Comparison in Fetus Dose in Whole Brain Radiotherapy with Cobalt 60 and Linear Accelerator

Document Type : Original Article (s)

Authors

1 Professor, Medical Physics Research Center, Mashhad University of Medical Sciences, Mashahd, Iran

2 Associate Professor, Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Associate Professor, Cancer Research Center, Mashhad University of Medical Sciences, Mashahd, Iran

4 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashahd, Iran

5 Associate Professor, Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

6 Medical physics department, faculty of medicine, Mashhad University of medical sciences

Abstract

Background: Given the increasing need for the use of ionizing radiation during pregnancy, the increase in the incidence of radiation therapy-related cancers has received attention. This study aims to determine the fetal dose resulting from whole-brain radiation therapy using two methods: a cobalt-60 treatment machine and a linear accelerator.
Methods: Using the Alderson RANDO phantom, after performing the calibration of TLD-100 chips, the fetal dose at weeks 12, 24, and 36 of pregnancy was evaluated based on the distance from the primary treatment field. The total brain radiation with therapeutic lateral opposing fields was delivered parallel to the phantom in a supine position. The treatment technique was carried out at SSDs of 100 cm and 80 cm for the linear accelerator and cobalt machine, respectively. The absorbed dose was measured using a TLD reader.
Findings: He mean radiation dose in an unshielded conceptus at gestational ages of 12, 24, and 36 weeks were about 926 ± 47, 2160 ± 125 and 6372 ± 498 micro Gy for Cobalt-60 gamma rays and 4559 ± 207, 6005 ± 260 and 6383 ± 228 micro Gy for 9 MV X-rays from linear accelerator.
Conclusion: Dosimetric results indicate that most of the dose from internal scatter radiation in the mother's body comes from scatter, and protecting the abdomen can only be partially effective. As the fetal age increases, the received dose varies significantly. Therefore, it is better not to rely on the average dose when assessing fetal dose, and the fetal dose should be estimated based on its maximum age.

Highlights

Mohammad Taghi Bahreyni Toosi: PubMed, Google Scholar

Mehdi Momennezhad: PubMed, Google Scholar

Ali Taghizadeh Kermani: PubMed, Google Scholar

Leila Pourali: PubMed, Google Scholar

Shahrokh  Nasseri: PubMed

Hamid Gholamhosseinian: PubMed, Google Scholar

Keywords

Main Subjects


  1. Parazzini F, Franchi M, Tavani A, Negri E, Peccatori FA. Frequency of pregnancy related cancer: a population based linkage study in Lombardy, Italy. Int J Gynecol Cancer 2017; 27(3): 613-9.
  2. Botha MH, Rajaram S, Karunaratne K. Cancer in pregnancy. Int J Gynaecol Obstet 2018; 143(Suppl 2): 137-42.
  3. Suwanbut P, Liamsuwan T, Nantajit D, Masa-Nga W, Tannanonta C. Assessment of fetal dose and health effect to the fetus from breast cancer radiotherapy during pregnancy. Life (Basel) 2022; 12(1): 84.
  4. Goyal S, Yadav A, Madan R, Chitkara A, Singh R, Khosla D, et al. Managing brain tumors in pregnancy: The oncologist's struggle with maternal-fetal conflict. J Cancer Res Ther 2022; 18(1): 5-18.
  5. Kang S, Kim KH, Kang SW, Shin DS, Lee S, Chung JB. Evaluation of a new foetal shielding device for pregnant brain tumour patients. Radiat Oncol 2021; 16(1): 109.
  6. Labby ZE, Barraclough B, Bayliss RA, Besemer AE, Dunkerley DA, Howard SP. Radiation treatment planning and delivery strategies for a pregnant brain tumor patient. J Appl Clin Med Phys 2018; 19(5): 368-74.
  7. Shirkhani M, Heydarheydari S, Farshchian N, Eivazi
    MT, Haghparast A. Fetal dose estimation for pregnant breast cancer patients during radiotherapy using an in-house phantom. Middle East Journal of Cancer 2020; 11(1): 99-104.
  8. Mianji FA, Karimi Diba J, Babakhani A. Fetus dose estimation in thyroid cancer post-surgical radioiodine therapy. Radiat Prot Dosimetry 2015; 163(1): 27-36.
  9. Eric J Hall, Amato J Giaccia. Radiobiology for the radiologist. 8th Philadelphia, PA: Wolters Kluwer; 2019.x
  10. Chaparian A, Aghabagheri M. Fetal radiation doses and subsequent risks from X-ray examinations: Should we be concerned? Iran J Reprod Med 2013; 11(11): 899-904.
  11. Gibbons JP. Khan’s The physics of radiation therapy. 6th Philadelphia, PA: Wolters Kluwer Health; 2019.
  12. Bahreyni Toossi MT, Vejdani Noghreiyan A, Gholamhosseinian H. Assessment of the Effects of Radiation Type and Energy on the Calibration of TLD-100. Iran J Med Phys 2018; 15(3): 140-5.
  13. Han B, Bednarz B, Xu XG. A study of the shielding used to reduce leakage and scattered radiation to the fetus in a pregnant patient treated with a 6-MV external X-ray beam. Health Phys 2009; 97(6): 581-9.