Complete patient exposure during paediatric brain cancer treatment for photon and proton therapy techniques including imaging procedures

Background In radiotherapy, especially when treating children, minimising exposure of healthy tissue can prevent the development adverse outcomes, including second cancers. this study we propose a validated Monte Carlo framework to evaluate complete patient during paediatric brain cancer treatment. Materials and methods Organ doses were calculated for treatment diffuse midline glioma (50.4 Gy with 1.8 per fraction) on 5-year-old anthropomorphic phantom 3D-conformal intensity modulated radiotherapy (IMRT), volumetric arc therapy (VMAT) pencil beam scanning (PBS) proton therapy. Doses from computed tomography (CT) planning on-board imaging positioning (kV-cone CT X-ray imaging) accounted estimate therapeutic dose. For dose calculations used Carlo-based tools (PRIMO, TOPAS, PENELOPE), while lifetime attributable risk (LAR) was estimated dose-response relationships induction, proposed by Schneider et al. Results Out-of-field organ equivalent data are lower, between 0.6 mSv (testes) 120 (thyroid), compared photon revealing highest out-of-field IMRT ranging 43 575 (thyroid). Dose delivered ranged 0.01 72 (scapula) single 2 μ Sv 1.3 (thyroid) CBCT 0.03 48 X-ray. Adding daily demonstrated an important contribution overall radiation burden in course treatment, which is subsequently predict LAR, selected organs. Conclusion The combining results different dosimetry tools, showing that allows significant reduction secondary