ArticleJournal of applied clinical medical physics2021
Out-of-field doses from radiotherapy using photon beams: A comparative study for a pediatric renal treatment.
Article in Journal of applied clinical medical physics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Assessment of out-of-field doses in pediatric radiotherapy.Radiological physics and technology · 2026Article
- Investigation of the effect of planning techniques on thyroid and lens absorbe doses in radiotherapy of left breast cancer by in vivo dosimetry: a prospective study.Physical and engineering sciences in medicine · 2026Article
- A comprehensive Study of the Out of Field Non Target Dose Associated with 6 and 10 MV Flattened and Flattening Filter Free X Ray Beam in a True Beam Linear Accelerator.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Accuracy and reliability of a commercial treatment planning system in nontarget regions in modern prostate radiotherapy.Journal of applied clinical medical physics · 2023Article
- Analytical models for external photon beam radiotherapy out-of-field dose calculation: a scoping review.Frontiers in oncology · 2023Article
- Influence of Specific Treatment Parameters on Nontarget and Out-of-Field Doses in a Phantom Model of Prostate SBRT with CyberKnife and TrueBeam.Life (Basel, Switzerland) · 2022Article
- Development of a quasi-humanoid phantom to perform dosimetric and radiobiological measurements for out-of-field doses from external beam radiation therapy.Journal of applied clinical medical physics · 2022Article
- Comparison of 3DCRT and IMRT out-of-field doses in pediatric patients using Monte Carlo simulations with treatment planning system calculations and measurements.Frontiers in oncology · 2022Article
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Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFirst, this experimental study aims at comparing out-of-field doses delivered by three radiotherapy techniques (3DCRT, VMAT (two different accelerators), and tomotherapy) for a pediatric renal treatment. Secondly, the accuracy of treatment planning systems (TPS) for out-of-field calculation is evaluated.
methodsEBT3 films were positioned in pediatric phantoms (5 and 10 yr old). They were irradiated according to four plans: 3DCRT (Clinac 2100CS, Varian), VMAT (Clinac 2100CS and Halcyon, Varian), and tomotherapy for a same target volume. 3D dose determination was performed with an in-house Matlab tool using linear interpolation of film measurements. 1D and 3D comparisons were made between techniques. Finally, measurements were compared to the Eclipse (Varian) and Tomotherapy (Accuray) TPS calculations.
resultsAdvanced radiotherapy techniques (VMATs and tomotherapy) deliver higher out-of-field doses compared to 3DCRT due to increased beam-on time triggered by intensity modulation. Differences increase with distance to target and reach a factor of 3 between VMAT and 3DCRT. Besides, tomotherapy delivers lower doses than VMAT: although tomotherapy beam-on time is higher than in VMAT, the additional shielding of the Hi-Art system reduces out-of-field doses. The latest generation Halcyon system proves to deliver lower peripheral doses than conventional accelerators. Regarding TPS calculation, tomotherapy proves to be suitable for out-of-field dose determination up to 30 cm from field edge whereas Eclipse (AAA and AXB) largely underestimates those doses.
conclusionThis study shows that the high dose conformation allowed by advanced radiotherapy is done at the cost of higher peripheral doses. In the context of treatment-related risk estimation, the consequence of this increase might be significative. Modern systems require adapted head shielding and a particular attention has to be taken regarding on-board imaging dose. Finally, TPS advanced dose calculation algorithms do not certify dose accuracy beyond field edges, and thus, those doses are not suitable for risk assessment.
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