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Comparison of 3DCRT and IMRT out-of-field doses in pediatric patients using Monte Carlo simulations with treatment planning system calculations and measurements

2022-08Journal article Open access
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dc.contributor.authorSá, Ana Cravo
dc.contributor.authorBarateiro, Andreia
dc.contributor.authorBednarz, Bryan P.
dc.contributor.authorAlmeida, Pedro
dc.contributor.authorVaz, Pedro
dc.contributor.authorMadaleno, Tiago
dc.date.accessioned2022-08-29T11:04:50Z
dc.date.available2022-08-29T11:04:50Z
dc.date.issued2022-08
dc.descriptionThis research was partially funded by Fundação para a Ciência e Tecnologia (FCT)/Portugal through the contract UIDB/04349/2020).pt_PT
dc.description.abstractPurpose: Out-of-field doses are given to healthy tissues, which may allow the development of second tumors. The use of IMRT in pediatric patients has been discussed, as it leads to a "bath" of low doses to large volumes of out-of-field organs and tissues. This study aims to compare out-of-field doses in pediatric patients comparing IMRT and 3DCRT techniques using measurements, Monte Carlo (MC) simulations, and treatment planning system (TPS) calculations. Materials and methods: A total dose of 54 Gy was prescribed to a PTV in the brain of a pediatric anthropomorphic phantom, for both techniques. To assess the out-of-field organ doses for both techniques, two treatment plans were performed with the 3DCRT and IMRT techniques in TPS. Measurements were carried out in a LINAC using a pediatric anthropomorphic phantom and thermoluminescent dosimeters to recreate the treatment plans, previously performed in the TPS. A computational model of a LINAC, the associated multileaf collimators, and a voxelized pediatric phantom implemented in the Monte Carlo N-Particle 6.1 computer program were also used to perform MC simulations of the out-of-field organ doses, for both techniques. Results: The results obtained by measurements and MC simulations indicate a significant increase in dose using the IMRT technique when compared to the 3DCRT technique. More specifically, measurements show higher doses with IMRT, namely, in the right eye (13,041 vs. 593 mGy), left eye (6,525 vs. 475 mGy), thyroid (79 vs. 70 mGy), right lung (37 vs. 28 mGy), left lung (27 vs. 20 mGy), and heart (31 vs. 25 mGy). The obtained results indicate that out-of-field doses can be seriously underestimated by TPS. Discussion: This study presents, for the first time, out-of-field dose measurements in a realistic scenario and calculations for IMRT, centered on a voxelized pediatric phantom and an MC model of a medical LINAC, including MLC with log file-based simulations. The results pinpoint significant discrepancies in out-of-field doses for the two techniques and are a cause of concern because TPS calculations cannot accurately predict such doses. The obtained doses may presumably increase the risk of the development of second tumors.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSá AC, Barateiro A, Bednarz BP, Almeida P, Vaz P, Madaleno T. Comparison of 3DCRT and IMRT out-of-field doses in pediatric patients using Monte Carlo simulations with treatment planning system calculations and measurements. Front Oncol. 2022;12:879167.pt_PT
dc.identifier.doi10.3389/fonc.2022.879167pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/14943
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontiers Mediapt_PT
dc.relation.publisherversionhttps://www.frontiersin.org/articles/10.3389/fonc.2022.879167/fullpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectRadiotherapypt_PT
dc.subject3DCRTpt_PT
dc.subjectIMRTpt_PT
dc.subjectMonte Carlo simulationspt_PT
dc.subjectComputational voxel phantomspt_PT
dc.subjectOut-of-field dosept_PT
dc.subjectPediatric tumorspt_PT
dc.subjectRadiotherapy planningpt_PT
dc.subjectFCT_UIDB/04349/2020pt_PT
dc.titleComparison of 3DCRT and IMRT out-of-field doses in pediatric patients using Monte Carlo simulations with treatment planning system calculations and measurementspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage879167pt_PT
oaire.citation.titleFrontiers in Oncologypt_PT
oaire.citation.volume12pt_PT
person.familyNameMorais Cravo de Sá
person.givenNameAna Maria
person.identifier.ciencia-id281E-62F9-4138
person.identifier.orcid0000-0002-1617-5193
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication945fd84c-3438-4df7-981c-9b70916ba612
relation.isAuthorOfPublication.latestForDiscovery945fd84c-3438-4df7-981c-9b70916ba612

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