Collateral exposure: the additional dose from radiation treatment
Degree GrantorUniversity of Canterbury
Degree NameMaster of Science
For patients receiving radiation therapy, there is a risk of developing radiation induced carcinomas, especially if they have a long life expectancy. However, radiotherapy is not the only contributor of radiation exposure to healthy tissue. With the introduction of highly conformal treatment techniques comes the increase in pretreatment imaging necessary to accurately target tumour volumes and consequently, radiation exposure to healthy tissue.
In this work the radiation dose delivered to radiosensitive organs from a number of treatment planning techniques was evaluated and the risk of radiation induced cancer was assessed. MOSFET detectors and Gafchromic film were used to measure the accumulative concomitant dose to the thyroid and contralateral breast from early stage breast carcinoma radiotherapy and to the contralateral testis from seminoma radiotherapy, with dose contributions from CT imaging for treatment planning, pretreatment imaging (CBCT) and treatment delivery peripheral dose. To the author's knowledge this is the first work investigating the total concomitant treatment related dose and associated risk to these treatment sites.
Peripheral dose contributed the largest concomitant dose to the healthy tissue, measuring up to 0.7, 1.0 and 5.0 Gy to the testis, thyroid and contralateral breast, respectively. The highest testicular, thyroid and contralateral breast carcinoma risk was found to be 0.4, 0.2 and 1.4%, respectively.
In conclusion, the risk of radiation induced carcinoma to the assessed radiosensitive tissues was found to be minimal, however, when considering treatment techniques and/or introducing pretreatment imaging protocols, the dose to the normal tissue should be kept as low as reasonably achievable.