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Rep Pract Oncol Radiother. 2011 Nov 15;17(1):38-43. doi: 10.1016/j.rpor.2011.09.001. eCollection 2011.

Effect of the bone heterogeneity on the dose prescription in orthovoltage radiotherapy: A Monte Carlo study.

Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology

James C L Chow, Grigor N Grigorov

Affiliations

  1. Radiation Medicine Program, Princess Margaret Hospital and Department of Radiation Oncology, University of Toronto, Toronto, ON M5G 2M9, Canada ; Department of Physics, Ryerson University, Toronto, ON M5B 2K3, Canada.
  2. Department of Medical Physics, Grand River Regional Cancer Center, Kitchener, ON N2G 1G3, Canada.

PMID: 24376995 PMCID: PMC3863236 DOI: 10.1016/j.rpor.2011.09.001

Abstract

BACKGROUND: In orthovoltage radiotherapy, since the dose prescription at the patient's surface is based on the absolute dose calibration using water phantom, deviation of delivered dose is found as the heterogeneity such as bone present under the patient's surface.

AIM: This study investigated the dosimetric impact due to the bone heterogeneity on the surface dose in orthovoltage radiotherapy.

MATERIALS AND METHODS: A 220 kVp photon beam with field size of 5 cm diameter, produced by a Gulmay D3225 orthovoltage X-ray machine was modeled by the BEAMnrc. Phantom containing water (thickness = 1-5 mm) on top of a bone (thickness = 1 cm) was irradiated by the 220 kVp photon beam. Percentage depth dose (PDD), surface dose and photon energy spectrum were determined using Monte Carlo simulations (the BEAMnrc code).

RESULTS: PDD results showed that the maximum bone dose was about 210% higher than the surface dose in the phantoms with different thicknesses of water. Surface dose was found to be increased in the range of 2.5-3.7%, when the distance between the phantom surface and bone was increased in the range of 1-5 mm. The increase of surface dose was found not to follow the increase of water thickness, and the maximum increase of surface dose was found at the thickness of water equal to 3 mm.

CONCLUSIONS: For the accepted total orthovoltage radiation treatment uncertainty of 5%, a neglected consideration of the bone heterogeneity during the dose prescription in the sites of forehead, chest wall and kneecap with soft tissue thickness = 1-5 mm would cause more than two times of the bone dose, and contribute an uncertainty of about 2.5-3.7% to the total uncertainty in the dose delivery.

Keywords: Bone backscatter and surface dose; Monte Carlo simulation; Orthovoltage photon beam; Orthovoltage radiation therapy

References

  1. Med Phys. 1995 Jun;22(6):767-73 - PubMed
  2. Rep Pract Oncol Radiother. 2010 Nov 09;15(6):190-4 - PubMed
  3. Med Phys. 2004 Oct;31(10):2883-98 - PubMed
  4. Australas Phys Eng Sci Med. 2008 Mar;31(1):49-55 - PubMed
  5. Phys Med Biol. 1997 Dec;42(12):2421-33 - PubMed
  6. Med Phys. 2001 Jun;28(6):868-93 - PubMed
  7. Med Phys. 2005 Mar;32(3):685-99 - PubMed
  8. Med Phys. 1997 Nov;24(11):1781-7 - PubMed
  9. Med Phys. 1995 May;22(5):503-24 - PubMed
  10. Int J Radiat Oncol Biol Phys. 1990 May;18(5):1237-8 - PubMed
  11. Med Phys. 2002 Dec;29(12):2745-52 - PubMed
  12. Int J Radiat Oncol Biol Phys. 1992;23(4):769-79 - PubMed

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