Blake R Smith1, Daniel E Hyer2, Patrick M Hill3, Wesley S Culberson4. 1. Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin. Electronic address: bsmith34@wisc.edu. 2. Department of Radiation Oncology, University of Iowa, Iowa City, Iowa. 3. Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin. 4. Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
Abstract
PURPOSE: Patients receiving pencil beam scanning (PBS) proton therapy with the addition of a dynamic collimation system (DCS) are potentially subject to an additional neutron dose from interactions between the incident proton beam and the trimmer blades. This study investigates the secondary neutron dose rates for both single-field uniform dose (SFUD) and intensity modulated proton therapy treatments. METHODS AND MATERIALS: Secondary neutron dose distributions were calculated for both a dynamically collimated and an uncollimated, dual-field chordoma treatment plan and compared with previously published neutron dose rates from other contemporary scanning treatment modalities. Monte Carlo N-Particle transport code was used to track all primary and secondary particles generated from nuclear reactions within the DCS during treatment through a model of the patient geometry acquired from the computed tomography planning data set. Secondary neutron ambient dose equivalent distributions were calculated throughout the patient using a meshgrid with a tally resolution equivalent to that of the treatment planning computed tomography. RESULTS: The median healthy-brain neutron ambient dose equivalent for a dynamically collimated intracranial chordoma treatment plan using a DCS was found to be 0.97 mSv/Gy for the right lateral SFUD field, 1.37 mSv/Gy for the apex SFUD field, and 1.24 mSv/Gy for the composite intensity modulated proton therapy distribution from 2 fields. CONCLUSIONS: These results were at least 55% lower than what has been reported for uniform scanning modalities with brass apertures. However, they still reflect an increase in the excess relative risk of secondary cancer incidence compared with an uncollimated PBS treatment using only a graphite range shifter. Regardless, the secondary neutron dose expected from the DCS for these PBS proton therapy treatments appears to be on the order of, or below, what is expected for alternative collimated proton therapy techniques.
PURPOSE:Patients receiving pencil beam scanning (PBS) proton therapy with the addition of a dynamic collimation system (DCS) are potentially subject to an additional neutron dose from interactions between the incident proton beam and the trimmer blades. This study investigates the secondary neutron dose rates for both single-field uniform dose (SFUD) and intensity modulated proton therapy treatments. METHODS AND MATERIALS: Secondary neutron dose distributions were calculated for both a dynamically collimated and an uncollimated, dual-field chordoma treatment plan and compared with previously published neutron dose rates from other contemporary scanning treatment modalities. Monte Carlo N-Particle transport code was used to track all primary and secondary particles generated from nuclear reactions within the DCS during treatment through a model of the patient geometry acquired from the computed tomography planning data set. Secondary neutron ambient dose equivalent distributions were calculated throughout the patient using a meshgrid with a tally resolution equivalent to that of the treatment planning computed tomography. RESULTS: The median healthy-brain neutron ambient dose equivalent for a dynamically collimated intracranial chordoma treatment plan using a DCS was found to be 0.97 mSv/Gy for the right lateral SFUD field, 1.37 mSv/Gy for the apex SFUD field, and 1.24 mSv/Gy for the composite intensity modulated proton therapy distribution from 2 fields. CONCLUSIONS: These results were at least 55% lower than what has been reported for uniform scanning modalities with brass apertures. However, they still reflect an increase in the excess relative risk of secondary cancer incidence compared with an uncollimated PBS treatment using only a graphite range shifter. Regardless, the secondary neutron dose expected from the DCS for these PBS proton therapy treatments appears to be on the order of, or below, what is expected for alternative collimated proton therapy techniques.
Authors: Blake R Smith; Nicholas P Nelson; Theodore J Geoghegan; Kaustubh A Patwardhan; Patrick M Hill; Jen Yu; Alonso N Gutiérrez; Bryan G Allen; Daniel E Hyer Journal: Med Phys Date: 2022-02-21 Impact factor: 4.071
Authors: Theodore J Geoghegan; Nicholas P Nelson; Ryan T Flynn; Patrick M Hill; Suresh Rana; Daniel E Hyer Journal: Med Phys Date: 2020-04-06 Impact factor: 4.071
Authors: Christian Bäumer; Sandija Plaude; Dalia Ahmad Khalil; Dirk Geismar; Paul-Heinz Kramer; Kevin Kröninger; Christian Nitsch; Jörg Wulff; Beate Timmermann Journal: Front Oncol Date: 2021-05-12 Impact factor: 6.244
Authors: Nicholas P Nelson; Wesley S Culberson; Daniel E Hyer; Theodore J Geoghegan; Kaustubh A Patwardhan; Blake R Smith; Ryan T Flynn; Jen Yu; Suresh Rana; Alonso N Gutiérrez; Patrick M Hill Journal: Med Phys Date: 2021-04-09 Impact factor: 4.506