A simulation based dosimetric study for electron therapy during breast surgery

Document Type : Original Article

Authors

1 Department of Physics, University of Damghan, Damghan, Iran

2 Nuclear Fuel Cycle Research School, Nuclear Science and Technology Research Institute, Tehran, Iran

Abstract

Intraoperative electron radiotherapy (IOERT) is a relatively new method of direct ionizing radiation to the tumor or tumor bed during surgery. In order to properly treat the intended target, it is necessary to examine the radiation dose curves and the shield used to protect healthy tissues and organs. In particular, radiation therapy during breast surgery requires the protection of critical tissues within the field and underlying the target volume such as the heart and lungs. In this case, a thin layer of high-Z material is placed between the treated (breast) tissue and the underlying vital tissue. The breast, lung, and radiation shield were geometrically considered as three coaxial cylinders. Using the MCNPX code, breast tissue, shield, and lung were irradiated with 6, 9, and 12 MeV electrons. The flux and dose of electrons and secondary photons in different tissues were calculated. Investigations showed that for 6 MeV electrons, the use of shielding has a negligible effect on the amount of dose received by the tissues around the breast. At energies of 9 and 12 MeV, Al-Pb shielding and St-PMMA shielding have almost the same performance in reducing the amount of dose received by the tissues around the breast. At the energy of 18 MeV, the Al-Pb shielding has a better performance than the St-PMMA shielding in reducing the dose received by the organs adjacent to the breast tissue.

Keywords


  1. C. G. Willett, B. G. Czito, D. S. Tyler. Intraoperative radiation therapy. J. Clin. Oncology 25 (8) (2007) 971-977.
  2. J. R. Palta, P. J. Biggs, J. D. Hazle, M. S. Huq, R. A. Dahl, T. G. Ochran, J. Soen, R. R. Dobelbower, E. C. McCullough. Intraoperative electron beam radiation therapy: technique, dosimetry, and dose specification: report of task force 48 of the Radiation Therapy Committee, American Association of Physicists in Medicine. Int. J. Radiat. Oncology Biol. Phys. 33 (3) (1995) 725-746.
  3. A. Soriani, G. Felici, M. Fantini, M. Paolucci, O. Borla, G. Evangelisti, M. Benassi, L. Strigari. Radiation protection measurements around a 12 MeV mobile dedicated IORT accelerator. Medical Physics 37 (3) (2010) 995-1003.
  4. A. Esposito, T. Sakellaris, P. Limede, F. Costa, L. T. Cunha, A. G. Dias, J. Lencart, S. Sarmento, C. C. Rosa. Effects of shielding on pelvic and abdominal IORT dose distributions. Phys. Med.11 (2016) 1397-1404.
  5. S. Darby, P. McGale, C. Correa, C. Taylor, R. Arriagada, M. Clarke, D. Cutter, C. Davies, M. Ewertz, J. Godwin, R. Gray, L. Pierce, T. Whelan, Y. Wang, R. Peto. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15- year breast cancer death: meta-analysis of individual patient data for 10, 801 women in 17 randomised trials. Lancet. 378 (9804) (2011) 1707-1716.
  6. P. McGale, C. Taylor, C. Correa, D. Cutter, F. Duane, M. Ewertz, R. GrayG. MannuR. PetoT. WhelanY. WangZ. WangS. Darby. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet. 383 (9935) (2014) 2127-2135.
  7. CRP, Adult Reference Computational Phantoms. ICRP Publication 110. Ann. ICRP 39 (2) (2009).
  8. A. Martignano, L. Menegotti, A. Valentini. Monte Carlo investigation of breast intraoperative radiation therapy with metal attenuator plates. Med. Phys. 34 (2007) 4578-4584.