Evidence map›Paper›PMID 40181766›Full record

ArticleMedical physics2025

Out-of-field neutron radiation from clinical proton, helium, carbon, and oxygen ion beams.

Matteo Bolzonella, Marco Caresana, Andrea Cirillo, Josep M Martí-Climent, Evangelina Martínez-Francés, Christina Mooshammer, Stefan Schmidt, Stephan Brons, Marco Silari, Christina Stengl and 2 more

Abstract read
In one paragraph

Article in Medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
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  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Matteo BolzonellaDepartment of Energy, Politecnico di Milano, Milan, Italy.ORCID https://orcid.org/0000-0001-7882-9060
Marco CaresanaDepartment of Energy, Politecnico di Milano, Milan, Italy.ORCID https://orcid.org/0000-0002-6860-7859
Andrea CirilloDepartment of Energy, Politecnico di Milano, Milan, Italy.ORCID https://orcid.org/0000-0001-9432-1734
Josep M Martí-ClimentMedical Physics and Radiation Protection Department, Clínica Universidad de Navarra, Pamplona, Spain.ORCID https://orcid.org/0000-0003-2020-8127
Evangelina Martínez-FrancésMedical Physics and Radiation Protection Department, Clínica Universidad de Navarra, Madrid, Spain.ORCID https://orcid.org/0009-0008-4254-9305
Christina MooshammerDepartment of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0009-0000-6581-9998
Stefan SchmidtDepartment of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0009-0008-0250-4145
Stephan BronsHeidelberg Ion Beam Therapy Center (HIT), Heidelberg University Hospital, Heidelberg, Germany.ORCID https://orcid.org/0000-0002-4695-0816
Marco SilariDepartment of Energy, Politecnico di Milano, Milan, Italy.ORCID https://orcid.org/0000-0001-8851-0950
Christina StenglDepartment of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0000-0003-0273-0878
Liliana StolarczykDanish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark.ORCID https://orcid.org/0000-0002-6333-3350
José VedelagoDepartment of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0000-0001-5510-9749

Funding

European Radiation Dosimetry GroupGerman Research Foundation 495217943
6 · The paper itself

Abstract

backgroundIn hadron therapy, out-of-field doses, which may in the long-term cause secondary cancers, are mostly due to neutrons. Very recently, PURPOSE: The focus of this article is to compare secondary neutron doses produced by clinical protons,

methodsAmbient dose equivalent, H*(10), measurements were performed, with five types of rem counters, of the neutron field produced by the four primary ions impinging on a water phantom. This experiment was performed at the Heidelberg Ion Beam Therapy Center (HIT) in the framework of the activities of the European Radiation Dosimetry Group (EURADOS). The experimental data are normalized to both unit primary particle and target dose, and are further compared to Monte Carlo (MC) simulations performed with the FLUKA and MCNP codes.

resultsThe intensity of the neutron field increases with ion mass, and the trend is more significant in the forward direction. The minimum H*(10) for all ions, 5µSv/Gy to 10µSv/Gy, was measured in the transverse and backward directions, whereas the maximum measured value was about 1.3 mSv/Gy for primary

conclusionThe four extended-range instruments provide reliable and consistent results, whereas the conventional rem counter underestimates H*(10) in a neutron field with a large high-energy component. FLUKA and MCNP provide consistent predictions, within a factor of 1.6 for the downstream position and lower differences in the other cases, and are in agreement with the experimental data. It was found that under certain conditions neutrons do not represent the only secondary radiation field to be monitored; the presence of charged particles affects the performance of moderator-type neutron detectors.

Indexed as

CarbonHeavy Ion RadiotherapyHeliumNeutronsOxygenProtonsProton TherapyMonte Carlo MethodRadiometryCarbonHeliumOxygenProtons

Identifiers

PMID40181766
PMCPMC12149714

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.