Evaluation of lead acrylic as a filter for contaminant electrons in megavoltage photon beams

Effects of beam spoiler on radiation dose for head and neck irradiation with 10-MV photon beam

PURPOSE

To determine the effects of a lucite beam spoiler on the dose distribution to points inside and outside the primary beam for head and neck irradiation with a 10-MV photon beam.

METHODS AND MATERIALS

Build-up and depth-dose measurements were performed with a parallel-plate ionization chamber for 5 x 5, 10 x 10, and 15 x 15-cm field sizes using lucite spoilers with two different thicknesses at two different lucite-to-skin distances (LSD) for a 10-MV x-ray beam. Corrections were applied to account for finite chamber size. Beam profiles and isodose curves were obtained at several depths using film dosimetry. Beam uniformity was determined from uniformity indices. Peripheral doses (PD) were measured at the surface and at 1.5- and 2.5-cm depths using film dosimetry and a parallel-plate ionization chamber. Measurement points were positioned at the edge of a 10 x 10-cm field and at distances extending to 5.0 cm away. The treatment planning data for the 10-MV x-ray beam were modified to account for the effects of the beam spoiler when treating head and neck patients.

RESULTS

The spoiler increased the surface and build-up dose and shifted the depth of maximum dose toward the surface. With a 10-MV x-ray beam and a 1.2-cm-thick lucite at 15 cm LSD, a build-up dose similar to a 6-MV x-ray beam was achieved. The beam uniformity was altered at shallow depths. The peripheral dose was enhanced particularly at the surface and at the points close to the beam edge. The effects of the beam spoiler on beam profile and PD were reduced with increasing depths.

CONCLUSION

The lucite spoiler allowed use of a 10-MV x-ray beam for head and neck treatment by yielding a build-up dose similar to that of a 6-MV x-ray beam while maintaining skin sparing. The increase in PD was at superficial depths and was reduced at points away from the edge; therefore, it is clinically nonsignificant. Spoiling the 10-MV x-ray beam resulted in treatment plans that maintained dose homogeneity without the consequence of increased skin reaction or treatment volume underdose for regions near the skin surface.

Effects of beam modifiers and immobilization devices on the dose in the build-up region

PURPOSE

To analyze the effect that immobilization devices used in conjunction with beam modifiers may have on the dose to the skin and build-up region.

METHODS AND MATERIALS

Central axis depth dose measurements were made in a polystyrene phantom in the build-up regions using the 6 and 15 MV photon beams, at two different source-to-phantom distances, and various field sizes. The effects of acrylic blocking trays, lead wedges, and cerrobend blocks were assessed in conjunction with the enhancement of dose in the build-up region due to immobilizing devices using plaster and thermoplastic casting materials of different thicknesses.

RESULTS

For the 6 MV photons, solid (3 mm) thermoplastic casting material was found to have the greatest effect on surface dose: for a 12 x 12 cm field we measured 79% of maximum dose when treating through the material versus 22% of maximum dose when no beam modifiers or immobilization devices are used. Measurements were also made to evaluate the effect of the immobilization of patients receiving three-dimensional conformal treatments using a 15 MV photon beam.

CONCLUSIONS

The relevance of these results to treatments in the pelvis, breast, and head and neck regions is discussed. For 6 MV beams, special consideration should be given if the need arises to treat through the immobilization device, as unacceptable skin reactions may result.