An alternative to the use of lead for patient treatment shielding in superficial radiotherapy.

Abstract

Lead shielding is commonly used in the delivery of superficial radiotherapy albeit that the toxicity of this substance is of concern. The feasibility of using a non-toxic alternative, AttenuFlex™, is assessed using Xstrahl and Sensus treatment units. A series of lead and AttenuFlex™ circular cut outs and applicators were used with superficial beams (1.0-8.5mm Al HVL) to measure percentage depth dose (PDD), output factors (OF) and surface dose correction factors (DCF). X-ray transmission for each material was determined for each beam quality. For these measurements an Advanced Markus chamber either embedded within a virtual water phantom (PDD, OF, transmission) or placed on the surface of the phantom with entrance window downstream (DCF), was used. The depth of the phantom is 10cm for PDD and surface OF measurements. DCF(t) measurements were obtained with underlying lead or AttenuFlex™ at depth t = 0.1-10cm. Additionally, using EBT3 film fluorescent surface doses, to non-target tissue, due to underlying lead or AttenuFlex™ were compared.PDDs and OFs for both materials were within ± 1%. Lead and AttenuFlex™ transmission differences were clinically acceptable, all transmission values were < 5% and non-target doses were comparable. The variation of DCF(t) for lead and AttenuFlex™ exhibit a minima for all beams. In the minima region energy and applicator dependent differences between DCF(lead) and DCF(AttenuFlex™) are observed. These differences do not preclude the use of AttenuFlex™ as an alternative to lead in superficial therapy.