Matching of electron and photon beams with a multi-leaf collimator.

Multi-leaf collimators (MLCs) are offered as an accessory to many accelerators for radiation therapy. However, beam edges generated with these collimators are not as smooth as can be achieved with individually made blocks. The clinical drawbacks and benefits of this ripple were evaluated both for single field treatments and for combined adjacent fields of different beam qualities. In this investigation the MLC-collimated beams of the MM50 racetrack microtron were studied. The distance between the field edge and the 90% isodose was measured at the reference depth for four beam qualities (20 MV photons and 10, 20 and 50 MeV electrons). This distance was found to vary from approximately 6 mm for straight beam edges (i.e., all collimator leaves aligned) to approximately 2 mm from the tip of the leaves for a saw-tooth shaped beam edge. The over- and under-dosage in the joint between combined adjacent fields was found to be typically +/- 10% in small volumes. Improved clinical techniques using adjacent photon and electron fields with the same isocentre and source position (without moving the gantry) have been developed. For treatments of the breast, including the mammary chain, a uniform dose distribution was created with special attention given to the irradiation of the heart and lung outside the target volume. A method for head and neck treatments was optimised to give uniform dose distribution in the joint between the photon and electron fields and a method of treating the mediastinum, including the chest wall in front of the left lung, was analysed with respect to dose uniformity in the tumour and shielding of the lung.