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Mobile shielding evaluation on the fetal dose during a breast radiotherapy using Monte Carlo simulation

Published:April 04, 2021DOI:https://doi.org/10.1016/j.ejmp.2021.03.023

      Highlights

      • Breast radiotherapy in a pregnant patient was simulated using MCNPX.
      • A third trimester pregnancy was simulated using a voxelized anthropomorphic phantom.
      • Two different types of mobile shieldings, based on AAPM models, were used.
      • The dose on the fetus depends on the shields, type of projection, and collimation.

      Abstract

      Purpose

      Evaluation of the out-of-field dose is an important aspect in radiotherapy. Due to the fetus radiosensitivity, this evaluation becomes even more conclusive when the patient is pregnant. In this work, a linear accelerator Varian Clinac 2100c operating at 6 MV, a pregnant anthropomorphic phantom (Maria), and different shields added above the abdominal region of the phantom were used for the analysis based on MCNPX. Methods: The simulations were performed for the medial and lateral projections, using either an open field collimation (10×16 cm2) or a multileaf collimator. The added shields (M1 and M2) were designed based on models proposed by Stovall et al. [

      Stovall M, Blackwell CR., Cundiff J., Novack DH, Palta JR., Wagner L K, Webster EW, Shalek RJ. Fetal dose from radiotherapy with photon beams: report of aapm radiation therapy committee task group no. 36. Med Phys 2016;39:7662-76. http://dx.doi.org/10.1118/1.597525.

      ], intending to reduce the deposited dose on the fetus and related structures. Results: The presence of the shields showed to be effective in reducing the doses on the fetus, amniotic sac, and placenta, for example. A reduction of about 43% was found in the dose on the fetus when M2 was added, using the open field collimation, in comparison with the situation with no shield, being the lateral projection the main responsible for the dose. The use of MLC significatively reduced the doses in different structures, including on the fetus and amniotic sac, for example, in comparison to the open field situation. A slight increment on the dose in organs such as the eyes, thyroid and brain was found in both collimation systems, due to the presence of the shields. The contribution of the leakage radiation from the tube head of the linear accelerator was found to be in the order of µGy, being reduced by the presence of the M2 shield. Conclusion: Using the shields showed to be an essential feature in order to reduce the dose not only on the fetus, but also in important structures responsible to its development.

      Keywords

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