Dosimetric evaluation of parallel opposed spatially fractionated radiation therapy of deep-seated bulky tumors.

Application of a single fraction of parallel opposed GRID beams as a means of increasing the efficiency of radiation delivery to deep-seated tumors has been investigated. This evaluation was performed by measurement of dosimetric characteristics of the GRID radiation field in parallel opposed and single beam geometry. The limitations of the parallel opposed technique in terms of field size and tumor thickness have been evaluated for the conditions of acceptable spatial modulation. The results of this investigation have demonstrated an increase in therapeutic advantage for the parallel opposed technique over the single beam method when treating a deep seated tumor.

Dosimetric characteristics of a newly designed grid block for megavoltage photon radiation and its therapeutic advantage using a linear quadratic model.

Grid radiation therapy with megavoltage x-ray beam has been proven to be an effective technique for management of large, bulky malignant tumors. The clinical advantage of GRID therapy, combined with conventional radiation therapy, has been demonstrated using a prototype GRID block [Mohiuddin, Curtis, Grizos, and Komarnicky, Cancer 66, 114-118 (1990)]. Recently, a new GRID block design with improved dosimetric properties has become commercially available from Radiation Product Design, Inc. (Albertive, MN). This GRID collimator consists of an array of focused apertures in a cerrobend block arranged in a hexagonal pattern having a circular cross-section with a diameter and center-to-center spacing of 14.3 and 21.1 mm, respectively, in the plane of isocenter. In this project, dosimetric characteristics of the newly redesigned GRID block have been investigated for a Varian 21EX linear accelerator (Varian Associates, Palo Alto, CA). These determinations were performed using radiographic films, thermoluminescent dosimeters in Solid Water phantom materials, and an ionization chamber in water. The output factor, percentage depth dose, beam profiles, and isodose distributions of the GRID radiation as a function of field size and beam energy have been measured using both 6 and 18 MV x-ray beams. In addition, the therapeutic advantage obtained from this treatment modality with the new GRID block design for a high, single fraction of dose has been calculated using the linear quadratic model with alpha/beta ratios for typical tumor and normal cells. These biological characteristics of the new GRID block design will also be presented.