Comparison of eye shields in radiotherapeutic beams

Full text: Both MeV electrons and kV photons are used in the treatment of superficial cancers. The advantages and disadvantages for each of these modalities have been widely reported in the literature (See for example [1-2]). Of particular note in the literature is the use of lead and tungsten eye shields to protect ocular structures during radiotherapy. An investigation addressing issues raised in the literature that are relevant to the Wellington Cancer Centre method of treatment of lesions near the eye shall be summarised. Various small sized fields were irradiated to determine depth dose and profile curves in a water phantom shielded by various commercially available eye shields. Transmission factors relevant to critical ocular structures and particle distribution theories are used to further elucidate the comparison between the use of MeV electrons and kV photons in the treatment of superficial cancers. Superficial X-rays from a Pantak Therapax unit SXT 150 model of HVL 4.90mm Al were used for the lead eye shield measurements and electrons from a Varian Clinac 2100C nominal energies 6MeV and 9MeV (Rp 3.00cm and 4.34cm respectively) were used for the tungsten eye shield measurements. For the photon measurements circular applicators of 3cm, 4cm and 5cm diameter were used and for the electrons standard 6x6cm and 10x 10cm applicators were used, with no custom inserts. A Scanditronix RFA-300 water phantom and Scanditronix RFAplus version 5.3 software application were used to collect and collate all data. The eye shields were the Radiation Products Design Inc. medium lead eye shield (item 934-014) and the MED-TEC tungsten eye shields MT-T-45 M and MT-T-45 S. It is demonstrated that electron fields have appreciably greater scatter into the area directly under the eye shields than the photon fields. Similarly at the region of dmax for the electron fields the relative dose is appreciably greater than the photon fields at similar depth. The relative merits for electron and photon treatments are discussed with respect to the investigations findings and reference to the literature. When comparing electrons and photons it is usually the definite range of electrons within tissue that recommends electron treatments. However, one should weigh this consideration against some of the salient features of a well-constructed superficial photon treatment, for example the effective blocking of kilovoltage photons by lead and the sharp edges of the kilovoltage photon fields. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine