Influence dosimetric study of different couches in radiotherapy treatments

Abstract

Radiotherapy is a recommended procedure for 52% of cancer cases, in average, as one of the treatment forms, therefore, it is important for the clinical practice to investigate the affecting factors in dose distribution received by the patients, such as immobilization devices and treatment couch. With the introduction of treatments with modulated intensity techniques like IMRT and VMAT, the number of incidence fields used for patient treatment increased, making couch’s dosimetric effect more significant in these modalities. The attenuation data acquisition referring to the treatment couches, as well as the TPS data evaluation, show important parameters for the clinical practice because they influence what happens with the dose delivery during the treatment, ensuring a better quality and safety to the treatments. This research presents experimental results evaluating the couch’s impact in the treatments by a study of perturbation in the distribution of surface dose, and dose attenuation according to the gantry’s angle for the couches BrainLABTM, ExactTM and iBEAMTM. Then we propose better density values for the couches BrainLABTM and ExactTM for their inclusion in EclipseTM TPS. Lastly, we compare the dose difference considering the presence or not of couch in the planning. In conclusion, the beam’s attenuation increase by the couches and the doses alterations on the skin must be taken in consideration in the treatment planning process. It is of great relevance that each treatment center perform internal tests to determinate the best density values for available TPS.