• Proceedings of the Korean Society of Medical Physics Conference
• /
• 2003.09a
• /
• pp.56-56
• /
• 2003

For the treatment of superficial tumors like squamous cell carcinoma of the head and neck, 6 MV photon beam is not appropriate and a spoiler is widely used to increase dose in the buildup region, while preserving the skin sparing effect. However, commercially available treatment planning systems assume a normal unspoiled beam, thereby cannot predict the buildup dose with spoiler accurately. We aimed to implement a Monte Carlo (MC) based planning system to apply it to the radiation treatment of head and neck. Lucite with thickness of 10-mm was used for the beam spoiler with Siemens Primus 6 MV photon beam. BEAM/DOSXYZ MC system was employed to model the linac and the spoiler. To verify the calculation accuracy of MC simulations, the percent depth doses (PDDs) and profiles with and without spoiler were measured using a parallel-plate chamber. For the MC based planning, we adopted a hybrid interface system between Pinnacle (Philips, USA) and BEAM/DOSXYZ to support treatment parameters of Siemens linac and the spoiler. The measurements of PDDs and profiles agreed with the corresponding MC simulations within 2% (lSD), which demonstrate the reliability of our MC simulations. The spoiler generated electrons make a contribution to the absorbed dose up to depth of 2cm, which shows that the dominant source of increased dose from spoiler system is the contaminating electrons created by the spoiler. The whole procedures necessary for MC based treatment planning were performed seamlessly between Pinnacle and BEAM/DOSXYZ system. This ability helps to increase the clinical efficiency of the spoiler technique. In conclusion, we implemented a MC based treatment planning system for a 6 MV photon beam with a spoiler. We demonstrate sophisticated MC technique makes it possible to predict dose distributions around buildup region accurately.

• The Journal of Korean Society for Radiation Therapy
• /
• v.18 no.1
• /
• pp.21-28
• /
• 2006

Purpose: The purpose of this study is to find a optimal beam spoiler condition on the dose distribution near the surface, when treating a squamous cell carcinoma of the head and neck and a lymphatic region with 10 MV photon beam. The use of a optimal spoiler allows elivering high dose to a superficial tumor volume, while maintaining the skin-sparing effect in the area between the surface to the depth of 0.4 cm. Materials and Methods: The lucite beam spoiler, which were a tissue equivalent, were made and placed between the surface and the photon collimators of linear accelerator. The surface-dose, the dose at the depth of 0.4 cm, and the maximum dose at the dmax were measured with a parallel-plate ionization chamber for $5{\times}5cm\;to\;30{\times}30cm^2$ field sizes using lucite spoilers with different thicknesses at varying skin-to-spoiler separation (SSS). In the same condition, the dose was measured with bolus and compared with beam spoiler. Results: The spoiler increased the surface and build-up dose and shifted the depth of maximum dose toward the surface. With a 10 MV x-ray beam and a optimal beam spoiler when treating a patient, a similer build-up dose with a 6 MV photon beam could be achieved, while maintaining a certain amount of skin spring. But it was provided higher surface dose under SSS of less than 5 cm, the spoiler thickness of more than 1.8 cm or more, and larger field size than $20{\times}20cm^2$ provided higher surface dose like bolus and obliterated the spin-sparing effect. the effects of the beam spoiler on beam profile was reduced with increasing depths. Conclusion: The lucite spoiler allowed using of a 10 MV photon beam for the radiation treatment of head and neck caner by yielding secondary scattered electron on the surface. The dose at superficial depth was increased and the depth of maximum dose was moved to near the skin surface. Spoiling the 10 MV x-ray beam resulted in treatment plans that maintained dose homogeneity without the consequence of increased skin reaction or treat volume underdose for regions near the skin surface. In this, the optimal spoiler thickeness of 1.2 cm and 1.8 cm were found at SSS of 7 cm for $10{\times}10cm^2$ field. The surface doses were measured 60% and 64% respectively. In addition, It showed so optimal that 94% and 94% at the depth of 0.4 cm and dmax respectively.

• The Journal of Korean Society for Radiation Therapy
• /
• v.19 no.1
• /
• pp.51-54
• /
• 2007

Purpose: Total body irradiation is used to kill the total malignant cell and for immunosuppression component of preparatory regimens for bone-marrow restitution of patients. Beam spoiler is used to increase the dose to the superficial tissues. This paper finds the property of the distance between beam spoiler and patient. Materials and Methods: Set-up conditions are 6 MV-Xray, 300 MU, SAD = 400 cm, field size = $40{\times}40cm^2$. The parallel plate chamber located in surface, midpoint and exit of solid water phantom. The surface dose is measured while the distance between beam spoiler and patient is altered. Because it should be found proper distance. The solid water phantom is fixer and beam spoiler is moving. Results: Central dose of phantom is 10.7 cGy and exit dose is 6.7 cGy. In case of distance of 50 cm to 60 cm between beam spoiler and solid water phantom, incidence dose is $14.58{\sim}14.92cGy$. Therefore, The surface dose was measured $99.4{\sim}101%$ with got near most to the prescription dose. Conclusion: In clinical case, distance between beam spoiler and patient affect surface dose. If once $50{\sim}60cm$ of distance between beam spoiler and patient, surface dose of patient got near prescription dose. It would be taken distance between beam spoiler and patient into account in clinical therapy.

• Journal of Radiation Protection and Research
• /
• v.36 no.3
• /
• pp.160-167
• /
• 2011

This study conducts cross-comparison through verification of treatment planning of using beam spoiler and bolus, according to the dose variation of different tumor bed and metastatic lymph node cancers, against ionization and optically stimulated luminescence detectors(OSLDs), in head and neck radiotherapy. Verification of treatment planning examined the feasibility of inserting detectors through simulated solid dry water slabs under identical irradiated conditions from treatment planning system to measure beam spoiler and 0.5, 1 cm bolus. In addition, two detectors were cross-compared for verification of treatment planning accuracy and reliability within ${\pm}$2%. The study found that, given a beam spoiler thickness of 0.5 cm and beam spoiler-to-skin distance of 10 cm subjected to optimal dose distribution given for metastatic lymph node cancers, the bolus low-level skin dose was less, and the tumor bed dose reduced slightly. Additionally, two detectors were cross-compared for accuracy within ${\pm}$1%. Accordingly, The use of beam spoiler was determined that reduces skin side effects and can deliver an optimal dose distribution for tumor, and to apply to future clinical studies should be performed.

• Journal of radiological science and technology
• /
• v.41 no.2
• /
• pp.141-148
• /
• 2018

This study examined the properties of photons and the dose distribution in a human body via a simulation where the total body irradiation(TBI) is performed on a pediatric anthropomorphic phantom and a child size water phantom. Based on this, we tried to find the optimal photon beam energy and material for beam spoiler. In this study, MCNPX (Ver. 2.5.0), a simulation program based on the Monte Carlo method, was used for the photon beam analysis and TBI simulation. Several different beam spoiler materials (plexiglass, copper, lead, aluminium) were used, and three different electron beam energies were used in the simulated accelerator to produce photon beams (6, 10, and 15 MeV). Moreover, both a water phantom for calculating the depth-dependent dosage and a pediatric anthropomorphic phantom for calculating the organ dosage were used. The homogeneity of photon beam was examined in different depths for the water phantom, which shows the 20%-40% difference for each material. Next, the org an doses on pediatric anthropomorphic phantom were examined, and the results showed that the average dose for each part of the body was skin 17.7 Gy, sexual gland 15.2 Gy, digestion 13.8 Gy, liver 11.8 Gy, kidney 9.2 Gy, lungs 6.2 Gy, and brain 4.6 Gy. Moreover, as for the organ doses according to materials, the highest dose was observed in lead while the lowest was observed in plexiglass. Plexiglass in current use is considered the most suitable material, and a 6 or 10 MV photon energy plan tailored to the patient condition is considered more suitable than a higher energy plan.

• Journal of the Korean Society of Radiology
• /
• v.8 no.5
• /
• pp.265-269
• /
• 2014

The therapy of total body irradiation on leukemia carries out to kill harmful bacteria or suppression of immune system by external beam therapy, which is a preparatory stage to reconstitute bone marrow before a pre-treatment of bone marrow transplantation to patients with health bone marrow cells. In case of this kind of radiation therapy, the spoiler use to increase surface dose of patient which varies depending on distance and thickness between patient and spoiler. In this study, the change was investigated the surface dose according to thickness of spoiler. The 0.5% increase of surface dose was observed with each 2.0 cm when the spioler in acrylic was prepared from 0.5 cm to 3.0 cm at intervals of 0.5 cm was evaluated. Based on this result, it suggests that this kind of application will be somewhat limited on clinical trials directly but proper surface dose can be useful method when is applied on patients of treatment prognosis who are required each different surface dose.

• Radiation Oncology Journal
• /
• v.12 no.2
• /
• pp.225-232
• /
• 1994

Purpose : This study was to obtain the basic dosimetric data using the 10 MV X-ray for the total body irradiation. Materials and Methods : A linear accelerator photon beam is planned to be used as a radiation source for total body irradiation (TBI) in Chonnam University Hospital. The planned distance from the target to the midplane of a patient is 360cm and the maximum geometric field size is 144cm x 144cm. Polystyrene phantom sized $30{\times}30{\times}30.2cm^3$ and consisted of several sheets with various thickness, and a parallel plate ionization chamber were used to measure surface dose and percent depth dose (PDD) at 345cm SSD, and dose profiles. To evaluate whether a beam modifier is necessary for TBI, dosimetry in build up region was made first with no modifier and next with an 1cm thick acryl plate 20cm far from the polystyrene phantom surface. For a fixed sourec-chamber distance, output factors were measured for various depth. Results : As any beam modifier was not on the way of radiation of 10MV X-ray, the $d_{max}$ and surface dose was 1.8cm and $61\%$, respectively, for 345cm SSD. When an 1cm thick acryl plate was put 20cm far from polystyrene phantom for the SSD, the $d_{max}$ and surface dose were 0.8cm and $94\%$, respectively. With acryl as a beam spoiler, the PDD at 10cm depth was $78.4\%$ and exit dose was a little higher than expected dose at interface of exit surface. For two-opposing fields for a 30cm phantom thick phantom, the surface dose and maximum dose relative to mid-depth dose in our experiments were $102.5\%$ and $106.3\%$, respectively. The off-axis distance of that point of $95\%$ of beam axis dose were 70cm on principal axis and 80cm on diagonal axis. Conclusion: 1. To increase surface dose for TBI by 10MV X-ray at 360cm SAD, 1cm thick acrylic spoiler was sufficient when distance from phantom surface to spoiler was 20cm. 2. At 345cm SSD, 10MV X-ray beam of full field produced a satisfiable dose uniformity for TBI within $7\%$ in the phantom of 30cm thickness by two-opposing irradiation technique. 3. The uniform dose distribution region was 67cm on principal axis of the beam and 80cm on diagonal axis from beam axis. 4. The output factors at mid-point of various thickness revealed linear relation with depth, and it could be applicable to practical TBI.

• The Journal of Korean Society for Radiation Therapy
• /
• v.9 no.1
• /
• pp.87-93
• /
• 1997

The using of compensator is required to adjust the irregular dose distribution due to irregular thickness of the body in Total Body Irradiation. Aluminuim, copper or lead is generally used as compensator. In our study, we would like to introduce a result of the attenuation and compensation effect of radiation use compensator made by duralumin and its clinical use. The thickness of compensator was calculated by the attenustion of radiation, which was measured by polystyrene phantom and ionization chamber(farmer). The compensation effect of radiation was measured by diode detector. All of conditions were set as in real treatment, and the distanc from source to detector was 446 cm. We also made fixation of device to easily attach the compensator to LINAC. Beam spoiler was menufactured and placed on the patient to irradiate sufficient dose to the skin. diode detector were placed on head, neck, chest, umbilicus. pelvis and knee with each their entranced exit points, and datas of dose distribution were evaluated and compared in each points for eleven patients(Feb. 96-Feb. 97). The attenuation rate of irradiation by duralumin compensator was measured as $1.4\%$ in 2mm thickness. The mean attenuation rate was $1.3\%$ per 2mm as increasing the thickness gradually to 50 mm. By using duralunim compensator, dose distribution in each points of body was measured with ${\pm}2.8\%$ by diode detectior. We could easily calculate the thickness of compensator by measuring the attenuation rate of radiation, remarkably reduce the irragularity of dose distribution duo to the thickness of body and magnify the effect of radiation therapy.

• Progress in Medical Physics
• /
• v.16 no.3
• /
• pp.130-137
• /
• 2005

In total body irradiation (T81) for leukemia, we have a two methode. One is a AP (anterior-posterior) method and the other is a Lateral methode. Our hospital used lateral methode. T81 must consider about body contour, because of homogeneous dose distribution. For compensation about irregular body contour, we use compensator. For T81 treatment, we must be considered, accurate manufacture of compensator and accurate calculation of dose. We developed the automatic program for T81. This program accomplished for compensator design and dose calculation for irregular body. This program was developed for uses to use in a windows environment using the IDL language. In this program, it use energy data for each energy: TMR, output factor, inverse square law, spoiler, field size factor. This program reduces the error to happen due to the manual. As a development of program, we could decrease the time of treatment plan and care the patient accurately.

• The Journal of Korean Society for Radiation Therapy
• /
• v.7 no.1
• /
• pp.156-166
• /
• 1995

Total body irradiation (TBI) requires large radiation field and extended source to axis distance (SAD), therefore in needs large size treatment room and it needs compensators which components. Appropriate thickness beam spoiler should be used to raise skin dose. Treatment machine, photon energy, total dose, dose rate, dose fractionation, patient position, shield of normal tissues and organs were known to important parameters for TBI. TBI disturbes regular daily treatment schedule and significantly overloads Radiation on oncology departments and during the treatment session it requires accurate reproduction of radiation field and patient position. We were enable to TBI in small size treatment room and short SAD with parallel opposing lateral fields technique and achieved homogenious whole body dose distribution using pb compensators and controled lung dose by lung shield blocks. Drawing a patient shadow on the wall, we could shortened set up time and possible to accurate reproduction of radiation field and patient position.