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Evaluations des doses dues aux neutrons secondaires reçues par des patients de différents âges traités par protonthérapie pour des tumeurs intracrâniennes

Abstract : Proton therapy is an advanced radiation therapy technique that allows delivering high doses to the tumor while saving the healthy surrounding tissues due to the protons’ ballistic properties. However, secondary particles, especially neutrons, are created during protons’ nuclear reactions in the beam-line and the treatment room components, as well as inside the patient. Those secondary neutrons lead to unwanted dose deposition to the healthy tissues located at distance from the target, which may increase the secondary cancer risks to the patients, especially the pediatric ones. The aim of this work was to calculate the neutron secondary doses received by patients of different ages treated at the Institut Curie-centre de Protonthérapie d’Orsay (ICPO) for intracranial tumors, using a 178 MeV proton beam. The treatments are undertaken at the new ICPO room equipped with an IBA gantry. The treatment room and the beam-line components, as well as the proton source were modeled using the Monte Carlo code MCNPX. The obtained model was then validated by a series of comparisons between model calculations and experimental measurements. The comparisons concerned: a) depth and lateral proton dose distributions in a water phantom, b) neutron spectrometry at one position in the treatment room, c) ambient dose equivalents at different positions in the treatment room and d) secondary absorbed doses inside a physical anthropomorphic phantom. A general good agreement was found between calculations and measurements, thus our model was considered as validated. The University of Florida hybrid voxelized phantoms of different ages were introduced into the MCNPX validated model, and secondary neutron doses were calculated to many of these phantoms’ organs. The calculated doses were found to decrease as the organ’s distance to the treatment field increases and as the patient’s age increases. The secondary doses received by a one year-old patient may be two times higher than the doses received by an adult. A maximum dose of 16.5 mGy for a whole treatment delivering 54 Gy to the tumor was calculated to the salivary glands of a one year-old phantom. The calculated doses for a lateral proton beam incidence (left or right) may be, for some organs, two times higher than doses for an upper incidence (left or right) and four times higher than doses for an antero-superior incidence. Neutron equivalent doses were also calculated for some organs. The neutron weighting factors wR were found to vary between 4 and 10 and the equivalent doses for the considered organs reached at maximum 155 mSv during a whole treatment.
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https://tel.archives-ouvertes.fr/tel-00810289
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Submitted on : Wednesday, April 10, 2013 - 9:37:15 AM
Last modification on : Wednesday, October 14, 2020 - 3:46:37 AM
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  • HAL Id : tel-00810289, version 1

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Rima Sayah. Evaluations des doses dues aux neutrons secondaires reçues par des patients de différents âges traités par protonthérapie pour des tumeurs intracrâniennes. Autre [cond-mat.other]. Université Paris Sud - Paris XI, 2012. Français. ⟨NNT : 2012PA112229⟩. ⟨tel-00810289⟩

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