Simulation studies of field shaping in rotational radiation therapy.

This article presents simulation studies of field shaping in rotational radiation therapy by means of two categories of beam modifying devices: protectors and shapers. The protectors used are diminished copies of the organs at risk (OARs) and stay parallel to them during gantry rotation. Thus, each protector always keeps the corresponding OAR in its shadow, significantly reducing the irradiation. The shapers are used in order to obtain a more uniform dose distribution in the planning target volume (PTV) while preserving their initial orientation during gantry rotation. Thus, the use of beam modifying devices allows modulation of the beam intensity, to better fit irradiation requirements, at every gantry position. A software tool for calculations of geometrical position and dimensions of the beam modifying devices, using information about the shape, size, and position of the protected organ or area at risk as input, was developed. This tool was integrated into the in-house-developed Monte Carlo radiation therapy simulator (MCRTS), used to simulate the particle transport through the designed system. The verification of the software tool showed good agreement between experimental and simulation data, with discrepancies of less than 3%. Dose distributions in solid-geometry and voxel-based neck models were evaluated. Furthermore, the effectiveness of the shapers to modify the dose distribution outside the protected area was studied. Results demonstrated that the use of the shapers effectively improves dose uniformity. Studies using shapers of different materials were also carried out and resulted in similar dose distributions. The results of the simulation studies with a voxel-based model showed that rotational therapy with beam modifying devices offers adequate protection of the OAR and a uniform dose distribution outside the protected region.