Dosimetry and dose planning in boron neutron capture therapy : Monte Carlo studies

Boron neutron capture therapy (BNCT) is a biologically targeted radiotherapy modality. So far, 249 cancer patients have received BNCT at the Finnish Research Reactor 1 (FiR 1) in Finland. The effectiveness and safety of radiotherapy are dependent on the radiation dose delivered to the tumor and healthy tissues, and on the accuracy of the doses. At FiR 1, patient dose calculations are performed with the Monte Carlo (MC) -based treatmentplanning system (TPS), Simulation Environment for Radiotherapy Applications (SERA). Initially, BNCT was applied to head and neck cancer, brain tumors, and malignant melanoma. To evaluate the applicability of the new target tumors for BNCT, calculation dosimetry studies are needed. So far, clinical BNCT has been performed with the neutrons from a nuclear reactor, while an accelerator based neutron sources applicable for hospital operation would be preferable. In this thesis, BNCT patient dose calculation practice in Finland was evaluated against reference calculations and experimental data in several cases. Calculations with two TPSs applied in clinical BNCT were compared. The suitability of the deuterium-deuterium (DD) and deuterium-tritium (D-T) fusion reaction-based compact neutron sources for BNCT were evaluated. In addition, feasibility of BNCT for noninvasive liver tumor treatments was examined. The deviation between SERA and the reference calculations was within 4% in the phantoms studied and in a brain cancer patient model elsewhere, except on the phantom or skin surface, for the boron, nitrogen, and photon dose components. These dose components produce 99% of the tumor dose and > 90% of the healthy tissue dose at points of relevance for treatment at the FiR 1 facility. The reduced voxel cell size ( 0.5 cm) in the SERA edit mesh improved calculation accuracy on the surface. The erratic biased fastneutron run option in SERA led to significant underestimation (up to 30–60%) of the fastneutron dose, while more accurate fast-neutron dose calculations without the biased option are too time-consuming for clinical practice. The SERA calculations for thermal neutron fluence are also accurate (within 5%) in comparison to the activation foil measurements at FiR 1. Large (> 5%) deviation was found between the measured and calculated photon doses, which produces from 25% up to > 50% of the healthy tissue dose at certain depths.