Out-of-field doses from secondary radiation produced in proton therapy and the associated risk of radiation-induced cancer from a brain tumor treatment |
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| Institution: | 1. Medical Radiation Physics, Department of Physics, Stockholm University, Box 260, 171 76 Stockholm, Sweden;2. The Skandion Clinic, von Kraemers allé 26, 752 37 Uppsala, Sweden;3. Swedish Radiation Safety Authority, Solna Strandväg 96, 171 16 Stockholm, Sweden;1. National Centre for Nuclear Research, ul. Andrzeja Sołtana 7, 05-400 Otwock, Świerk, Poland;2. Institute of Experimental Physics, University of Warsaw, ul. Hoża 69, 00-681 Warsaw, Poland;3. Heavy Ion Laboratory, University of Warsaw, ul. Pasteura 5A, 02-093 Warsaw, Poland;1. Medical Physics Department, A.O. Mauriziano, 10128 Turin, Italy;2. Cardiology Department, A.O. Mauriziano, 10128 Turin, Italy;3. Medical Physics Department, A.S.L. TO4, 10015 Ivrea, Italy;1. Institute of Medical Physics, School of Physics, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia;2. Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW, Australia;3. Ingham Institute for Applied Medical Research, Sydney, NSW, Australia;4. Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark;5. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark;6. Illawarra Cancer Care Centre, Wollongong, NSW, Australia;7. Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia;8. South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia;1. School of Chemistry and Physics, Faculty of Science, Queensland University of Technology (QUT), Brisbane, Australia;2. Curriculum Design Studio, Learning and Teaching Unit, Queensland University of Technology (QUT), Brisbane, Australia;1. Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;2. Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;3. Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;4. Department of Radiological Science, Faculty of Health Sciences, Junshin Gakuen University, 1-1-1, Chikushigaoka, Minami-ku, Fukuoka 815-8510, Japan;1. Institute of Nuclear Physics, Polish Academy of Sciences (IFJ PAN), Radzikowskiego 152, 31-342 Krakow, Poland;2. Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Pôle Radioprotection de l’Homme, BP-17, 92260 Fontenay-aux-Roses, France;4. Nuclear Physics Institute, Academy of Sciences of the Czech Republic (NPI), CZ-250 68 Řež, Czech Republic;5. Centre od Oncology, Kraków Division, PL-31-115 Kraków, Poland |
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| Abstract: | PurposeTo determine out-of-field doses produced in proton pencil beam scanning (PBS) therapy using Monte Carlo simulations and to estimate the associated risk of radiation-induced second cancer from a brain tumor treatment.MethodsSimulations of out-of-field absorbed doses were performed with MCNP6 and benchmarked against measurements with tissue-equivalent proportional counters (TEPC) for three irradiation setups: two irradiations of a water phantom using proton energies of 78–147 MeV and 177–223 MeV, and one brain tumor irradiation of a whole-body phantom. Out-of-field absorbed and equivalent doses to organs in a whole-body phantom following a brain tumor treatment were subsequently simulated and used to estimate the risk of radiation-induced cancer. Additionally, the contribution of absorbed dose originating from radiation produced in the nozzle was calculated from simulations.ResultsOut-of-field absorbed doses to the TEPC ranged from 0.4 to 135 µGy/Gy. The average deviation between simulations and measurements of the water phantom irradiations was about 17%. The absorbed dose contribution from radiation produced in the nozzle ranged between 0 and 70% of the total dose; the contribution was however small in absolute terms. The absorbed and equivalent doses to the organs ranged between 0.2 and 60 µGy/Gy and 0.5–151 µSv/Gy. The estimated lifetime risk of radiation-induced second cancer was approximately 0.01%.ConclusionsThe agreement of out-of-field absorbed doses between measurements and simulations was good given the sources of uncertainties. Calculations of out-of-field organ doses following a brain tumor treatment indicated that proton PBS therapy of brain tumors is associated with a low risk of radiation-induced cancer. |
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| Keywords: | Monte Carlo Proton therapy Out-of-field doses Radiation-induced cancer |
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