Weighting of secondary radiations in organ dose calculations

The current system of dose quantities in radiological protection is based, in addition to the absorbed dose, on the concepts of equivalent dose and effective dose. This system has been developed mainly with uniform whole-body exposures in mind. Conceptual and practical problems arise when the system is applied to more general exposure situations where the radiation quality is altered within the human body. In this article these problems are discussed, using proton beam radiotherapy as a specific example, and a proposition is made that dose equivalent quantities should be used instead of equivalent doses when organ doses are of interest. The calculations of out-of-field organ doses in proton therapy show that the International Commission on Radiological Protection-prescribed use of the proton weighting factor generally leads to an underestimation of the stochastic risks, while the use of neutron weighting factors in the way as practised in the literature leads to a significant overestimation of these risks.