title: Monte Carlo study on secondary neutrons in passive carbon-ion radiotherapy: identification of the main source and reduction in the secondary neutron dose.
abstract: OBJECTIVE
  Recent successful results in passive carbon-ion radiotherapy allow the patient to live for a longer time and allow younger patients to receive the radiotherapy. Undesired radiation exposure in normal tissues far from the target volume is considerably lower than that close to the treatment target, but it is considered to be non-negligible in the estimation of the secondary cancer risk. Therefore, it is very important to reduce the undesired secondary neutron exposure in passive carbon-ion radiotherapy without influencing the clinical beam. In this study, the source components in which the secondary neutrons are produced during passive carbon-ion radiotherapy were identified and the method to reduce the secondary neutron dose effectively based on the identification of the main sources without influencing the clinical beam was investigated.
  
  
  METHODS
  A Monte Carlo study with the PHITS code was performed by assuming the beamline at the Heavy-Ion Medical Accelerator in Chiba (HIMAC). At first, the authors investigated the main sources of secondary neutrons in passive carbon-ion radiotherapy. Next, they investigated the reduction in the neutron dose with various modifications of the beamline device that is the most dominant in the neutron production. Finally, they investigated the use of an additional shield for the patient.
  
  
  RESULTS
  It was shown that the main source is the secondary neutrons produced in the four-leaf collimator (FLC) used as a precollimator at HIAMC, of which contribution in the total neutron ambient dose equivalent is more than 70%. The investigations showed that the modification of the FLC can reduce the neutron dose at positions close to the beam axis by 70% and the FLC is very useful not only for the collimation of the primary beam but also the reduction in the secondary neutrons. Also, an additional shield for the patient is very effective to reduce the neutron dose at positions farther than 50 cm from the beam axis. Finally, they showed that the neutron dose can be reduced by approximately 70% at any position without influencing the primary beam used in treatment.
  
  
  CONCLUSIONS
  This study was performed by assuming the HIMAC beamline; however, this study provides important information for reoptimizing the arrangement and the materials of beamline devices and designing a new facility for passive carbon-ion radiotherapy and probably passive proton radiotherapy.
authors.affiliation: National Institute of Radiological Sciences, 4-9-1, Anagawa, Inage-ku, Chiba 263-8555, Japan. yonai@nirs.go.jp
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yonai
authors.forename: Naruhiro
authors.initials: N
authors.lastname: Matsufuji
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Kanai
mesh_terms: D002247:Carbon Isotopes / Q000627:therapeutic use*; D003198:Computer Simulation; D063193:Heavy Ion Radiotherapy; D006801:Humans; D008954:Models, Biological; D009010:Monte Carlo Method; D009369:Neoplasms / Q000532:radiotherapy*; D009502:Neutrons / Q000627:therapeutic use*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*
chemical_list: D002247:Carbon Isotopes