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multiple filed arrangement in Radiotherapy, Medical College Kolkata
1. Dose distribution in matter: Multiple and wedge field technique Dr. Dipanjan Majumder MD PGT Dept. of radiotherapy Medical college,kolkata
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7. Co- 60 4-6 MV beam thickness 15 cm dose uniform if 20 cm 10 MV or higher energy needed.
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10. Unit of intgral dose is gram-rad or kilogram-gray Or simply joule. 1000 rad delivered at midpoint of a 25 cm thick pt. Field size 10 cm d ; SSD = 100 cm.
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15. Isocentric technique: Point of intersection of collimator axis and gantry axis - isocenter Stationary beam: Isocenter placed within patient beams directed from different direction. SSD=SAD-d if SSD SAD isocentric method can be used Advantage: setup accuracy Machine isocentricity dependence rather skin marks
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17. Calculations: D iso = D o ×S c ×S p ×TMR Diso=dose rate at isocenter Do=Dmax dose rate for 10,10 field at the SAD Sc=collimator scater factor Sp=phantom scater factor.(for given field size at isocenter) TMR=average TMR over all deapths.
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21. HOW TO TREAT SUPERFICIAL TUMOR BY MULTIPLE FIELDS?
30. Field separation methods : Geometric: Two adjacent beams are considered.joined at given depth d. L1&L2 be the lengths, SSD1&SSD2 are source to surface distance.then S=S1+S2=½.L1.d/SSD1+½.L2.d/SSD2
33. Calculations: Three-field overlap dS=S1-S2 dS=0 then L1/L2=SSD1/SSD2 If field sizes different SSD s to be adjusted accordingly. If S1+S2 increased by dS three field overlap eliminated but cold spot at mid line. Practically dS* used; dS*=dS.[(d*-d)/d] d* =distance of critical organ from surface ; d= midline distance
34. Dosimetric: Separation of the fields can be determined by optimizing placement of the fields on contour so that composite isodose uniform. Hot and cold spots are acceptable .