The Influence of Air Cavity on Interface Doses for Photon Beams

X선치료 조사야 내 공동의 존재에 따른 선량분포의 측정

When a high energy photon beam is used to treat lesions located in the upper respiratory air passages or in maxillary sinus, the beams often must traverse an air cavity before it reaches the lesion. Because of this traversal of air, it is not clear that the surface layers of the lesion forming the air-tumor tissue interface will be in a state of near electronic equilibrium; if they are not, underdosing of these layers could result. Although dose corrections at large distances beyond an air cavity are accountable by attenuation differences, perturbations at air-tissue interfaces are complex to measure or calculate. This problem has been investigated for 4MV and 10MV X-ray beams which are becoming widely available for radiotherapy with linear accelerator. Markus chamber was used for measurement with variouse air cavity geometries in X-ray beams. Underdosing effects occur at both the distal and proximal air cavity interface. The magnitude depended on geometry, energy, field sizes and distance from the air-tissue interfaces. As the cavity thickness increased, the central axis dose at the distal interface decreased. Increasing field size remedied the underdosing, as did the introduction of lateral walls. Fellowing a $20{\times}2{\times}2\;cm^3$\;air\;cavity,\;4{\times}4\;cm\;field\;there\;was\;an\;11.5\%\;and\;13\%\;underdose\;at\;the\;distal\;interface,\;while\;a\;20{\times}20{\times}2\;cm^3\;air\;cavity\;yielded\;a\;24\%\;and\;29\%$ loss for the 4MV and 10MV beams, respectively. The losses were slightly larger for the 10MV beams. The measurements reported here can be used to guide the development of new calculation models under non-equilibrium conditions. This situation is of clinical concern when lesions such as larynx and maxillary carcinoma beyond air cavities are irradiated.