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Risk Assessment of Scattered Neutrons for a Fetus From Proton Therapy of a Brain Tumor During Pregnancy

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C Geng

C Geng1,2*, M Moteabbed1 , X Xu3 , H Paganetti1 , (1) Massachusetts General Hospotal and Harvard Medical School, Boston, MA, (2) Nanjing University of Aeronautics and Astronautics, Nanjing, China, (3) Rensselaer Polytechnic Inst., Troy, NY


TU-G-CAMPUS-T-2 (Tuesday, July 14, 2015) 4:30 PM - 5:00 PM Room: Exhibit Hall

Purpose:To determine the scattered neutron dose and the resulting risk for a fetus from proton therapy for brain tumors during pregnancy.

Methods:Using the Monte Carlo platform TOPAS, the ICRP reference parameters based anthropomorphic pregnancy phantoms for three stages (3-, 6-, 9-month) were applied to evaluate the scattered neutron dose and dose equivalent. To calculate the dose equivalent, organ specific linear energy transfer (LET) based quality factor was used. Treatment plans from both passive scattering (PS) and pencil beam scanning (PBS) methods were considered in this study.

Results:For pencil beam scanning, the neutron dose equivalent in the soft tissue of the fetus increases from 1.53x10⁻³ to 2.84x10⁻³ mSv per treatment Gy with increasing stage of gestation. This is due to scattered neutrons from the patient as the main contaminant source in PBS and a decrease in distance between the soft tissue of the fetus and GTV with increasing stage of gestation. For passive scattering, neutron dose equivalent to the soft tissue of the fetus shows a decrease from 0.17 to 0.13 mSv per treatment Gy in different stages, while the dose to the brain shows little difference around 0.18 mSv per treatment Gy because scattered neutrons from the treatment head contribute predominantly in passive scattering.

Conclusion:The results show that the neutron dose to the fetus assuming a prescribed dose of 52.2 Gy is negligible for PBS, and is comparable to the scattered dose (0-10 mSv) from a head and neck CT scan for PS. It can be concluded that the dose to fetus is far lower than the thresholds of malformation, SMR and lethal death. The excess relative risk of childhood cancer induction would be increased by 0.48 and 0.103 using the Oxford Survey of Childhood Cancers and Japanese atomic model, respectively.

Funding Support, Disclosures, and Conflict of Interest: Changran Geng is supported by the Chinese Scholarship Council (CSC) and the National Natural Science Foundation of China (Grant No. 11475087).

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