Howell Rebecca M, Hertel Nolan E, Wang Zhonglu, Hutchinson Jesson, Fullerton Gary D
Emory University School of Medicine, Department of Radiation Oncology, 1365 Clifton Road AT200, Atlanta, Georgia 30322, USA.
Med Phys. 2006 Feb;33(2):360-8. doi: 10.1118/1.2140119.
Effective doses were calculated from the delivery of 6 MV, 15 MV, and 18 MV conventional and intensity-modulated radiation therapy (IMRT) prostate treatment plans. ICRP-60 tissue weighting factors were used for the calculations. Photon doses were measured in phantom for all beam energies. Neutron spectra were measured for 15 MV and 18 MV and ICRP-74 quality conversion factors used to calculate ambient dose equivalents. The ambient dose equivalents were corrected for each tissue using neutron depth dose data from the literature. The depth corrected neutron doses were then used as a measure of the neutron component of the ICRP protection quantity, organ equivalent dose. IMRT resulted in an increased photon dose to many organs. However, the IMRT treatments resulted in an overall decrease in effective dose compared to conventional radiotherapy. This decrease correlates to the ability of an intensity-modulated field to minimize dose to critical normal structures in close proximity to the treatment volume. In a comparison of the three beam energies used for the IMRT treatments, 6 MV resulted in the lowest effective dose, while 18 MV resulted in the highest effective dose. This is attributed to the large neutron contribution for 18 MV compared to no neutron contribution for 6 MV.
有效剂量是根据6兆伏、15兆伏和18兆伏的传统及调强放射治疗(IMRT)前列腺治疗计划的剂量输出计算得出的。计算过程使用了ICRP-60组织权重因子。对所有射束能量在模体中测量光子剂量。测量了15兆伏和18兆伏的中子能谱,并使用ICRP-74质量转换因子来计算周围剂量当量。利用文献中的中子深度剂量数据对每个组织的周围剂量当量进行校正。然后,将深度校正后的中子剂量用作ICRP防护量器官当量剂量的中子成分的度量。IMRT导致许多器官的光子剂量增加。然而,与传统放疗相比,IMRT治疗导致有效剂量总体降低。这种降低与调强射野将剂量降至紧邻治疗体积的关键正常结构的能力相关。在用于IMRT治疗的三种射束能量的比较中,6兆伏产生的有效剂量最低,而18兆伏产生的有效剂量最高。这归因于18兆伏的中子贡献较大,而6兆伏没有中子贡献。