Low dose out-of-field radiotherapy, part 3: Qualitative and quantitative impact of scattered out-of-field radiation on MDA-MB-231 cell lines

Low dose out-of-field radiotherapy, part 1: Measurement of scattered doses

“…Recently, Skrobala and colleagues described a method for determining the energy spectrum and its composition by evaluating the mean outof-field energy for 6 MV photon beams (Skrobala et al, submitted for publication). Importantly, the energy spectrum and dose are both closely associated with cellular damage, as shown by Zaleska et al, who determined the impact of primary beam and scattered irradiation on cells, and the extent of DNA damage and apoptosis [14].…”

“…For radiochromic films, the energy dependence is low and thus not considered. Our measurements with thermoluminescent detectors were performed using an energy correlation factor based on Monte Carlo simulation from another publication [4,14,16]. It is essential to correct the response of detectors to minimize errors.…”

“…• the out-of-field radiation doses at varying distances from the primary beam (Part I); • the properties of the scattered radiation responsible for these outof-field doses (Part II; submitted for publication); • and the impact of these doses on biological response of in vitro cells (Part III) [14].…”

Development of a quasi‐humanoid phantom to perform dosimetric and radiobiological measurements for out‐of‐field doses from external beam radiation therapy

“…In clinical radiotherapy, out-of -field radiation doses could negatively impact the patients. Consequently, it is essential to determine the out-of -field radiation doses (both close to and far from the field edge) and their characteristics, including the following: dosimetric measurements of low dose radiation, 1 dose distribution and energy spectrum (calculated by advanced modeling methods such as Monte Carlo 2,3 ), and the impact on radiobiological response 4,5 to determine the risk of inducing a secondary tumor. 6,7 To fully understand the impact of dynamic radiotherapy techniques such as volumetric arc therapy (VMAT) or tomotherapy, 8 as well as non-coplanar techniques such as CyberKnife and stereotactic body radiation therapy (SBRT), it is essential to assess out-of -field doses using a consistent and repeatable process.…”

“…In clinical radiotherapy, out‐of‐field radiation doses could negatively impact the patients. Consequently, it is essential to determine the out‐of‐field radiation doses (both close to and far from the field edge) and their characteristics, including the following: dosimetric measurements of low dose radiation, 1 dose distribution and energy spectrum (calculated by advanced modeling methods such as Monte Carlo 2 , 3 ), and the impact on radiobiological response 4 , 5 to determine the risk of inducing a secondary tumor. 6 , 7 …”