Comparative Analysis of 60Co and 192Ir Sources in High Dose Rate Brachytherapy for Cervical Cancer

SIMPLE SUMMARY: High-dose-rate (HDR) brachytherapy (BT) is an effective treatment for bulky, middle, and advanced cervical cancer. Both 192Ir and 60Co are radiation sources recommended by the ICRU. Previously, due to the large geometric size of 60Co, 192Ir occupied most of the market share. After continuous technical improvements, the geometry of miniaturized 60Co sources has become comparable to that of 192Ir sources. Another important point is that people suspect that the use of 60Co sources will result in reduced efficacy, increased toxic reactions, and a series of issues. In this paper, we compared 60Co and 192Ir sources for HDR BT in terms of both dosimetry and clinical treatment. The results of reports published on the use of HDR BT for cervical cancer over the past few years as well as our own research show that this treatment is safe and 60Co can be promoted as a good alternative to 192Ir. ABSTRACT: High-dose-rate (HDR) brachytherapy (BT) is an essential treatment for cervical cancer, one of the most prevalent gynecological malignant tumors. In HDR BT, high radiation doses can be delivered to the tumor target with the minimum radiation doses to organs at risk. Despite the wide use of the small HDR 192Ir source, as the technique has improved, the HDR 60Co source, which has the same miniaturized geometry, has also been produced and put into clinical practice. Compared with 192Ir (74 days), 60Co has a longer half-life (5.3 years), which gives it a great economic advantage for developing nations. The aim of the study was to compare 60Co and 192Ir sources for HDR BT in terms of both dosimetry and clinical treatment. The results of reports published on the use of HDR BT for cervical cancer over the past few years as well as our own research show that this treatment is safe and it is feasible to use 60Co as an alternative source.