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Helical tomotherapy superficial dose measurements.

Chester R Ramsey¹, Rebecca M Seibert, Benjamin Robison

¹Department of Radiation Oncology, Thompson Cancer Survival Center, Knoxville, Tennessee 37916, USA. cramsey@utk.edu

Medical Physics

|September 21, 2007

Summary

Helical tomotherapy without a flattening filter can lead to inaccurate superficial dose calculations. Adding bolus is recommended for superficial target volumes to prevent underdosing during radiation therapy.

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Area of Science:

Radiation Oncology
Medical Physics
Radiotherapy Technology

Background:

Helical tomotherapy (HT) systems deliver radiation using a flattening filter-free (FFF) 6 MV fan beam, which increases dose rate but alters surface dose distributions.
The absence of a flattening filter in HT can result in significant differences in superficial dose compared to other intensity-modulated radiation therapy (IMRT) techniques.

Purpose of the Study:

To accurately measure and evaluate surface dose distributions for helical tomotherapy plans.
To investigate the impact of varying target volume-surface distances on superficial dose delivery in HT treatments.
To compare measured superficial doses with calculated doses from the tomotherapy treatment planning system.

Main Methods:

Utilized an anthropomorphic head phantom to simulate head and neck cancer treatments.
Defined planning target volumes (PTVs) with separations of 0 to 5 mm from the phantom surface.
Measured superficial doses using radiographic film and thermoluminescent dosimeters (TLDs) placed on the phantom surface.

Main Results:

Measured superficial doses decreased as the PTV-surface separation increased, ranging from 86.6% at 0 mm to 61.5% at 5 mm separation.
The tomotherapy treatment planning system overestimated superficial doses by 8.9% (TLDs) and between 3% and 13% (film and TLDs combined).
Tumor volumes extending to the surface may be underdosed without the use of bolus.

Conclusions:

Helical tomotherapy's FFF beam necessitates careful consideration of superficial dose calculations.
The use of bolus is recommended for clinical cases involving superficial target volumes to ensure adequate dose coverage.
Accurate surface dose assessment is crucial for optimizing HT treatment plans and avoiding potential underdosing in near-surface tumors.