title: Experimental evaluation of neutron dose in radiotherapy patients: Which dose?
abstract: OBJECTIVE
  The evaluation of peripheral dose has become a relevant issue recently, in particular, the contribution of secondary neutrons. However, after the revision of the Recommendations of the International Commission on Radiological Protection, there has been a lack of experimental procedure for its evaluation. Specifically, the problem comes from the replacement of organ dose equivalent by the organ-equivalent dose, being the latter "immeasurable" by definition. Therefore, dose equivalent has to be still used although it needs the calculation of the radiation quality factor Q, which depends on the unrestricted linear energy transfer, for the specific neutron irradiation conditions. On the other hand, equivalent dose is computed through the radiation weighting factor wR, which can be easily calculated using the continuous function provided by the recommendations. The aim of the paper is to compare the dose equivalent evaluated following the definition, that is, using Q, with the values obtained by replacing the quality factor with wR.
  
  
  METHODS
  Dose equivalents were estimated in selected points inside a phantom. Two types of medical environments were chosen for the irradiations: a photon- and a proton-therapy facility. For the estimation of dose equivalent, a poly-allyl-diglicol-carbonate-based neutron dosimeter was used for neutron fluence measurements and, additionally, Monte Carlo simulations were performed to obtain the energy spectrum of the fluence in each point.
  
  
  RESULTS
  The main contribution to dose equivalent comes from neutrons with energy higher than 0.1 MeV, even when they represent the smallest contribution in fluence. For this range of energy, the radiation quality factor and the radiation weighting factor are approximately equal. Then, dose equivalents evaluated using both factors are compatible, with differences below 12%.
  
  
  CONCLUSIONS
  Quality factor can be replaced by the radiation weighting factor in the evaluation of dose equivalent in radiotherapy environments simplifying the practical procedure.
authors.affiliation: Grup de Recerca en Radiacions Ionizants (GRRI), Departament de Física, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Romero-Expósito
authors.affiliation: Grup de Recerca en Radiacions Ionizants (GRRI), Departament de Física, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Domingo
authors.affiliation: Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Sevilla 41009, SpainServicio de Radiofísica, Hospital Universitario Virgen Macarena, Sevilla 41009, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Sánchez-Doblado
authors.affiliation: Grup de Recerca en Radiacions Ionizants (GRRI), Departament de Física, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Ortega-Gelabert
authors.affiliation: Grup de Recerca en Radiacions Ionizants (GRRI), Departament de Física, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Gallego
mesh_terms: D006801:Humans; D009502:Neutrons / Q000627:therapeutic use*; D011829:Radiation Dosage; D011878:Radiotherapy / Q000379:methods*; D011879:Radiotherapy Dosage