Towards breast cancer rotational radiotherapy with synchrotron radiation

Purpose: We performed the first investigations, via measurements and Monte Carlo simulations on phantoms, of the feasibility of a new technique for synchrotron radiation rotational radiotherapy for breast cancer ((SRT)-T-3). Methods: A Monte Carlo (MC) code based on Geant4 toolkit was developed in order to simulate the irradiation with the SR3T technique and to evaluate the skin sparing effect in terms of centre-to-periphery dose ratio at different energies in the range 60-175 keV. Preliminary measurements were performed at the Australian Synchrotron facility. Radial dose profiles in a 14-cm diameter polyethylene phantom were measured with a 100-mm pencil ionization chamber for different beam sizes and compared with the results of MC simulations. Finally, the dose painting feasibility was demonstrated with measurements with EBT3 radiochromic films in a phantom and collimating the SR beam at 1.5 cm in the horizontal direction. Results: MC simulations showed that the SR3T technique assures a tumour-to-skin absorbed dose ratio from about 7: 1 (at 60 keV photon energy) to about 10: 1 (at 175 keV), sufficient for skin sparing during radiotherapy. The comparison between the results of MC simulations and measurements showed an agreement within 5%. Two off-centre foci were irradiated shifting the rotation centre in the horizontal direction. Conclusions: The SR3T technique permits to obtain different dose distributions in the target with multiple rotations and can be guided via synchrotron radiation breast computed tomography imaging, in propagation based phase-contrast conditions. Use of contrast agents like iodinated solutions or gold nanoparticles for dose enhancement (DE-(SRT)-T-3) is foreseen and will be investigated in future work. (C) 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.