The effect of carbon fibre inserts on the build-up and attenuation of high energy photon beams.

BACKGROUND AND PURPOSE: The use of new materials in radiotherapy requires an investigation of the effects of these materials on the relevant beam parameters. The high strength and low density of carbon fibre suggest an excellent material for table inserts with minimal attenuation, without changing the skin sparing effect in the build-up zone. MATERIALS AND METHODS: In this paper three different carbon fibre plates and two conventionally table top materials are studied in Co-60, 6 MV and 23 MV photon beams. RESULTS AND CONCLUSIONS: From depth dose measurements it is clear that the dose in the build-up zone is influenced in the qualities of the beams. The mutual differences for the three carbon plates are minimal. For Co-60 the depth of the maximum dose is decreased by carbon from 5 to 2 mm and the surface dose is increased from 18 to 76%. For 6 and 23 MV the surface dose is increased from 21 to 52% and 20 to 32%, respectively, as well as the dose in the build-up region. A transmission of 99% was measured for two carbon plates out of three in Co-60 and for one out of three in 6 MV.

Influence of respiration on calculation and delivery of the prescribed dose in external radiotherapy.

During the delivery of the prescribed dose in external beam radiotherapy, respiration alters the patient's body outline and consequently the basis for dose calculations. The influence of this effect was studied on both healthy volunteers and patients. In a subgroup of volunteers, we measured that respiratory movements modify a person's thickness, in particular in the antero-posterior direction at the lower abdominal level, by more than 4% implying a variation in absorbed dose of more than 2%. In view of the I.C.R.U. requirements for absorbed dose accuracy, these variations must be taken into account. Extension of the study to a group of 160 patients confirmed that for a subgroup of about 25%, respiration induces an important deviation from the prescribed dose as dose calculations are based on a body outline taken at an unknown stage during the respiratory cycle. Our results indicate that dose calculations should be based on an average body outline which takes the respiratory movements into account.