The peripheral dose distribution is a growing concern for the improvement of new external radiation modalities. Secondary particles, especially photo-neutrons produced by the accelerator, irradiate the patient more than tens of centimeters away from the tumor volume. However the out-of-field dose is still not estimated accurately by the treatment planning softwares. This study demonstrates the possibility of using a specially designed CMOS sensor for fast and thermal neutron monitoring in radiotherapy. The 14 microns-thick sensitive layer and the integrated electronic chain of the CMOS are particularly suitable for real-time measurements in γ/n mixed fields. An experimental field size dependency of the fast neutron production rate, supported by Monte Carlo simulations and CR-39 data, has been observed. This dependency points out the potential benefits of a real-time monitoring of fast and thermal neutron during beam intensity modulated radiation therapies.

The out-of-field dose in radiation therapy is a growing concern in regards to the late side-effects and secondary cancer induction. In high-energy x-ray therapy, the secondary neutrons generated through photonuclear reactions in the accelerator are part of this secondary dose. The neutron dose is currently not estimated by the treatment planning system while it appears to be preponderant for distances greater than 50 cm from the isocenter. Monte Carlo simulation has become the gold standard for accurately calculating the neutron dose under specific treatment conditions but the method is also known for having a slow statistical convergence, which makes it difficult to be used on a clinical basis. The neutron track length estimator, a neutron variance reduction technique inspired by the track length estimator method has thus been developped for the first time in the Monte Carlo code GATE to allow a fast computation of the neutron dose in radiotherapy. The details of its implementation, as well as the comparison of its performances against the analog MC method, are presented here. A gain of time from 15 to 400 can be obtained by our method, with a mean difference in the dose calculation of about 1% in comparison with the analog MC method.

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Previously we characterized radiophotoluminescent (RPL) detectors for measuring both fast and thermal neutrons for personal monitoring. The linear response and angular dependence, which satisfies the ISO 21909 standard makes their application possible in neutron dosimetry. The polymer CR-39 track detectors remain one of the most used dosimeters where neutron radiations are to be measured, but the visualization process is time consuming. The difference between results obtained by RPL and CR-39 has been discussed mainly for fast neutrons. The present study has also looked at thermal neutron dosimetry, where we found few results in the literature for CR-39. Our measurements demonstrate that RPL detectors can be advantageously incorporated into a dosimeter to measure thermal neutrons.