title: Effects of beam spoiler on radiation dose for head and neck irradiation with 10-MV photon beam.
abstract: OBJECTIVE
  To determine the effects of a lucite beam spoiler on the dose distribution to points inside and outside the primary beam for head and neck irradiation with a 10-MV photon beam.
  
  
  METHODS
  Build-up and depth-dose measurements were performed with a parallel-plate ionization chamber for 5 x 5, 10 x 10, and 15 x 15-cm field sizes using lucite spoilers with two different thicknesses at two different lucite-to-skin distances (LSD) for a 10-MV x-ray beam. Corrections were applied to account for finite chamber size. Beam profiles and isodose curves were obtained at several depths using film dosimetry. Beam uniformity was determined from uniformity indices. Peripheral doses (PD) were measured at the surface and at 1.5- and 2.5-cm depths using film dosimetry and a parallel-plate ionization chamber. Measurement points were positioned at the edge of a 10 x 10-cm field and at distances extending to 5.0 cm away. The treatment planning data for the 10-MV x-ray beam were modified to account for the effects of the beam spoiler when treating head and neck patients.
  
  
  RESULTS
  The spoiler increased the surface and build-up dose and shifted the depth of maximum dose toward the surface. With a 10-MV x-ray beam and a 1.2-cm-thick lucite at 15 cm LSD, a build-up dose similar to a 6-MV x-ray beam was achieved. The beam uniformity was altered at shallow depths. The peripheral dose was enhanced particularly at the surface and at the points close to the beam edge. The effects of the beam spoiler on beam profile and PD were reduced with increasing depths.
  
  
  CONCLUSIONS
  The lucite spoiler allowed use of a 10-MV x-ray beam for head and neck treatment by yielding a build-up dose similar to that of a 6-MV x-ray beam while maintaining skin sparing. The increase in PD was at superficial depths and was reduced at points away from the edge; therefore, it is clinically nonsignificant. Spoiling the 10-MV x-ray beam resulted in treatment plans that maintained dose homogeneity without the consequence of increased skin reaction or treatment volume underdose for regions near the skin surface.
authors.affiliation: Department of Radiation Medicine, Georgetown University Medical Center, Washington, DC 20007, USA.
authors.forename: A
authors.initials: A
authors.lastname: Niroomand-Rad
authors.forename: K
authors.initials: K
authors.lastname: Javedan
authors.forename: J E
authors.initials: JE
authors.lastname: Rodgers
authors.forename: K W
authors.initials: KW
authors.lastname: Harter
mesh_terms: D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D011874:Radiometry / Q000295:instrumentation*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D011882:Radiotherapy, High-Energy / Q000295:instrumentation*