Out-of-Field Doses Produced by a Proton Scanning Beam Inside Pediatric Anthropomorphic Phantoms and Their Comparison With Different Photon Modalities

Since 2010, EURADOS Working Group 9 (Radiation Dosimetry in Radiotherapy) has been involved in the investigation of secondary and scattered radiation doses in X-ray and proton therapy, especially in the case of pediatric patients. The main goal of this paper is to analyze and compare out-of-field neutron and non-neutron organ doses inside 5- and 10-year-old pediatric anthropomorphic phantoms for the treatment of a 5-cm-diameter brain tumor. Proton irradiations were carried out at the Cyclotron Centre Bronowice in IFJ PAN Krakow Poland using a pencil beam scanning technique (PBS) at a gantry with a dedicated scanning nozzle (IBA Proton Therapy System, Proteus 235). Thermoluminescent and radiophotoluminescent dosimeters were used for non-neutron dose measurements while secondary neutrons were measured with track-etched detectors. Out-of-field doses measured using intensity-modulated proton therapy (IMPT) were compared with previous measurements performed within a WG9 for three different photon radiotherapy techniques: 1) intensity-modulated radiation therapy (IMRT), 2) three-dimensional conformal radiation therapy (3D CDRT) performed on a Varian Clinac 2300 linear accelerator (LINAC) in the Centre of Oncology, Krakow, Poland, and 3) Gamma Knife surgery performed on the Leksell Gamma Knife (GK) at the University Hospital Centre Zagreb, Croatia. Phantoms and detectors used in experiments as well as the target location were the same for both photon and proton modalities. The total organ dose equivalent expressed as the sum of neutron and non-neutron components in IMPT was found to be significantly lower (two to three orders of magnitude) in comparison with the different photon radiotherapy techniques for the same delivered tumor dose. For IMPT, neutron doses are lower than non-neutron doses close to the target but become larger than non-neutron doses further away from the target. Results of WG9 studies have provided out-of-field dose levels required for an extensive set of radiotherapy techniques, including proton therapy, and involving a complete description of organ doses of pediatric patients. Such studies are needed for validating mathematical models and Monte Carlo simulation tools for out-of-field dosimetry which is essential for dedicated epidemiological studies which evaluate the risk of second cancers and other late effects for pediatric patients treated with radiotherapy

Photon dosimetry methods outside the target volume in radiation therapy: Optically stimulated luminescence (OSL), thermoluminescence (TL) and radiophotoluminescence (RPL) dosimetry

International audienceDosimetry methods outside the target volume are still not well established in radiotherapy. Luminescence detectors due to their small dimensions, very good sensitivity, well known dose and energy response are considered as an interesting approach in verification of doses outside the treated region. The physical processes of thermoluminescence (TL), radiophotoluminescence (RPL) and optically stimulated luminescence (OSL) are very similar and can be described in terms of the energy band model of electron-hole production following irradiation.This work is a review of the main dosimetric characteristics of luminescence detectors which were used in experiments performed by EURADOS Working Group 9 for in-phantom measurements of secondary radiation (scattered and leakage photons). TL LiF:Mg,Ti detectors type MTS-7 (IFJ PAN, Poland), types TLD-100 and TLD-700 (Harshaw), OSL Al2O3:C detectors type nanoDot™ (Landauer Inc.) and RPL rod glass elements type GD-352M (Asahi Techno Glass Coorporation) are described. The main characteristics are discussed, together with the readout and calibration procedures which lead to a determination of absorbed dose to water.All dosimeter types used show very good uniformity, batch reproducibility and homogeneity. For improved accuracy, individual sensitivity correction factors should be applied for TL and OSL dosimeters while for RPL dosimeters there is no need for individual sensitivity corrections.The dose response of all dosimeters is linear for a wide range of doses.The energy response of GD-352M type dosimeters (with Sn filter) used for out-of-field measurements is flat for medium and low energy X-rays.The energy dependence for TLDs is low across the range of photon energies used and the energy correction was neglected. A significant over response of Al2O3:C OSLDs irradiated in kilovoltage photon beams was taken into account. The energy correction factor fen was calculated by using the 2006 PENELOPE Monte Carlo code.With suitable calibration, all dosimeter types are appropriate for out-of-field dose measurements as well as for the in-phantom measurements of radiotherapy MV X-rays beams

Editorial: Out-of-field second primary cancer induction: Dosimetry and modelling

Second primary cancer induction is a growing concern, particularly for the younger cancer patient population with a longer life expectancy, as demonstrated by the increasing number of publications on the topic. Still, there is much work to do (1), such as assessing problems associated with the dosimetry under no reference conditions (particularly in proton treatments) or the presence of mixed-fields. Additionally, due to the poor performance of commercial treatment planning systems (TPS) in stray dose calculations for photon (2) and proton radiotherapy (RT), the development and implementation of computational tools are needed for out-of-field dose estimation in a systematic way. Thus, dosimetric information might be part of databases for cancer patients treated with modern RT techniques together with detrimental outcomes such as second primary cancers. The latter will improve existing risk models, which should also be considered during RT plan optimization. (extract