An Accelerated Simulation Method for ELDRS of Bipolar Operational Amplifiers Using a Dose-Rate Switching Experiment

Through different dose-rate switching evaluation methods,the radiation-response rules of operational amplifiers are studied when the irradiation dose rate is switched from high to low under different radiation temperatures and total doses. The experimental results indicate that the response characteristics could be affected by the switching total doses, irradiation temperatures,and dose rates individually or together. Accelerated evaluation on the ELDRS can be realized by adopting a proper dose-rate switching method. Meanwhile, the irradiation time can also be reduced. Finally, the mechanisms of the difference between various radiation responses are analyzed.

High-dose-rate intraluminal brachytherapy during preoperative chemoradiation for locally advanced rectal cancers

AIM:To determine the feasibility and safety of high dose rate intraluminal brachytherapy(HDR-ILBT) boost during preoperative chemoradiation for rectal cancer.METHODS:Between 2008 and 2009,thirty-six patients with locally advanced rectal cancer(≥ T3 or N+),were treated initially with concurrent capecitabine(825 mg/m2 oral twice daily) and pelvic external beam radiotherapy(EBRT)(45 Gy in 25 fractions),then were randomized to group A;HDR-ILBT group(n = 17) to receive 5.5-7 Gy×2 to gross tumor volume(GTV) and group B;EBRT group(n = 19) to receive 5.4 Gy×3 fractions to GTV with EBRT.All patients underwent total mesorectal excision.RESULTS:Grade 3 acute toxicities were registered in 12 patients(70.6%) in group A and in 8(42.1%) in group B.Complete pathologic response of T stage(ypT0) in group A was registered in 10 patients(58.8%) and in group B,3 patients(15.8%) had ypT0(P < 0.0001).Sphincter preservation was reported in 6/9 patients(66.7%) in group A and in 5/10 patients(50%) in group B(P < 0.01).Overall radiological response was 68.15% and 66.04% in Group A and B,respectively.During a median follow up of 18 mo,late grade 1 and 2 sequelae were registered in 3 patients(17.6%) and 4 patients(21.1%) in the groups A and B,respectively.CONCLUSION:HDR-ILBT was found to be effective dose escalation technique in preoperative chemoradiation for rectal cancers,with higher response rates,downstaging and with manageable acute toxicities.

Systematic analysis and modeling of the FLASH sparing effect as a function of dose and dose rate

Ultrahigh-dose-rate radiotherapy(FLASH-RT)is a revolutionary radiotherapy technology that can spare normal tissues without compromising tumor control.Although qualitative experimental results have been reported,quantitative and systematic analysis of data is necessary.Particularly,the FLASH effect response model to the dose or dose rate is still unclear.This study investigated the relationships between the FLASH effect and experimental parameters,such as dose,dose rate,and other factors by analyzing published in vivo experimental data from animal models.The data were modeled based on logistic regression analysis using the sigmoid function.The model was evaluated using prediction accuracy,receiver operating characteristic(ROC)curve,and area under the ROC curve.Results showed that the FLASH effect was closely related to the dose,mean dose rate,tissue type,and corresponding biological endpoints.The dose rate corresponding to a 50% probability of triggering cognitive protection in the brain was 45 Gy s^(-1).The dose rate corresponding to a 50% probability of triggering intestinal crypt survival and regeneration was 140 Gy s^(-1).For the skin toxicity effect,the dose corresponding to a 50% probability of triggering the FLASH effect was 24 Gy.This study helps to characterize the conditions underlying the FLASH effect and provides important information for optimizing experiments.

Dose-volume parameters and clinical outcome of CT-guided free-hand high-dose-rate interstitial brachytherapy for cervical cancer

Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-dose- rate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach. Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer. Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied. With a median of 5 (range, 4-7) implanted needles for each patient, the median dose of brachytherapy alone delivered to 90% of the target volume (D90 ) was 45 (range, 33-54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range, 20-36) Gyα/β10 for intermediate-risk clinical target volume (IR-CTV). The percentage of the CTV covered by the prescribed dose (V100 ) of HR-CTV with brachytherapy alone was 81.9%-99.2% (median, 96.7%). With an additional dose of external beam radiotherapy (EBRT), the median D90 was 94 (range, 83-104) Gyα/β10 for HR-CTV and 77 (range, 70 -87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100 ) was 75 (range, 66-84) Gyα/β10 for HR-CTV and 65 (range, 57-73) Gyα/β10 for IR-CTV. The minimum dose to the most irradiated 2 cc volume (D2cc ) was 73-96 (median, 83) Gyα/β3 for the bladder, 64-98 (median, 73) Gyα/β3 for the rectum, and 52-69 (median, 61) Gyα/β3 for the sigmoid colon. After a median follow-up of 15 months (range, 3 -24 months), two patients experienced local failure, and 1 showed internal iliac nodal metastasis. Despite the relatively small number of needles used, CT-guided HDRISBT for cervical cancer showed favorable DVH parameters and clinical outcome.

Effect of ionizing radiation on dual 8-bit analog-to-digital converters (AD9058) with various dose rates and bias conditions

The radiation effects on several properties （reference voltage, digital output logic voltage, and supply current） of dual 8-bit analog-to-digital （A/D） converters （AD9058） under various biased conditions are investigated in this paper. Gamma ray and 10-MeV proton irradiation are selected for a detailed evaluation and comparison. Based on the measurement results induced by the gamma ray with various dose rates, the devices exhibit enhanced low dose rate sensitivity （ELDRS） under zero and working bias conditions. Meanwhile, it is obvious that the ELDRS is more severe under the working bias condition than under the zero bias condition. The degradation of AD9058 does not display obvious ELDRS during 10-MeV proton irradiation with the selected flux.

Study of the External Dose Rate and Retained Body Activity of Patients with Hyperthyroidism Who Are Receiving Ⅰ-131 Therapy

Hyperthyroidism refers to a clinical state that results from inappropriately hight hyroid hormone levels in the tissues;.Ⅰ-131 therapy plays a critical role and provides a remarkable curative effect in targeting thyroid diseases. Thyroid cells can take up isotope I-131, which emits not only beta rays but also

Estimation of enhanced low dose rate sensitivity mechanisms using temperature switching irradiation on gate-controlled lateral PNP transistor

The mechanisms occurring when the switched temperature technique is applied,as an accelerated enhanced low dose rate sensitivity(ELDRS)test technique,are investigated in terms of a specially designed gate-controlled lateral PNP transistor(GLPNP)that used to extract the interface traps(Nit)and oxide trapped charges(Not).Electrical characteristics in GLPNP transistors induced by ^(60)Co gamma irradiation are measured in situ as a function of total dose,showing that generation of Nit in the oxide is the primary cause of base current variations for the GLPNP.Based on the analysis of the variations of Nit and Not,with switching the temperature,the properties of accelerated protons release and suppressed protons loss play critical roles in determining the increased Nit formation leading to the base current degradation with dose accumulation.Simultaneously the hydrogen cracking mechanisms responsible for additional protons release are related to the neutralization of Not extending enhanced Nit buildup.In this study the switched temperature irradiation has been employed to conservatively estimate the ELDRS of GLPNP,which provides us with a new insight into the test technique for ELDRS.

Activation and shutdown dose-rate analyses for the EAST NBI test facility

An analysis of the neutron activation and shutdown dose rates was performed for the EAST high-power deuterium neutral beam injector test facility(EAST NBITF) by using the multiparticle transport code FLUKA2011.2. Also, the neutron and neutron-induced gamma spectra of the facility's vacuum vessel were evaluated. The results identified the major radionuclides^(99) Mo,^(65)Ni,^(58) Co,^(56)Mn, and^(51) Cr for the vacuum vessel and the primary nuclide^(64) Cu for both the ion dump and the calorimeter.The simulated results indicated that, when the EAST NBITF operates within the design parameters of deuterium energy 80 ke V, current 50 A, and pulse 100 s, the neutron intensity will achieve 10^(11)n/s with no radiation safety problems after the EAST NBITF shuts down.

Study on the dose rate upset effect of partially depleted silicon-on-insulator static random access memory

This paper implements the study on the Dose Rate Upset effect of PDSOI SRAM （Partially Depleted Silicon- On-Insulator Static Random Access Memory） with the Qiangguang-I accelerator in Northwest Institute of Nuclear Technology. The SRAM （Static Random Access Memory） chips are developed by the Institute of Microelectronics of Chinese Academy of Sciences. It uses the full address test mode to determine the upset mechanisms. A specified address test is taken in the same time. The test results indicate that the upset threshold of the PDSOI SRAM is about l×10s Gy（Si）/s. However, there are a few bits upset when the dose rate reaches up to 1.58 x 109 Gy（Si）/s. The SRAM circuit can still work after the high level 3~ ray pulse. Finally, the upset mechanism is determined to be the rail span collapse by comparing the critical charge with the collected charge after γ ray pulse. The physical locations of upset cells are plotted in the layout of the SRAM to investigate the layout defect. Then, some layout optimizations are made to improve the dose rate hardened performance of the PDSOI SRAM.

Implementation and application of PyNE sub-voxel R2S for shutdown dose rate analysis

PyNE R2S is a mesh-based R2S implementation with the capability of performing shutdown dose rate(SDR)analysis directly on CAD geometry with Cartesian or tetrahedral meshes.It supports advanced variance reduction for fusion energy systems.However,the assumption of homogenized materials of PyNE R2S with a Cartesian mesh throughout a mesh voxel introduces an approximation in the case where a voxel covers multiple non-void cells.This work implements a sub-voxel method to add fldelity to PyNE R2S with a Cartesian mesh during the process of activation and photon source sampling by performing independent inventory calculations for each cell within a mesh voxel and using the results of those independent calculations to sample the photon source more precisely.PyNE sub-voxel R2S has been verifled with the Frascati Neutron Generator(FNG)-ITER and ITER computational shutdown dose rate benchmark problems.The results for sub-voxel R2S show satisfactory agreement with the experimental values or reference results.PyNE sub-voxel R2S has been applied to the shutdown dose rate calculation of the Chinese Fusion Engineering Testing Reactor(CFETR).In conclusion,sub-voxel R2S is a reliable tool for SDR calculation and obtains more accurate results with the same voxel size than voxel R2S.

Relationship between Patient-Dependent Parameters and Radiation Dose Rates Measured around Patients Undergoing PET/CT Imaging Using ¹⁸F-FDG

Objectives: Patients undergoing 18F-FDG PET/CT imaging are considered external radiation sources. Accurate dose rate estimates are important for conducting realistic risk assessments and performing dose reconstruction in cases of accidental exposures. The patient radiation self-attenuation factor is assumed to be a function of the patient’s body size metrics, but we can use these metrics to predict the dose rate around the patients with accuracy. The objective of this work was first to measure the patient attenuation factor by performing direct dose rate measurements from patients undergoing PET/CT imaging studies using 18F-FDG. The second objective was to study the possible correlation between the measured dose rate constant per unit activity from the patients and their body size metrics;five metrics were tested in this work. The last objective was to measure the patients’ voiding factor. Methods: We have measured dose rates at one meter from 57 patients and noted the patient’s height (H), weight (W) and calculated patient size metrics namely: Equivalent Cylindrical Diameter (ECD), Equivalent Spherical Diameter (ESD) and the Body Mass Index (BMI). Results: The measured average dose rate was 92.2 ± 14 μSv&middot;h-1&middot;GBq-1 measured at one meter. Therefore, the dose rate constant of 92 μSv&middot;h-1&middot;GBq-1 proposed by the AAPM, TG-108 report is adequate for radiation protection purposes. There was no statistically significant correlation between the dose rate constant per unit activity and the patient body size metrics. We have measured a patient voiding factor of 0.89 ± 0.06 in comparison with 0.85 recommended by the AAPM. Conclusions: The presented data can be used by medical physicist working in nuclear medicine in formulating more accurate risk estimations resulting from radiation exposure from patients undergoing 18F-FDG PET/CT imaging.

Assessment of Natural Radioactivity Levels and Radiation Dose Rate in Some Soil Samples from Historical Area, AL-RAKKAH, Saudi Arabia

This study aims to determine the activity concentrations of naturally occurring, technically-enhanced levels of radiation and the gamma absorbed dose rates in soil samples collected across the land scape of historical area which discovered in east of Saudi Arabia at 2009 G, Called AL- RAKKAH. By using an HPGe detector gamma-ray spectrometer, the activity concentrations of 226Ra 232Th and 40K were found in surface soil samples ranged from 17. 4 ± 1.2 Bq/kg to 28.3 ± 2.3 Bq/kg with an average value of 23 ± 1.6 Bq/kg, ranging from 1.1 ± 1.8 Bq/kg to 81.0 ± 1.7 Bq/kg with the average value 20 ± 1.4 Bq/kg and from 218 ± 11 Bq/kg to 255 ± 18 Bq/kg, with the mean value of 233 ± 12 Bq/kg respectively. The mean radium equivalent (Raeq) and outdoor radiation hazard index (Hex) for the area under study were determined as 69.52 Bq/kg and 0.16 respectively. The total absorbed dose rate due to three primordial radionuclides lies in the range of 17.74 - 72.24 nGy·h-1 with a mean of 32.69 nGy·h-1, which yields total annual effective dose of 0.37 mSv·y-1. The measured values are comparable with other global radioactivity measurements and are found to be safe for public and environment. The baseline data of this type will almost certainly be of importance in making estimations of population exposure.

Fixed Dose Rate versus Standard Dose Rate Infusion of Gemcitabine and Cisplatin in Advanced Stage Non-Small Cell Lung Cancer

Background: Comparing the efficacy and safety of gemcitabine at a fixed-dose rate (FDR) infusion (10 mg/m2/min) with the standard dose rate infusion in patients with locally advanced and metastatic non-small squamous cell carcinoma (NSCLC). Methods: The study randomized 60 patients with confirmed diagnosis of NSCLC to receive gemcitabine at a dose of 1000 mg/m2 on days 1 and 8 given as a 30-min infusion (Arm A) or at a rate of 10 mg/m2/min (Arm B). Cisplatin 75 mg/m2 was administered intravenously on day 2 in both arms. Results: No difference in overall response rate (46.6% versus 43.3%). Median time to progression for Arm A was 7 months (95% CI, 6.207 - 7.793 months), versus 6 months for Arm B (95% CI, 4.990 - 7.010 months). Median survival time was comparable [12 months (95% CI, 8.588 - 15.412 months) versus 11 months (95% CI, 9.066 - 12.934 months)] respectively. Two-year survival (18% versus 11%, p = 0.38) was detected. No treatment related deaths occurred. Main hematological toxicities were grade I and II neutropenia, in 36.7% and 53.3% respectively (p = 0.044). Grade III anemia was observed in 10% and 6.7% in both arms respectively (p = 0.024). Grade I and II nausea and vomiting was observed in 50% and 46.7%. Conclusions: FDR gemcitabine in combination with cisplatin had equivalent efficacy and more severe hematologic toxicities compared to the standard 30-min gemcitabine infusion with cisplatin in patients with advanced NSCLC.

Laser-assisted Simulation of Dose Rate Effects of Wide Band Gap Semiconductor Devices

Laser-assisted simulation technique has played a crucial role in the investigation of dose rate effects of silicon-based devices and integrated circuits,due to its exceptional advantages in terms of flexibility,safety,convenience,and precision.In recent years,wide band gap materials,known for their strong bonding and high ionization energy,have gained increasing attention from researchers and hold significant promise for extensive applications in specialized environments.Consequently,there is a growing need for comprehensive research on the dose rate effects of wide band gap materials.In response to this need,the use of laser-assisted simulation technology has emerged as a promising approach,offering an effective means to assess the efficacy of investigating these materials and devices.This paper focused on investigating the feasibility of laser-assisted simulation to study the dose rate effects of wide band gap semiconductor devices.Theoretical conversion factors for laser-assisted simulation of dose rate effects of GaN-based and SiC-based devices were been provided.Moreover,to validate the accuracy of the conversion factors,pulsed laser and dose rate experiments were conducted on GaN-based and SiC-based PIN diodes.The results demonstrate that pulsed laser radiation andγ-ray radiation can produce highly similar photocurrent responses in GaN-based and SiC-based PIN diodes,with correlation coefficients of 0.98 and 0.974,respectively.This finding reaffirms the effectiveness of laser-assisted simulation technology,making it a valuable complement in studying the dose rate effects of wide band gap semiconductor devices.

Gamma Dose Rate Measurements in Kuwait Using a Car-Borne GPS Integrated Dosimetric System

A mobile system comprising of a Geiger-Muller (GM) dosimeter connected with a smart phone was used for ambient gamma dose rate survey within the districts and on the roads within the state of Kuwait. While the dosimeter provides data on gamma dose rates, the smart phone provides the GPS navigation information and saves the data for subsequent analysis and mapping. The survey covered a total distance of about 2300 km within the country and 3117 data points were recorded to show the dose rate distribution on the map of Kuwait. The results show that the ambient dose rates in Kuwait range from 40 to 180 nSv.h-1 with a mean value of 103 nSv.h-1. The dosimetric system described has good potential as a tool for determining baseline background radiation dose rates in an area.

Processing of Landsat 8 Imagery and Ground Gamma-Ray Spectrometry for Geologic Mapping and Dose-Rate Assessment, Wadi Diit along the Red Sea Coast, Egypt

Maximum Likelihood (MLH) supervised classification of atmospherically corrected Landsat 8 imagery was applied successfully for delineating main geologic units with a good accuracy (about 90%) according to reliable ground truth areas, which reflected the ability of remote sensing data in mapping poorly-accessed and remote regions such as playa (Sabkha) environs, subdued topography and sand dunes. Ground gamma-ray spectrometric survey was to delineate radioactive anomalies within Quaternary sediments at Wadi Diit. The mean absorbed dose rate (D), annual effective dose equivalent (AEDE) and external hazard index (Hex) were found to be within the average worldwide ranges. Therefore, Wadi Diit environment is said to be radiological hazard safe except at the black-sand lens whose absorbed dose rate of 100.77 nGy/h exceeds the world average. So, the inhabitants will receive a relatively high radioactive dose generated mainly by monazite and zircon minerals from black-sand lens.

Dose-rate effects of low-dropout voltage regulator at various biases

A low-dropout voltage regulator,LM2941,was irradiated by ^(60)Coγ-rays at various dose rates and biases for investigating the total dose and dose rate effects.The radiation responses show that the key electrical parameters, including its output and dropout voltage,and the maximum output current,are sensitive to total dose and dose rates, and are significantly degraded at low dose rate and zero bias.The integrated circuits damage change with the dose rates and biases,and the dose-rate effects are relative to its electric field.

Comparison of Gamma Pass Rate between the Dose-to-Water and Dose-to-Medium Reporting Modes for Patient-Specific QA Using a Helical Diode Array Dosimeter with a Fixed Phantom Density

Introduction: To compare the measured dose distributions to calculated ones in dose-to-water (Dw) and dose-to-medium (Dm) reporting modes for simple plans and patient-specific intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans using ArcCHECK with a fixed phantom density. Methods: The recommended density value of 1.18 g/cm3 for Acuros XB and X-ray voxel Monte Carlo was assigned to ArcCHECK on CT images. A total of 45 simple plans, including a 1-field plan, a 3-field plan, a 4-field plan, a half-arc plan from 270° to 90°, and a full-arc plan, were assessed. Subsequently, the patient-specific 96 IMRT and VMAT plans were evaluated. Gamma analysis with a 3% normalized global dose error and a 3 mm distance-to-agreement criteria (γ3%G/3mm) was performed in the Dw and Dm. The change in γ3%G/3mm between Dw and Dm were statistically analyzed using JMPPro11 software. Results: The median values of γ3%G/3mm for all simple plans for Dw and Dm were 98.1% (range, 75.2% - 100%) and 95.5% (range, 23.7% - 100%), respectively (p 0.01). In the patient-specific IMRT and VMAT plans, the median values of γ3%G/3mm for Dw and Dm were 98.6% (range, 90.1% - 100%) and 90.5% (range, 38.5% - 97.2%), respectively (p 0.01). Conclusion: Our results showed that the calculated and measured dose distributions were in good agreement for Dw, but were not for Dm. From the viewpoint of the rationale of dosimetry, Dw shows better agreement with measured dose distribution when using the fixedphantom density recommended by the vendor.

An Innovative Concept of High-Dose-Rate (HDR) Intracavitary Brachytherapy with an Intrauterine Inflatable Balloon for Endometrial Carcinoma

Purpose: Curative radiation therapy is an established treatment option for non-surgical patients with early-stage endometrial carcinoma. Dosimetric analyses were performed using a single tandem, double tandem, Heyman capsules, and an inflatable intrauterine balloon to assess the dose homogeneity and conformality in the definitive treatment of inoperable endometrial cancer. Methods and Materials: Patients’ informed-consent was obtained. Dosimetric analyses were performed using four different after-loading applicators to assess the dose homogeneity and conformality of isodose to the three-dimensional (3-D) shape of the target volume (uterus) based on CT data in four patients (n = 4). The single tandem and double tandems were standard Fletcher-type (Nucletron Corporation, Columbia, MD). Heyman capsules were the disposable after-loading type (Radiation Products Design, Inc., Albertville, MN). The inflatable balloon with a central bi-lumen catheter was the Mammo Site Radiation Therapy System (Proxima Therapeutics, Alpharetta, GA) that is currently used for local breast brachytherapy. Treatment planning and dosimetric analyses for all four techniques were done with HDR PLATO Brachytherapy (v14.2.3) Software (Nucletron Corporation). Results: The average dose gradient within the target (uterine wall) is highest with the tandem methods, followed by Heyman capsules. The intrauterine balloon method showed the least dose gradient across the uterine wall. The corresponding average homogeneity indices were 3.81, 3.83, 2.97, 2.50 for single tandem, double tandem, Heyman capsules, and intrauterine balloon respectively. Conclusions: The intra-uterine inflatable balloon appears to have the best overall dosimetric advantages for the treatment of the uterine wall. Furthermore, the potential ease of use, shorter time of applicator placement, and better patient comfort warrant further investigation and subsequent clinical implementation.

The Experience of Pain and Anxiety in Cervical Cancer Patients Undergoing Multiple Fraction High-Dose Rate Brachytherapy: A Prospective Observational Study

Purpose: To evaluate the anxiety and pain levels of cervical cancer patients undergoing intracavitary multifraction high-dose rate (HDR) brachytherapy, as part of a process to develop guidelines for quality patient-centered care. Methods: Cervical cancer patients (n = 31) undergoingmultiple fraction HDR brachytherapy treatment at the National Institute of Oncology in Rabat (Morocco) completed ratings of pain and anxiety intensity using 11-point verbal analog scales, at 6 key time points over 2 brachytherapy insertion procedures and 4 brachytherapy fractions. Women were evaluated for psychological status at baseline before starting the brachytherapy process using the Hospital Anxiety and Depression Scale (HADS). Scores were grouped as follows: 0 - 7 = normal, 8 - 10 = borderline, 11 - 21 = abnormal. Factors that could affect anxiety levels such as education level, relationship status, number of pregnancies and prior surgical history were documented. Results: Between July and August 2020, 31 women with a median age of 49.6 years were evaluated (range: 27 - 70). The HADS score identified depression in 5 patients (16.1%) and anxiety in 12 patients (38.7%). Throughout both treatment procedures, anticipatory anxiety was reported, with a maximum intensity in the operating room during spinal anesthesia (3.23 ± 1.7) and during applicator insertion (2.97 ± 2.4). Moderate-to-severe anxiety scores were reported in 25.8% and 22.6% of patients respectively. Level of education showed a significant correlation with anxiety scores (p = 0.027). Pain increased significantly during the procedure (p ± 1.4) and applicator removal (4.74 ± 1.5) turned out to be the most painful parts of the procedure. No correlation was found between pain and anxiety levels. Conclusion: Intracavitary multifraction high-dose rate brachytherapy is associated with mild to moderate levels of pain and anxiety, although a subset of patients reported more severe symptoms and may require additional medical and psychological support, with particular emphasis on bed-rest duration and applicator removal. The development of effective interventions (both pharmacological and non-pharmacological) is needed to improve women’s experiences of brachytherapy for locally advanced cervical cancer.