Secondary Neutron Dose in Carbon-ion Radiotherapy: Investigations in QST-NIRS

Background: The National Institutes for Quantum and Radiological Science and Technology- National Institute of Radiological Sciences (QST-NIRS) has continuously investigated the unde-sired radiation exposure in ion beam radiotherapy mainly in carbon-ion radiotherapy (CIRT). This review introduces our investigations on the secondary neutron dose in CIRT with the broad and scanning beam methods.Materials and Methods: The neutron ambient dose equivalents in CIRT are evaluated based on rem meter (WENDI-II) measurements. The out-of-field organ doses assuming prostate can-cer and pediatric brain tumor treatments are also evaluated through the Monte Carlo simula-tion. This evaluation of the out-of-field dose includes contributions from secondary neutrons and secondary charged particles.Results and Discussion: The measurements of the neutron ambient dose equivalents at a 90 degrees angle to the beam axis in CIRT with the broad beam method show that the neutron dose per treatment dose in CIRT is lower than that in proton radiotherapy (PRT). For the scanning beam with the energy scanning technique, the neutron dose per treatment dose in CIRT is lower than that in PRT. Moreover, the out-of-field organ doses in CIRT decreased with distance to the tar-get and are less than the lower bound in intensity-modulated radiotherapy (IMRT) shown in AAPM TG-158 (American Association of Physicists in Medicine Task Group).Conclusion: The evaluation of the out-of-field doses is important from the viewpoint of sec-ondary cancer risk after radiotherapy. Secondary neutrons are the major source in CIRT, espe-cially in the distant area from the target volume. However, the dose level in CIRT is similar or lower than that in PRT and IMRT, even if the contributions from all radiation species are in-cluded in the evaluation.