Estimation of the carcinogenic risk of radiotherapy of benign diseases from shoulder to heel.

BACKGROUND AND PURPOSE: To estimate risk on fatal tumour induction in patients by radiotherapy of benign diseases at various body sites, including heterotopic ossification, omarthritis, gonarthrosis, heel spurs and hidradenitis suppurativa. MATERIAL AND METHODS: The carcinogenic risk is estimated by applying the effective dose concept from the ICRP with the average risk factor of 10% per Sv for high dose and high dose rate. Although, the concept of effective dose for the present study has limitations, its use is considered acceptable for a fairly rough risk estimate. The organ doses are calculated using a Monte Carlo radiation transport code and anthropomorphic mathematical phantoms. Special risk modifying factors like patient's age at exposure and gender are taken into account. RESULTS: For the treatment of heterotopic ossification, omarthritis, gonarthrosis, heel spurs and hidradenitis suppurativa the effective dose is in the range of 5-400 mSv. For an average-aged population, the estimated number of radiation-induced fatal tumours due to these treatments is assessed to be between 0.5 and 40 persons per 1000 patients treated. At higher ages the risks are reduced. CONCLUSIONS: The range of effective doses found for the various types of treatment at various body sites is large. There are several possibilities to optimise the treatment protocols resulting in reduced effective doses and related radiation risks.

A comparison of MCNP4C electron transport with ITS 3.0 and experiment at incident energies between 100 keV and 20 MeV: influence of voxel size, substeps and energy indexing algorithm.

The condensed-history electron transport algorithms in the Monte Carlo code MCNP4C are derived from ITS 3.0, which is a well-validated code for coupled electron-photon simulations. This, combined with its user-friendliness and versatility, makes MCNP4C a promising code for medical physics applications. Such applications, however, require a high degree of accuracy. In this work, MCNP4C electron depth-dose distributions in water are compared with published ITS 3.0 results. The influences of voxel size, substeps and choice of electron energy indexing algorithm are investigated at incident energies between 100 keV and 20 MeV. Furthermore, previously published dose measurements for seven beta emitters are simulated. Since MCNP4C does not allow tally segmentation with the *F8 energy deposition tally, even a homogeneous phantom must be subdivided in cells to calculate the distribution of dose. The repeated interruption of the electron tracks at the cell boundaries significantly affects the electron transport. An electron track length estimator of absorbed dose is described which allows tally segmentation. In combination with the ITS electron energy indexing algorithm, this estimator appears to reproduce ITS 3.0 and experimental results well. If, however, cell boundaries are used instead of segments, or if the MCNP indexing algorithm is applied, the agreement is considerably worse.