First experience of 192 Ir source stuck event during high-dose-rate brachytherapy in Japan

To share the experience of an iridium-192 ( Ir) source stuck event during high-dose-rate (HDR) brachytherapy for cervical cancer. In 2014, we experienced the first source stuck event in Japan when treating cervical cancer with HDR brachytherapy. The cause of the event was a loose screw in the treatment device that interfered with the gear reeling the source. This event had minimal clinical effects on the patient and staff; however, after the event, we created a normal treatment process and an emergency process. In the emergency processes, each staff member is given an appropriate role. The dose rate distribution calculated by the new Monte Carlo simulation system was used as a reference to create the process. According to the calculated dose rate distribution, the dose rates inside the maze, near the treatment room door, and near the console room were ≅ 10 [cGy · h ], 10 [cGy · h ], and