1. Spot-scanning proton therapy for targets with adjacent cardiac implantable electronic devices – Strategies for breast and head & neck cancer
- Author
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Line Bjerregaard Stick, Peter Magnus Trock Lægdsmand, Henrik Laurits Bjerre, Morten Høyer, Kenneth Jensen, Maria Fuglsang Jensen, Mads Brix Kronborg, Birgitte Vrou Offersen, and Camilla Jensenius Skovhus Kronborg
- Subjects
Proton therapy ,Cardiac implantable electronic device ,Secondary neutron dose ,Breast cancer ,Head and neck cancer ,Monte Carlo ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background and purpose: Cardiac implantable electronic device (CIED) malfunctions can be induced by secondary neutron dose from spot-scanning proton therapy. A recent in-vitro study investigating secondary neutron dose to CIEDs up to 7 mSv per fraction found that exposure of secondary neutrons in this range was clinically manageable. This study presents decision algorithms proposed by a national expert group for selection of patients with breast and head & neck (H&N) cancer with CIEDs adjacent to target for proton therapy based on the 7 mSv threshold. Methods and materials: Ten patients with breast cancer and five with H&N cancer were included in the study. Five patients with breast cancer received photon therapy with CIED and proton plans were retrospectively created. The remaining patients received proton therapy without CIED and a worst-case position of a virtual CIED was retrospectively delineated. Secondary neutron dose was estimated as ambient dose equivalent H*(10) using Monte Carlo simulations. Results: For patients with breast cancer and with contralateral CIED, the secondary neutron dose to the CIED was below 7 mSv per fraction for CTV
- Published
- 2022
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