment planning system depending on the incident angle and the presence of bolus material. Conclusion: The distribution of the skin dose during breast cancer radiotherapy in mastectomy patients is heterogeneous with the highest dose in the area of the mastectomy scar, due to the presence of bolus material. A correlation can be noticed between the changed in microcirculation and the radiation dose to the skin. Estimation of the skin dose using the treatment planning system is inaccurate, but film doseimetry offers an easy-to use method to accurately measure the dose to different areas of the irradiated skin.

Spatially fractionated radiation therapy (or grid) using megavoltage x-rays is a relatively new method of treating bulky (>8 cm) malignant tumors. Unlike the conventional approach in which the entire tumor is targeted with a nearly uniform radiation field, in grid the incident radiation is collimated with a special grid collimator. As such, only the volume under the open areas of the grid receives direct irradiation from the incident beam; the rest only sees scattered radiation and hence receives significantly less dose. Those regions seeing less dose serve as regrowth areas for normal tissues, thus reducing the normal tissue complication probability after the treatment. Although the grid dose distribution in a tumor is non-uniform, the regression of tumor mass has exhibited uniform regression clinically. Protons have two advantages over megavoltage x-rays which are typically used for grid: (1) protons scatter less in tissue, and (2) they have a fixed range in tissue (the Bragg peak) that can be used to target a tumor. The goal of this thesis is to computationally and experimentally assess the feasibility of grid using clinical proton beams. The proton pencil beams at the Provision Cancer Center in Knoxville, Tennessee, are used to create an array of beams mimicking the arrangement of beams in grid therapy. The dose distributions at various depths in a solid-water phantom are obtained computationally by the Monte Carlo code MCNP and validated by RayStation experimental Gafchromic film EBT3. The results are compared with those of the grid using megavoltage x-rays.