This study aims to calculate the dose delivered to the upstream surface of a biocompatible flexible absorber covering lead for electron beam treatment of skin and subcutaneous tumour lesions for head and neck. Silicone (Ecoflex™ 00-30, Smooth-On, Easton, PA, USA) was used to cover the lead to absorb backscattered electrons from lead. A 3D printer (Zortrax M300, Zortrax, Olsztyn, Poland) was used to fabricate the lead shield. Analytic calculation, simplified Monte Carlo (MC) simulation, and detailed MC simulation which includes a modeling of metal-oxide-semiconductor field-effect transistor (MOSFET) detector were performed to determine the electron backscatter factor (EBF) for 6MeV and 9MeV electron beams of a Varian iX Silhouette. MCNP6.2 was used to calculate the EBF and corresponding measurements were carried out by using MOSFET detectors. The EBF was experimentally measured by the ratio of dose at the upstream surface of the silicone to the same point without the presence of the lead shield. The results derived by all four methods agreed within 2.8% for 6MeV and 3.4% for 9MeV beams. In detailed MC simulations, for 6MeV, dose to the surface of 7-mm-thick absorber was 103.7 [Formula: see text] 1.9% compared to dose maximum (Dmax) without lead. For 9MeV, the dose to the surface of the 10-mm-thick absorber was 104.1 [Formula: see text] 2.1% compared to Dmax without lead. The simplified MC simulation was recommended for practical treatment planning due to its acceptable calculation accuracy and efficiency. The simplified MC simulation was completed within 20min using parallel processing with 80 CPUs, while the detailed MC simulation required 40h to be done. In this study, we outline the procedures to use the lead shield covered by silicone in clinical practice from fabrication to dose calculation.
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