Neutron dose in and out of 18MV photon fields.

In radiation therapy, neutron contamination is an undesirable side effect of using high energy photons to treat patients. Neutron contamination requires adjustments to the shielding requirements of the linear accelerator vault and contributes to the risk of secondary malignancies in patients by delivering dose outside of the primary treatment field. Using MCNPX, an established Monte Carlo code, manufacturer blueprints, and the most up to date ICRP neutron dose conversion factors, the neutron spectra, neutron/photon dose ratio, and the neutron capture gamma ray dose were calculated at different depths and off axis distances in a tissue equivalent phantom. Results demonstrated that the neutron spectra and dose are dependent on field size, depth in the phantom, and off-axis distance. Simulations showed that because of the low neutron absorption cross section of the linear accelerator head materials, the contribution to overall patient dose from neutrons can be up to 1000 times the photon dose out of the treatment field and is also dependent on field size and depth. Beyond 45cm off-axis, the dependence of the neutron dose on field size is minimal. Neutron capture gamma ray dose is also field size dependent and is at a maximum at a depth of about 7cm. It is important to remember that when treating with high energy photons, the dose from contamination neutrons must be considered as it is much greater than the photon dose.

The effect of energy spectrum change on DNA damage in and out of field in 10-MV clinical photon beams.

The aim of this study was to quantify the DNA damage induced in a clinical megavoltage photon beam at various depths in and out of the field. MCNPX was used to simulate 10 × 10 and 20 × 20 cm(2) 10-MV photon beams from a clinical linear accelerator. Photon and electron spectra were collected in a water phantom at depths of 2.5, 12.5 and 22.5 cm on the central axis and at off-axis points out to 10 cm. These spectra were used as an input to a validated microdosimetric Monte Carlo code, MCDS, to calculate the RBE of induced DSB in DNA at points in and out of the primary radiation field at three depths. There was an observable difference in the energy spectra for photons and electrons for points in the primary radiation field and those points out of field. In the out-of-field region, the mean energy for the photon and electron spectra decreased by a factor of about six and three from the in-field mean energy, respectively. Despite the differences in spectra and mean energy, the change in RBE was <1 % from the in-field region to the out-of-field region at any depth. There was no significant change in RBE regardless of the location in the phantom. Although there are differences in both the photon and electron spectra, these changes do not correlate with a change in RBE in a clinical MV photon beam as the electron spectra are dominated by electrons with energies >20 keV.