Measurement of eye and lens doses in the presence and absence of shield during whole brain irradiation

J Cancer Res Ther. 2019 Jul-Sep;15(3):544-549. doi: 10.4103/0973-1482.191056.

Abstract

Aim: The aim was to measure doses of eyes and lenses in the presence and absence of shield during whole brain irradiation (WBI). In addition, the dose calculations accuracy of radiation therapy dose plan treatment planning system (TPS) in dose calculation of the eyes and lenses in WBI was evaluated.

Materials and methods: To measure the eyes and lenses doses during WBI, an inhomogeneous phantom of human head was used. Then, the eyes and lenses doses in the presence and absence of shield were measured by EBT3 film.

Results: In single fraction with 200 cGy to reference point, average doses received by the left and right eyes in the absence of shield were 20 ± 1.5 and 22 ± 1.0 cGy, respectively, and for the left and right eyes in the presence of shield were 18 ± 2.2 and 21 ± 2 cGy, respectively. In addition, the average dose received by the left and right lenses in the absence of shield were 19.5 ± 0.5 and 18.5 ± 0.5 cGy, respectively, and for the left and right lenses in the presence of shield were 20.5 ± 1.5 and 19.5 ± 1.5 cGy, respectively. The results showed the TPS compared to the film underestimates doses for the eyes and lenses.

Conclusion: The average dose received by the eyes and lenses during WBI were estimated around 9-11% of prescribed dose. According to the results, there is probability of radiation-induced cataractogenesis during WBI. By investigating the effect of shield on the lenses and eyes doses, using shield during WBI is not recommended. In addition, the results showed dose calculation accuracy of the TPS for the estimation of doses received by the eyes and lenses during WBI is not acceptable.

Keywords: Eye dose; lens dose; shield; treatment planning system; whole brain irradiation.

MeSH terms

  • Cranial Irradiation / adverse effects*
  • Dose-Response Relationship, Drug
  • Eye / radiation effects*
  • Humans
  • Lens, Crystalline / radiation effects*
  • Organs at Risk*
  • Phantoms, Imaging
  • Radiation Dosage*
  • Radiometry
  • Radiotherapy Planning, Computer-Assisted