Review of clinical brachytherapy uncertainties: Analysis guidelines of GEC-ESTRO and the AAPM

Background and purpose: A substantial reduction of uncertainties in clinical brachytherapy should result in improved outcome in terms of increased local control and reduced side effects. Types of uncertainties have to be identified, grouped, and quantified. Methods: A detailed literature review was performed to identify uncertainty components and their relative importance to the combined overall uncertainty. Results: Very few components (e.g., source strength and afterloader timer) are independent of clinical disease site and location of administered dose. While the influence of medium on dose calculation can be substantial for low energy sources or non-deeply seated implants, the influence…

Dosimetric Uncertainties in the Practice of Clinical Brachytherapy