A method of estimating fetal dose during brain radiation therapy

Abstract 

Purpose: To develop a simple method of estimating fetal dose during brain radiation therapy.

Methods and Materials: An anthropomorphic phantom was modified to simulate pregnancy at 12 and 24 weeks of gestation. Fetal dose measurements were carried out using thermoluminescent dosimeters. Brain radiation therapy was performed with two lateral and opposed fields using 6 MV photons. Three sheets of lead, 5.1-cm-thick, were positioned over the phantom’s abdomen to reduce fetal exposure. Linear and nonlinear regression analysis was used to investigate the dependence of radiation dose to an unshielded and/or shielded fetus upon field size and distance from field isocenter.

Results: Formulas describing the exponential decrease of radiation dose to an unshielded and/or shielded fetus with distance from the field isocenter are presented. All fitted parameters of the above formulas can be easily derived using a set of graphs showing their correlation with field size.

Conclusion: This study describes a method of estimating fetal dose during brain radiotherapy, accounting for the effects of gestational age, field size and distance from field isocenter. Accurate knowledge of absorbed dose to the fetus before treatment course allows for the selection of the proper irradiation technique in order to achieve the maximum patient benefit with the least risk to the fetus.

Keywords:  Fetal dose, Brain radiotherapy, Pregnancy