Monte Carlo simulation of backscatter from lead for clinical electron beams using EGSnrc

In electron radiotherapy of superficial lesions in the eyelid, lip, buccal mucosa, ear, and nose, backscattered electrons are produced from the lead shield used to protect the critical tissue underneath the tumor. In this study, the backscattered electrons, produced by clinical electron beams using a Varian 21 EX linear accelerator, were studied using Monte Carlo simulations. The electron backscatter factor (EBF), defined as the ratio of dose at the tissue-lead interface to the dose at the same point without the presence of backscatter, was calculated using the Monte Carlo EGSnrc-based code. The calculated EBFs were verified with measurements using metal-oxide-semiconductor field effect transistor detectors. The effect of the (1) initial electron beam energy, (2) thickness of bolus over the lead shield, (3) beam's angle of incidence, and (4) presence of an aluminum sheet used to absorb backscattered electrons, on the EBF, were studied. It is found that for lead shielding positioned at any fixed depth, the EBF decreases with an increase in initial electron beam energy (4-16 MeV). In addition, for depths within the electron practical range, Rp, and at a particular beam energy, the EBF increases with depth (or thickness of the treatment volume). When the electron beam angle increases from 0 degrees to 5 degrees, the EBF only decreases slightly (<4%) for all energies. The influence of the beam obliquity on the EBF is important when the treatment surface is not flat and perpendicular to the central beam axis. The use of an aluminum sheet to reduce backscattered electrons was also investigated. For a relatively low electron beam energy (4 MeV), a 2 mm aluminum sheet can reduce backscattering by 31%. While the electron beam energy increased, less backscattered electrons were produced and therefore removed by the same thickness of aluminum (only about 6% for 16 MeV). The Monte Carlo calculated EBFs from this study, characterized by the electron beam energy, depth of bolus above the lead shield, beam obliquity, and presence of an aluminum sheet, may provide important clinical information for radiation oncology staff when considering the effect of electron backscatter on radiotherapy using internal shielding.