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
Keywords
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Subscribe to Physica Medica: European Journal of Medical PhysicsReferences
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.
WORLD HEALTH ORGANIZATION. Cancer. 2018. Avaliable in: https://www.who.int/health-topics/cancer#tab=tab_1. Access em: 11 jun. 2020.
INSTITUTO NACIONAL DE CÂNCER (National Cancer Institute). Estatísticas de câncer. 2020. Avaliable in:https://www.inca.gov.br/numeros-de-cancer. Access in: 14 set. 2020 [in portuguese].
AMERICAN CANCER SOCIETY. How Common Is Breast Cancer? 2020. Avaliable in: https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html. Access in: 11 set. 2020.
- Chemotherapy against cancer during pregnancy: A systematic review on neonatal outcomes.Med (United States). 2016; 95: 1-6https://doi.org/10.1097/MD.0000000000004899
ICRP Publication 90. Biological Effects after Prenatal Irradiation (Embryo and Fetus). Annals of ICRP. 2003;33;1-2.
ICRP publication 103: The 2007 Recommendations of the International Commission on Radiological Protection. Annals of the ICRP. 2007;37:2-4.
- Threshold for radiation-related severe mental retardation in prenatally exposed A-bomb survivors: a re-analysis.Int J Radiat Biol. 1996; 70: 755-763https://doi.org/10.1080/095530096144644
- Radiotherapy during pregnancy: fact and fiction.Lancet Oncol. 2005; 6: 328-333https://doi.org/10.1016/S1470-2045(05)70169-8
- Fetal dose evaluation during breast cancer radiotherapy.Int J Radiat Oncol Biol Phys. 1998; 40: 995-999https://doi.org/10.1016/S0360-3016(97)00909-7
- Revisiting fetal dose during radiation therapy: evaluating treatment techniques and a custom shield.J Appl Clin Med Phys. 2016; 17: 34-46https://doi.org/10.1120/jacmp.v17i5.6135
- Radiotherapy during pregnancy for clinical stages IA-IIA Hodgkin’s disease.Int J Radiat Oncol Biol Phys. 1992; 23: 407-412https://doi.org/10.1016/0360-3016(92)90761-6
- Radiotherapy for supradiaphragmatic Hodgkin’s disease: Determination of the proper fetal shielding conditions using Monte Carlo methodology.Phys Med. 2011; 27: 181-187https://doi.org/10.1016/j.ejmp.2010.12.004
- Dose assessment for the fetus considering scattered and secondary radiation from photon and proton therapy when treating a brain tumor of the mother.Phys Med Biol. 2016; 61: 683-695https://doi.org/10.1088/0031-9155/61/2/683
- Monte Carlo simulation of radiotherapy for breast cancer in pregnant patients: how to reduce the radiation dose and risks to fetus?.Radiat Prot Dosim. 2017; 175: 10-16https://doi.org/10.1093/rpd/ncw260
- A feasibility study to calculate unshielded fetal doses to pregnant patients in 6-MV photon treatments using Monte Carlo methods and anatomically realistic phantoms.Med Phys. 2008; 35: 3054-3061
- Evaluating out-of-field doses during radiotherapy of paediatric brain tumours using lead shielding and flattening-filter free beams.Phys Med. 2019; 60: 1-6https://doi.org/10.1016/j.ejmp.2019.03.008
- AAPM TG 158: Measurement and calculation of doses outside the treated volume from external-beam radiation therapy.Med Phys. 2017; 44: e391-e429https://doi.org/10.1002/mp.2017.44.issue-1010.1002/mp.12462
- Monte Carlo modeling of a 6 and 18 MV Varian Clinac medical accelerator for in-field and out-of-field dose calculations: Development and validation.Phys Med Biol. 2009; 54: N43-N57https://doi.org/10.1088/0031-9155/54/4/N01
Pelowitz, D. B. MCNPX User‘s Manual, version 2.7.0. Report LA-CP-11-00438. Los Alamos National Laboratory, 2011. AAPM Task Group 36, 1994. Fetal Dose from Radiotherapy with Photon Beams.
Sheikh-Bagheri D, Rogers DWO. Monte Carlo calculation of nine megavoltage photon beam spectra using the BEAM code. Med Phys 2002;29:391–402. https://doi.org/10.1118/1.1445413.
- 89: Basic anatomical and physiological data for use in radiological protection: reference values.Annals of ICRP. 2002; 32: 1-277
Cabral MOM, Vieira JW, Leal Neto V, Andrade Lima FR de. Development of a pregnant woman phantom using polygonal mesh, for dosimetric evaluations. Brazilian J Radiat Sci 2015;3:1–11. https://doi.org/10.15392/bjrs.v3i1a.127.
- Fetal weight normograms for singleton pregnancies in a Jordanian population.Ann Saudi Med. 2010; 30: 134-140https://doi.org/10.4103/0256-4947.60519
- Calculation of organ doses from breast cancer radiotherapy: a monte carlo study.J Appl Clin Med Phys. 2013; 14: 133-146https://doi.org/10.1120/jacmp.v14i1.4029
- A Monte Carlo model for calculating out-of-field dose from a Varian 6 MV beam.Med Phys. 2006; 33: 4405-4413
- Evaluation of the accuracy of fetal dose estimates using TG-36 data.Med Phys. 2007; 34: 1193-1197https://doi.org/10.1118/1.2710332
- Assessment of out-of-field doses in radiotherapy treatments of paediatric patients using Monte Carlo methods and measurements.Phys Med. 2020; 71: 53-61https://doi.org/10.1016/j.ejmp.2020.02.008
- A study of the shielding used to reduce leakage and scattered radiation to the fetus in a pregnant patient treated with a 6-MV external x-ray beam.Health Phys. 2009; 97: 581-589https://doi.org/10.1097/01.HP.0000363838.70546.4c
ICRP PUBLICATION 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs : threshold doses for tissue reactions in a radiation protection context. Annals of the ICRP.
- Clinical implementation of intensity-modulated tangential beam irradiation for breast cancer.Med Phys. 2004; 31: 1023-1031https://doi.org/10.1118/1.1690195
Majer M, Stolarczyk L, De Saint-Hubert M, Kabat D, Knežević Ž, Miljanić S, et al. Out-of-field dose measurements for 3D conformal and intensity modulated radiotherapy of a paediatric brain tumour. Radiat Prot Dosimetry 2017;176:331–40. https://doi.org/10.1093/rpd/ncx015.
- IMRT in a Pregnant Patient: How to Reduce the Fetal Dose?.Med Dosim. 2009; 34: 301-310https://doi.org/10.1016/j.meddos.2008.11.003