Brachytherapy Treatment Planning Homework

DOS 425/525

Although there are problems where you measure from the center of the source, make sure
you know how to solve a problem from the ends of a source also.
I cannot stress to you enough the importance of getting help from mentors in the
clinic to demonstrate these types of problems clinically. If you don't do
brachytherapy in your clinic, make sure your mentors can explain to you when to
use them and how.
NOTE: You wont be able to solve these until we start getting into Brachtherapy
planning in week 3.
Refer to Tables 15.2, 15.3 15.7 in Bentel for some of these problems

Week 3:

1. The following implants are classified as surface applications (circle all that apply):

A. COMS Eye Plaque
B. LDR Cylinder Implant
C. U-shaped hairpin bend in the tongue
D. Cs-137 tubes embedded in plaster of paris placed on the skin
E. Ir-192 ribbons embedded in bolus draped over the neck

Week 4:

2. Calculate the dose rate at P for the following situation. The sources are 2cm long
and are filtered by 1mm Pt. Point P is 2cm from the source train.

A. 29.6 cGy/hr
B. 24.7 cGy/hr
C. 30.7 cGy/hr
D. 34 cGy/hr

3. The clinical definition of Point A is:

a. Represents the ureters tolerance
b. Represents the tolerance of the uterus
c. The area where the ureter crosses the uterine artery, which is the limiting
factor for dose prescription
d. Location of pelvis lymph nodes
e. None of the above


15 10 10
P
4. When selecting ovoids for a gynecological brachytherapy case, the optimal choice
would be:

a. The largest diameter, since this will shorten the treatment time
b. The largest diameter, since this will spare the vaginal mucosa
c. The smallest diameter, since this will cause the least discomfort to the
patient
d. The smallest diameter, since this will spare the vaginal mucosa
e. The smallest diameter, since this will shorten the treatment time

Week 5:

5. Calculate the number of mg Ra required to deliver 5000 cGy in 72 hours for a
Manchester implant of 9 x 6 cm
2
area. Both ends of the implant are crossed. The
dose is to be calculated to 0.5cm from the plane of the implant.

A. 30 mg
B. 55 mg
C. 110 mg
D. 790 mg

6. For a single implant, in the Manchester system, the treatment plane is parallel to
the implanted plane, at a distance of:

a. 5 mm on one side of the implanted plane
b. 10 mm on one side of the implanted plane
c. 5 mm on either side of the implanted plane
d. 10 mm on either side of the implanted plane


7. The initial dose rate at a point in tissue for a temporary implant is 10 Gy/day with
Cs-137. What is the total dose delivered to this point by a 72 hour implant?

A. 2050 cGy
B. 3000 cGy
C. 4500 cGy
D. 6000 cGy

8. Brachytherapy techniques can be classified as (circle all that apply):

a. Surface Mold Treatments
b. Interstitial Treatments
c. Intralumenal Therapy
d. Intracavitary Therapy
e. Intravascular Therapy

9. Sources presently used in use for permanent implants are (circle all that apply):

a. Ir-192 Seeds
b. Cs-137 Seeds
c. I-125 Seeds
d. Pd-103 Seeds
e. Au-198 Seeds


10. The initial dose rate at a point in tissue from a permanent seed implant with I-125
is 8 cGy/hr. The total dose at the same point will be cGy.

A. 690
B. 7980
C. 11,500
D. 16,600
E. 18,000