title: Comparison between a conventional treatment energy and 50 MV photons for the treatment of lung tumours.
abstract: Radiation therapy in the thoracic region is difficult due to the presence of many dose-limiting structures and the large density differences that affect the dose distribution. Conventional irradiation techniques use low-energy photon beams to avoid build-up effects superficially in the tumour and increased lateral scattering of the beams. For deep-seated tumours higher beam energies could have lung-sparing properties that would enable dose escalation. A comparison was made for a conventional low photon energy (6 MV) and 50 MV photons for the treatment of a lung tumour. A representative patient geometry was selected, consisting of a small tumour semi-enclosed in lung tissue. Treatment plans were designed using a commercial 3D-pencil beam treatment planning system. The treatment beams designed in the TPS were simulated with the Monte Carlo code EGS4/BEAM and the dose distribution in the phantom created from the patients CT-data was calculated using MCDOSE with identical beam geometry for both energies. The intrinsic difference between the two photon energies implies a sparing effect of lung that can be utilized for dose escalation. For a treatment with two beams the mean total dose to the tumour could be increased by 5.3% for 50 MV, corresponding to 3.2 Gy for a prescription dose of 60 Gy, with the same complication probability for the treated lung as for 6 MV. In conclusion, high-energy beams have qualities that can be taken advantage of for irradiation of lung tumours. Optimum solutions would probably require the use of both high- and low-energy beams.
authors.affiliation: Department of Radiation Sciences, Radiation Physics, Umeå University, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Blomquist
authors.forename: Jinsheng
authors.initials: J
authors.lastname: Li
authors.forename: Chang-Ming
authors.initials: CM
authors.lastname: Ma
authors.forename: Björn
authors.initials: B
authors.lastname: Zackrisson
authors.forename: Mikael
authors.initials: M
authors.lastname: Karlsson
mesh_terms: D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D009010:Monte Carlo Method; D019047:Phantoms, Imaging; D017785:Photons; D011878:Radiotherapy / Q000379:methods*