title: Investigations of peripheral dose for helical tomotherapy.
abstract: OBJECTIVE
  Whenever treating a patient with percutaneous radiotherapy, a certain amount of dose is inevitably delivered to healthy tissue. This is mainly due to beam's entry and exit in the region of the target volume. In regions distant from the target volume, dose is delivered by leakage from the MLC and head scatter from the accelerator head and phantom scatter from the target volume (peripheral dose). Helical tomotherapy is a form of radiation therapy with a uniquely designed machine and delivery pattern which influence the peripheral dose. The goal of this work was to investigate peripheral dose in helical tomotherapy. The experiments were used to establish a complex characterization of the peripheral dose.
  
  
  METHODS
  A 30*30*60cm(3) slab phantom and TLD-100 (Lithium fluoride) were used for the experiments. Treatment procedures were generated with the tomotherapy planning system (TPS). Additionally, procedures were created on the Operator Station of the tomotherapy system without a calculation of the dose distribution. The peripheral dose which was produced by a typical tomotherapy treatment plan was measured. Furthermore, these procedures were used to differentiate the parts of the peripheral dose in phantom scatter dose and head scatter and leakage dose. Additionally, the relation between peripheral dose and treatment time and between peripheral dose and delivered dose was investigated. Additionally, the peripheral dose was measured in an Alderson phantom.
  
  
  RESULTS
  Distances of 30cm or more resulted in a decrease of the peripheral dose to less than 0.1% of the target dose. The measured doses have an offset of approximately 1cGy in comparison to the calculated doses from the TPS. The separated head scatter and leakage dose was measured in the range of 1cGy for typical treatments. Furthermore, the investigations show a linear correlation between head scatter leakage dose and treatment time and between scatter dose parts and delivered dose. A peripheral dose of 0.28% of the target dose was measured in the Alderson phantom at a distance of 17.5cm from the edge of the target volume.
  
  
  CONCLUSIONS
  The peripheral dose delivered by a tomotherapy treatment is clinically unobjectionable. The measurements confirmed a linear correlation between head scatter and leakage and treatment time and between scatter dose and delivered dose.
authors.affiliation: Department of Radiation Oncology, University Hospital Heidelberg, Germany. Electronic address: steffen.lissner@med.uni-heidelberg.de.
authors.forename: Steffen
authors.initials: S
authors.lastname: Lissner
authors.forename: Kai
authors.initials: K
authors.lastname: Schubert
authors.forename: Tilo
authors.initials: T
authors.lastname: Wiezorek
authors.forename: Florian
authors.initials: F
authors.lastname: Sterzing
authors.forename: Klaus
authors.initials: K
authors.lastname: Herfarth
authors.forename: Gabriele
authors.initials: G
authors.lastname: Sroka-Perez
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
mesh_terms: D001822:Body Burden; D003198:Computer Simulation; D006801:Humans; D008954:Models, Biological; D011874:Radiometry / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D020266:Radiotherapy, Conformal / Q000379:methods*; D015203:Reproducibility of Results; D012542:Scattering, Radiation; D012680:Sensitivity and Specificity
keywords: Abschirmung; IMRT; Leckdosis; Peripheral dose; Tomotherapie; leakage; periphere Dosis; shielding; tomotherapy