Monte Carlo study of organ doses and related risk for cancer in Algeria from scattered neutrons in prostate treatment involving 3D-CRT.

The present study aimed to evaluate organ doses and related risk for cancer from scattered neutrons involving 3D Conformational Radiotherapy (3D-CRT) for patients with prostate cancer in Algeria based on Monte Carlo technique and to estimate the secondary cancer risks. To this purpose, a detailed geometric Monte Carlo (MC) modeling of the LINAC Varian 2100C combined with a computational whole-body phantom was carried out. The neutron equivalent doses were calculated in-field and out-of field of patient's organs using the phase-space method. The obtained neutron equivalent doses were used to estimate the Lifetime Attributable Risks (LARs) for cancer incidence in out of field organs. LARs was evaluated assuming Biological Effects of Ionizing Radiation VII (BEIR VII) risk model for exposure age in the range 35-70 years, according to the interval's age of treated patients in Algeria. The baselines cancer risks and survival data were associated with the statistical data for the Algerian population. The results showed that the neutrons equivalent doses per prescribed dose (Photon Dose) mostly depend on the distance of organs from the treated volume. The highest and lowest equivalent doses of 1.18 mSv/Gy and 0.25 mSv/Gy were recorded in the bladder and heart, respectively. The highest estimated lifetime attributable risk per 100,000 population was found for 35 yrs' exposure age in colon 49.94, lung 16.63 and stomach 11.17. The lowest risks were found for 70 yrs' age, in spine 0.06 and thyroid 0.14. The results showed that LARs values decrease with the increase of the exposure age and cancer incidence risk is lower than the baseline cancer risk incidence for all organs. The present study may help in providing a database on the impact of radiotherapy-induced secondary cancer incidence during 3D-CRT for prostate cancer in Algeria.

Effects of energy spectrum on dose distribution calculations for high energy electron beams.

In an early work we have demonstrated the possibility of using Monte Carlo generated pencil beams for 3D electron beam dose calculations. However, in this model the electron beam was considered as monoenergetic and the effects of the energy spectrum were taken into account by correction factors, derived from measuring central-axis depth dose curves. In the present model, the electron beam is considered as polyenergetic and the pencil beam distribution of a clinical electron beam, of a given nominal energy, is represented as a linear combination of Monte Carlo monoenergetic pencil beams. The coefficients of the linear combination describe the energy spectrum of the clinical electron beam, and are chosen to provide the best-fit between the calculated and measured central axis depth dose, in water. The energy spectrum is determined by the constrained least square method. The angular distribution of the clinical electron beam is determined by in-air penumbra measurements. The predictions of this algorithm agree very well with the measurements in the region near the surface, and the discrepancies between the measured and calculated dose distributions, behind 3D heterogeneities, are reduced to less than 10%. We have demonstrated a new algorithm for 3D electron beam dose calculations, which takes into account the energy spectra. Results indicate that the use of this algorithm leads to a better modeling of dose distributions downstream, from complex heterogeneities.

In-air fluence profiles and water depth dose for uncollimated electron beams.

Advanced electron beam dose calculation models for radiation treatment planning systems require the input of a phase space beam model to configure a clinical electron beam in a computer. This beam model is a distribution in position, energy, and direction of electrons and photons in a plane in front of the patient. The phase space beam model can be determined by Monte Carlo simulation of the treatment head or from a limited set of measurements. In the latter case, parameters of the electron phase space beam model are obtained by fitting measured to calculated dosimetric data. In the present work, data for air fluence profiles and water depth doses have been presented for electron beams without an applicator for a medical linear accelerator. These data are used to parameterize the electron phase space beam model to a Monte Carlo dose calculation module available in the first commercial (MDS Nordion, now Nucletron) Monte Carlo treatment planning for electron beams.