Contemporary cardiac pacemakers can fail from radiation damage at doses as low as 10 gray and can exhibit functional changes at doses as low as 2 gray. A review and discussion of this potential problem is presented and a protocol is offered that suggests that radiation therapy patients with implanted pacemakers be planned so as to limit accumulated dose to the pacemaker to 2 gray. Although certain levels and types of electromagnetic interference can cause pacemaker malfunction, there is evidence that this is not a serious problem around most contemporary radiation therapy equipment.

No abstract

Measurements on the Sagittaire linear accelerator and Allis-Chalmers betatron at M. D. Anderson Hospital indicate that the observed dmax shift with field size is due to the presence of Compton-scattered photons in the therapy beam, and not electrons as proposed by others. Separating the primary from other radiation components indicates that the secondary fraction represents a percentage contribution to the overall beam that increases as the collimators are opened. This is consistent with what would be expected from Compton scattering and explains the effective softening of the beam as field size increases.