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EVALUATION OF SECONDARY DOSE AND CANCER RISK FOR OUT-OF-FIELD ORGAN IN ESOPHAGEAL CANCER IMRT IN A CHINESE HOSPITAL USING ATOM PHANTOM MEASUREMENTS.

Abstract：

:There have been few studies on the secondary cancer after radiation treatment in Chinese hospitals. This study has measured out-of-field absorbed organ doses from intensity-modulated radiation therapy (IMRT) radiotherapy for esophageal cancer in a Chinese hospital and evaluated the risks of secondary cancer. The dose measurements were based on the thermo-luminescence dosemeter (TLD) and the ATOM® phantom, which represents an adult male. Over 100 TLD chips were placed in 35 different organ sites and one group of the same TLDs was set as background contrast. All TLDs were calibrated against the same Linac accelerator performing an IMRT plan for esophageal cancer. The measured doses were used to calculate the secondary cancer risks according to biological effects of ionizing radiation (BEIR) VII methodology. The baseline risks and survival data were based on relevant statistics for the Chinese population. It is found that the out-of-field organ doses depended greatly on the distance between organ sites and the target isocenter. The organ doses decreased exponentially as the distance from the target isocenter increased, and, for distances <15 cm, the organ doses fell off more rapidly and almost decreased by 99.55%. When compared with the calculation results by the Pinnacle treatment planning system (TPS), most of the out-of-field organ doses were underestimated in the TPS and the percentage of underestimation reached 100% for distant organs such as the bladder, prostate and testis. These trends are due to a known fact that out-of-field organs received secondary radiation resulted from patients and collimator scattering as well as leakage in the gantry head. The higher lifetime attribute risks (LARs) per 100 000 population were in the lower esophagus (186) and lungs (93.2) near the target. But all LARs of considered organs were found to be less than the baseline cancer risks. Results in this article can help to provide a database about the effect of radiotherapy-induced secondary cancer incidence during esophageal cancer treatment in China.

journal_name

Radiat Prot Dosimetry

journal_title

Radiation protection dosimetry

authors

Qi Y,He L,Wang Z,Liu Y,Liu H,Huo W,Xu XG,Chen Z

doi

10.1093/rpd/ncx057

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

389-396

issue

eissn

0144-8420

issn

1742-3406

pii

3792450

journal_volume

177

pub_type

杂志文章

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EVALUATION OF SECONDARY DOSE AND CANCER RISK FOR OUT-OF-FIELD ORGAN IN ESOPHAGEAL CANCER IMRT IN A CHINESE HOSPITAL USING ATOM PHANTOM MEASUREMENTS.