Physical and dosimetric properties of the applicators used in cervix cancer brachytherapy: ICRU 89 recommendations

When radiation therapy is the primary choice of the curative treatment, brachytherapy plays a crucial role in the therapeutic management of cervix cancer. Brachytherapy techniques and the selection of suitable applicator primarily depend on the patients’ anatomy and extension or location of the disease. In addition to applicator selection, technical adequacy of the brachytherapy implant and treatment conditions like simulation or treatment protocol (rectum and bladder fullness), packing, use of rectal spacer or rectal retractor significantly affect the quality of the brachytherapy treatment. This review provides an overview of the dosimetric and physical properties of the brachytherapy applicators used in treating cervix cancer with the guidance of ICRU 89.