Secondary radiation from supervoltage accelerators - its implications in patient protection

If the collimator and compensator of a supervoltage accelerator are made of high atomic number material they will tend to interact with the high energy photon beam predominantly by pair production. Associated with pair-production is a cascade formation resulting in a variety of radiations which may be serious from the point of view of patient protection, particularly if the field of treatment is close to some superficially located critical organ such as the lens of the eye or the gonads. Gonadal doses of about 15% of the mid-depth dose were measured on a young male patient undergoing treatment of the prostate by a 42MV X-ray beam from a Siemen's betatron. A lead block 1.5 cm thick placed over the patient's thighs covering the scrotum reduced the gonadal dose to less than 2% of the mid-depth dose. A similar set of measurements made on a specially constructed scrotum-penis phantom confirmed these results, and showed that the lead block must be placed close to the phantom to be effective. Comparative measurements made just outside a cobalt 60 beam showed that the doses were far smaller than those outside the 42MeV X-ray beam. Recommendations are therefore made for the thickness and positioning of lead shielding required to protect critical organs from secondary radiation in radiotherapy. (U.K.)