A Monte Carlo evaluation of beam characteristics for total body irradiation at extended treatment distances
The aim is to study beam characteristics at large distances when focusing on the electron component. In particular, to investigate the utility of spoilers with various thicknesses as an electron source, as well as the effect of different spoiler‐to‐surface distances (STSD) on the beam characteristics and, consequently, on the dose in the superficial region. A MC model of a 15 MV Varian accelerator, validated earlier by experimental data at isocenter and extended distances used in large‐field total body irradiation, is applied to evaluate beam characteristics at distances larger than 400 cm. Calculations are carried out using BEAMnrc/DOSXYZnrc code packages and phase space data are analyzed by the beam data processor BEAMdp. The electron component of the beam is analyzed at isocenter and extended distances, with and without spoilers as beam modifiers, assuming vacuum or air surrounding the accelerator head. Spoiler thickness of 1.6 cm is found to be optimal compared to thicknesses of 0.8 cm and 2.4 cm. The STSD variations should be taken into account when treating patients, in particular when the treatment protocols are based on a fixed distance to the patient central sagittal plane, and also, in order to maintain high dose in the superficial region. PACS numbers: 87.55.D‐, 87.55.de, 87.55.K‐
Inverse-planned modulated-arc total-body irradiation.
PURPOSE
To develop a simple and robust method for inverse-planned total-body irradiation (TBI) that is more comfortable and has better dose homogeneity than the conventional forward-planned techniques and that can be delivered in a standard-sized treatment vault.


METHODS
Modulated-arc TBI (MATBI) utilizes an arc of static open-field beams to irradiate patients as they lay on a stationary couch beneath the gantry, with cerrobend blocks suspended over organs at risk to provide shielding. Prior to treatment, full-body computed tomography (CT) images are acquired of each patient and imported into the PINNACLE(3) planning system, which modulates the monitor units for the open-field beams to optimize the body dose uniformity. The volume of the body within 10% of the prescription dose, V(±10), is used as a metric to evaluate the dose uniformity. For comparison to MATBI, the dose distribution of a conventional forward-planned treatment is also calculated. Quality assurance measurements are acquired before treatment by delivering the plans to a phantom and during treatment with an ionization chamber inside a buildup block, placed between the patient's ankles.


RESULTS
For MATBI, the achieved values of V(±10) were 75.8%, 90.2%, 84.6%, and 79.8% compared to 60.3%, 77.4%, 65.6%, and 68.5% for the conventional TBI technique, respectively. The pretreatment ion chamber measurements in the phantom had an average error of 1.2%. Those acquired during treatment had larger errors, with most points being within 3% of predictions.


CONCLUSIONS
MATBI provides better dose uniformity and comfort than the conventional forward-planned TBI techniques. In addition, the technique can be implemented on most linacs, in standard-sized vaults, without the use of a translating couch.
DESIGN CONSIDERATION TO PPM KLYSTRONS FOR INDUSTRIAL LINAC
Toshiba has been developing the C-band and X-band Periodic Permanent Magnet (PPM) focused klystron in collaboration with KEK and manufactured prototypes for the JLC project. [1] The PPM klystron has an advantage to enhance the total efficiency as a result of eliminating the electric power for the focusing magnet. From experience on the development the PPM focused klystrons for the JLC project, we plan to apply the PPM focused klystron to the medical and industrial linac. The periodic magnet focusing scheme has some technical difficulties such as stop band voltage. To design the PPM klystron for the medical and industrial linac, it is necessary to give heed to electron beam instability; so that the tube parameters of the PPM focused klystrons have some constraints. The size of the accelerator system is substantially reduced if a PPM focused klystron is used. The majority of medical and industrial linacs use frequencies of S-band range. We discuss the availability of the S-band PPM focused klystron in this paper.