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Monte Carlo optimization of total body irradiation in a phantom and patient geometry.

Journal article
Authors Roumiana Chakarova
Kristina Müntzing
Marcus Krantz
Emma Hedin
Sven Hertzman
Published in Physics in medicine and biology
Volume 58
Issue 8
Pages 2461-9
ISSN 1361-6560
Publication year 2013
Published at Institute of Clinical Sciences, Department of Radiation Physics
Pages 2461-9
Language en
Keywords Medical physics
Subject categories Radiological physics


The objective of this work is to apply a Monte Carlo (MC) accelerator model, validated by experimental data at isocentre distances, to a large-field total body irradiation (TBI) technique and to develop a strategy for individual patient treatment on the basis of MC dose distributions. Calculations are carried out using BEAMnrc/DOSXYZnrc code packages for a 15 MV Varian accelerator. Acceptable agreement is obtained between MC data and measurements in a large water phantom behind a spoiler at source-skin distances (SSD) = 460 cm as well as in a CIRS® thorax phantom. Dose distributions in patients are studied when simulating bilateral beam delivery at a distance of 480 cm to the patient central sagittal plane. A procedure for individual improvement of the dose uniformity is suggested including the design of compensators in a conventional treatment planning system (TPS) and a subsequent update of the dose distribution. It is demonstrated that the dose uniformity for the simple TBI technique can be considerably improved. The optimization strategy developed is straightforward and suitable for clinics where the TPS available is deficient to calculate 3D dose distributions at extended SSD.

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