Design, implementation and validation of a motorized wedge filter for a telecobalt machine (Bhabhatron-II)

Radiotherapy in India: History, current scenario and proposed solutions

The history and current status of a biomedical discipline in a country or region provide important health system indicators. During the last one hundred years, radiotherapy has established its position as a vital specialty in cancer management. It has proved to be one of the most cost effective ways of treating cancer providing both radical and palliative treatments depending on patient stage and performance status. However, access to radiotherapy for cancer patients in India is limited by several factors including physical proximity of centre, cost and availability of required technology. This article gives an outline of the history, existing radiotherapy facilities and future trends related to radiotherapy practice in India.

FLUKA-BASED MONTE CARLO INVESTIGATION OF MICRODOSIMETRIC DISTRIBUTIONS OF TELECOBALT BEAM

FLUKA-based Monte Carlo calculations of microdosimetric distributions in water phantom involving a walled spherical Tissue-Equivalent Proportional Counter filled with tissue-equivalent propane gas have been studied for an indigenously developed telecobalt machine. The simulated site size considered in the study was 2 μm. In the Monte Carlo calculations, field size was varied from 10 cm × 10 cm to 35 cm × 35 cm and the depth was varied as 5-20 cm. The study also includes calculation of microdosimetric distributions with a 30° wedge filter. The efficiency of the calculations was improved up to a factor of 26 by choosing appropriate cut off values for production and transport of electrons. The calculated microdosimetric distributions of telecobalt machine is distinctly different from that of a bare 60Co source which is attributed to the influence of scattered photons from the machine head and the water phantom.

Radiation Oncology in India: Challenges and Opportunities

Rising cancer incidence and mortality in India emphasize the need to address the increasing burden of this disease and the stark inequities in access to radiotherapy and other essential medical treatments. State-of-the-art technology is available within the private sector and a few hospitals in the public sector, but 75% of patients in the public sector in India do not have access to timely radiotherapy. This inequity in access to radiotherapy in the public sector is amplified in rural areas, where most of India׳s population lives. A long-term government commitment to machine purchase and human resource development in the public sector is needed to improve access. A number of innovative initiatives to improve cancer treatment and access have emerged that could support such an investment. These include local production of equipment, twinning programs between institutions in high- and low-income countries to exchange knowledge and expertise, and nongovernmental and state-sponsored schemes to sponsor and support patients in their cancer journey. Strengthening of cancer registries and regulatory bodies with authority to enforce minimum standards is also required to improve care. The more uniform and frequent availability of high-quality radiotherapy can improve cancer outcomes and may be regarded as a marker of a comprehensive and equitable system of health care delivery.

Determination of an Effective Wedge Angle by Combination of Two Arbitrary Universal Wedge Fields in Radiation Therapy of Cancer Patients with Megavoltage Photon Beams

BACKGROUND

Wedge filters are commonly used in radiation oncology for eliminating hot spots and creating a uniform dose distribution in optimizing isodose curves in the target volume for clinical aspects. These are some limited standard physical wedges (15°, 30°, 45°, 60°),or creating an arbitrary wedge angle, like motorized wedge or dynamic wedge,... The new formulation is presented by the combination of wedge fields for determining an arbitrary effective wedge angles. The isodose curves also are derived for these wedges.

MATERIALS AND METHODS

we performed the dosimetry of Varian Clinac 2100C/D with Scanditronix Wellhofer water blue phantom, CU500E, OmniPro - Accept software and 0.13cc ionization chamber for 6Mv photon beam in depth of 10cm (reference depth) for universal physical wedges (15°, 30°, 45°, and 60°) and reference field 10x10cm2. By combining the isodose curve standard wedge fields with compatible weighting dose for each field, the effective isodose curve is calculated for any wedge angle.

RESULTS

The relation between a given effective wedge angle and the weighting of each combining wedge fields was derived. A good agreement was found between the measured and calculated wedge angles and the maximum deviation did not exceed 3°. The difference between the measured and calculated data decreased when the combined wedge angles were closer. The results are in agreement with the motorized single wedge appliance in the literature.

CONCLUSIONS

This technique showed that the effective wedge angle that is obtained from this method is adequate for clinical applications and the motorized wedge formalism is a special case of this consideration.