title: Radiotherapy dose compensation for lung patients.
abstract: The purpose of the present paper is to provide a more homogeneous dose distribution in the target volume from compensated anterior and posterior fields while the healthy lung is spared by de-weighting the lateral fields. A compensation computation which used linear iterations to compute the most homogeneous dose distribution across the target volume was applied to produce optimum compensator designs. The equivalent tissue-air ratio (E-TAR) inhomogeneity correction was applied for the computations using a GE target series II planning computer. The compensators designed were tested for accuracy in a modified water/lung phantom using a scanning diode and an anthropomorphic phantom using thermoluminescent dosimeters. A comparison has been made between the compensated and uncompensated plans for the first nine patients who we have treated with this technique. The dose profiles produced by the computation agreed with the prediction of the computed isodose plans to within +/- 2% at the target depth. The thermoluminescent dosimeter (TLD)-measured results in the anthropomorphic phantom agreed with the planning computer within +/- 3%. A comparison of nine compensated plans of radiotherapy patients for large-volume targets in the lung region showed a maximum variation in the target to be 19% uncompensated versus 10% compensated. By providing compensated treatment fields from anterior and posterior treatment portals, a homogeneous dose that conforms well to the target volume is provided. As an added bonus, this enables the lateral lung fields to be significantly de-weighted and the healthy lung is spared considerable dose.
authors.affiliation: Cancer Care Centre, Wollongong Hospital, New South Wales, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Piyaratna
authors.forename: G
authors.initials: G
authors.lastname: Emeleus
authors.forename: A
authors.initials: A
authors.lastname: Arnold
authors.forename: P
authors.initials: P
authors.lastname: Metcalfe
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D019047:Phantoms, Imaging; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation*