Volume 22 (2016): Edizione 1 (March 2016)

The aim of the study was to investigate the influence of thermoplastic masks material (Klarity Medical&Equipment Co., Guangzhou, China) with different diameters of holes (ϕ 0.25 cm and ϕ 0.40 cm) on the dose distribution in the build-up region for photon beams. Measurements were made for external radiation beams produced by the linear accelerator (TrueBeam, Varian Medical Systems, Inc., Palo Alto, CA, USA) using the Markus parallel plane ionization chamber and the Unidos electrometer (both from PTW, Freiburg, Germany). Measurements were made in a solid water phantom for two photon energies 6 MV and 15 MV, at 90 cm source to skin distance, for four fields of 5 cm × 5 cm, 10 cm × 10 cm, 15 cm × 15 cm and 20 cm × 20 cm. Compared to the open field, the maximum dose with mask was closer to the surface of the phantom by about 1.4 mm and 1.2 mm for 6 MV and 15 MV X-Rays, respectively. The surface dose increase from 10% to 42% for 6 MV and from 5% to 28% for 15 MV X-Rays.

The use of a dual electron multileaf collimator (eMLC) to collimate therapeutic electron beam without the use of cutouts has been previously shown to be feasible. Further Monte Carlo simulations were performed in this study to verify the nature and appearance of the isodose distribution in water phantom of irregular electron beams delivered by the eMLC. Electron fields used in this study were selected to reflect those used in electron beam therapy. Results of this study show that the isodose distribution in a water phantom obtained from the simulation of irregular electron beams through the eMLC conforms to the pattern of the eMLC used in the delivery of the beam. It is therefore concluded that the dual eMLC could deliver isodose distributions reflecting the pattern of the eMLC field that was used in the delivery of the beam.

Background: The paper shows the methodology of an in-phantom study of the protection level of the bone marrow in patients with cervical or endometrial cancer for three radiotherapy techniques: three-dimensional conformal radiotherapy, intensity modulated radiotherapy, and volumetric modulated arc therapy, preceded by the procedures of image guidance.

Methods/Design: The dosimetric evaluation of the doses will be performed in an in-house multi-element anthropomorphic phantom of the female pelvic area created by three-dimensional printing technology. The volume and position of the structures will be regulated according to the guidelines from the Bayesian network. The input data for the learning procedure of the model will be obtained from the retrospective analysis of imaging data obtained for 96 patients with endometrial cancer or cervical cancer treated with radiotherapy in our centre in 2008-2013. Three anatomical representations of the phantom simulating three independent clinical cases will be chosen. Five alternative treatment plans (1 × three-dimensional conformal radiotherapy, 2 × intensity modulated radiotherapy and 2 × volumetric modulated arc therapy) will be created for each representation. To simulate image-guided radiotherapy, ten specific recombinations will be designated, for each anatomical representation separately, reflecting possible changes in the volume and position of the phantom components.

Discussion: The comparative analysis of planned measurements will identify discrepancies between calculated doses and doses that were measured in the phantom. Finally, differences between the doses cumulated in the hip plates performed by different techniques simulating the gynaecological patients' irradiation of dose delivery will be established. The results of this study will form the basis of the prospective clinical trial that will be designed for the assessment of hematologic toxicity and its correlation with the doses cumulated in the hip plates, for gynaecologic patients undergoing radiation therapy.