Prog Med Phys.  2013 Dec;24(4):295-302. 10.14316/pmp.2013.24.4.295.

Estimation of Secondary Scattered Dose from Intensity-modulated Radiotherapy for Liver Cancer Cases

• Kim DW
• Sung J
• Lee H
• Yoon M
• Chung WK
• Bae SH
• Shin DO
• Chung K
• Lim YK
• Shin D
• Lee SB

• KMID: 1910573
• DOI: http://doi.org/10.14316/pmp.2013.24.4.295

Abstract

We estimated secondary scattered and leakage doses for intensity-modulated radiotherapy (IMRT), volumetric arc therapy (VMAT) and tomotherapy (TOMO) in patients with liver cancer. Five liver patients were planned by IMRT, VMAT and TOMO. Secondary scatter (and leakage) dose and organ equivalent doses (OEDs) are measured and estimated at various points 20 to 80 cm from the iso-center by using radiophotoluminescence glass dosimeter (RPLGD). The secondary dose per Gy from IMRT, VMAT and TOMO for liver cancer, measured 20 to 80 cm from the iso-center, are 0.01~3.13, 0.03~2.34 and 0.04~1.29 cGy, respectively. The mean values of relative OED of secondary dose of VMAT and TOMO for five patients, which is normalized by IMRT, measured as 75.24% and 50.92% for thyroid, 75.14% and 40.61% for bowel, 72.30% and 47.77% for rectum, 76.21% and 49.93% for prostate. The secondary dose and OED from TOMO is relatively low to those from IMRT and VMAT. OED based estimation suggests that the secondary cancer risk from TOMO is less than or comparable to the risks from conventional IMRT and VMAT.

Keyword

Liver cancer; Scatter; Leakage; Intensity-modulated radiotherapy; Volumetric Arc therapy; Helical tomotherapy

MeSH Terms

Glass
Humans
Liver Neoplasms*
Liver*
Prostate
Radiotherapy, Intensity-Modulated*
Rectum
Thyroid Gland

Figure

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  Fig. 1. Treatment plan for patient #4 with different modalities; IMRT, VMAT and TOMO. The prescription dose 62.5 Gy with 25 fractions.

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  Fig. 2. Secondary scattered dose measurement set up. Measuring positions are 20, 35, 50, 65 and 80 cm from the iso-center. Two RPLGDs are positioned at each measuring point.

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  Fig. 3. The secondary scattered dose measurements of five patients for IMRT (diamond), VMAT (square) and TOMO (triangle) at each distance from the iso-center. All data are normalized by prescription dose.

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