Journal of Medical Physics
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ORIGINAL ARTICLE
Year : 2022  |  Volume : 47  |  Issue : 3  |  Page : 225-234

Dose estimation using optically stimulated luminescence dosimeter and EBT3 films for various treatment techniques in Alderson Rando phantom and estimation of secondary cancer incidence for carcinoma of left breast


1 Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bengaluru; Division of Medical Physics, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
2 Division of Medical Physics, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
3 Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
4 Advanced Medical Physics, Houston, Texas, USA

Correspondence Address:
Dr. K M Ganesh
Department of Radiation Physics, Kidwai Memorial Institute of Oncology, Dr. M.H. Marigowda Road, Bengaluru - 560 029, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmp.jmp_36_22

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Aim: The aim of this study was to measure the dose to planning target and organ at risk (OAR) using Alderson Rando phantom for various treatment techniques in left breast radiotherapy and to estimate the secondary cancer incidence. Materials and Methods: Eleven different combinations of plans containing four techniques (three dimensional conformal radiotherapy, intensity-modulated radiation therapy [IMRT], volumetric modulated arc therapy [VMAT], and combination of 3DCRT and VMAT plans (HYBRID)) were created with 6 MV FF and 6 MV FFF (flattening filter and flattening filter-free) photon energies in phantom. Planned target volume and OAR doses in 23 different locations were measured using optically stimulated luminescence dosimeter (OSLD) and EBT3 films. Assuming the age of exposure as 30 years, lifetime attributable risk (LAR) was estimated based on excess absolute risk (EAR) models outlined in the Biological Effects of Ionizing Radiation VII report. Results: Film showed maximum deviations of 6.15% with IMRT_C_FF plan when compared with treatment planning system (TPS). The maximum percentage difference of 1.7% was found with OSLD measurement when compared with TPS for VMAT_T_FFF plan. EAR estimation was done for all the OARs including target. The LARs for left lung, right lung, and right breast were evaluated. The maximum LAR values of 2.92 ± 0.14 were found for left lung with VMAT_C_FFF plans. Conclusion: This study shows that both OSLD and EBT3 films are suitable for dose measurements using Rando phantom. OSLD shows superior results when compared with films, especially with relatively larger distances. Maximum LAR values were found with VMAT_C_FFF plans. Considering the secondary cancer risk associated with the patients treated in the younger age group, it is suggested that in vivo dose estimation should be a part of treatment quality audit whenever possible.


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