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Out-of-field dose in stereotactic radiotherapy for paediatric patients

机译：儿科患者立体定向放疗的现场外剂量

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Background and purpose Stereotactic radiotherapy combines image guidance and high precision delivery with small fields to deliver high doses per fraction in short treatment courses. In preparation for extension of these treatment techniques to paediatric patients we characterised and compared doses out-of-field in a paediatric anthropomorphic phantom for small flattened and flattening filter free (FFF) photon beams. Method and materials Dose measurements were taken in several organs and structures outside the primary field in an anthropomorphic phantom of a 5?year old child (CIRS) using thermoluminescence dosimetry (LiF:Mg,Cu,P). Out-of-field doses from a medical linear accelerator were assessed for 6?MV flattened and FFF beams of field sizes between 2?×?2 and 10?×?10?cm 2 . Results FFF beams resulted in reduced out-of-field doses for all field sizes when compared to flattened beams. Doses for FFF and flattened beams converged for all field sizes at larger distances (40?cm) from the central axis as leakage becomes the primary source of out-of-field dose. Rotating the collimator to place the MLC bank in the longitudinal axis of the patient was shown to reduce the peripheral doses measured by up to 50% in Varian linear accelerators. Conclusion Minimising out-of-field doses by using FFF beams and aligning the couch and collimator to provide tertiary shielding demonstrated advantages of small field, FFF treatments in a paediatric setting.
机译：背景和目的立体定向放射疗法将图像引导和高精度输送与小型田野相结合，以便在短处理课程中每小材分配高剂量。为了准备将这些处理技术延长到小儿患者中，我们表征和比较了小儿拟方向体模的剂量外，用于小扁平和平坦过滤器（FFF）光子束。使用热荧光剂量剂（LiF：Mg，Cu，P），在几个器官和主要场外的方法和材料中捕获剂量测量的多种器官和结构。评估来自医用线性加速器的场外剂量6？MV扁平和FFF梁的场尺寸在2？×2和10之间的FFF梁×10？cm 2之间。结果与扁平梁相比，FFF梁导致所有场尺寸减少外部剂量。用于FFF和扁平梁的剂量，从中央轴的较大距离（＆40Ωcm）处的所有场尺寸均匀，因为泄漏成为野外缺失剂量的主要源。旋转准直器将MLC组放置在患者的纵向轴上显示，在Varian线性加速器中减少了高达50％的外周剂量。结论通过使用FFF梁并对准沙发和准直器以提供三级屏蔽的小场，FFF处理在儿科环境中的优势，最小化现场使用野外剂量。

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