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Please use this identifier to cite or link to this item: http://hdl.handle.net/2241/116746

Title: Influence of secondary neutrons induced by proton radiotherapy for cancer patients with implantable cardioverter defibrillators
Authors: Hashimoto, Takayuki
Isobe, Tomonori
Hashii, Haruko
Kumada, Hiroaki
Tada, Hiroshi
Okumura, Toshiyuki
Tsuboi, Koji
Sakae, Takeji
Aonuma, Kazutaka
Sakurai, Hideyuki
橋本, 孝之
磯辺, 智範
熊田, 博明
夛田, 浩
奥村, 敏之
坪井, 康次
榮, 武二
青沼, 和隆
櫻井, 英幸
Issue Date: Jan-2012
Publisher: BioMed Central Ltd.
Journal Title: Radiation oncology
Volume: 7
Start Page: 10
DOI: 10.1186/1748-717X-7-10
PMID: 22284700
Abstract: Background: Although proton radiotherapy is a promising new approach for cancer patients, functional interference is a concern for patients with implantable cardioverter defibrillators (ICDs). The purpose of this study was to clarify the influence of secondary neutrons induced by proton radiotherapy on ICDs.  Methods: The experimental set-up simulated proton radiotherapy for a patient with an ICD. Four new ICDs were placed 0.3 cm laterally and 3 cm distally outside the radiation field in order to evaluate the influence of secondary neutrons. The cumulative in-field radiation dose was 107 Gy over 10 sessions of irradiation with a dose rate of 2 Gy/min and a field size of 10 × 10 cm2. After each radiation fraction, interference with the ICD by the therapy was analyzed by an ICD programmer. The dose distributions of secondary neutrons were estimated by Monte-Carlo simulation.  Results: The frequency of the power-on reset, the most serious soft error where the programmed pacing mode changes temporarily to a safety back-up mode, was 1 per approximately 50 Gy. The total number of soft errors logged in all devices was 29, which was a rate of 1 soft error per approximately 15 Gy. No permanent device malfunctions were detected. The calculated dose of secondary neutrons per 1 Gy proton dose in the phantom was approximately 1.3-8.9 mSv/Gy.  Conclusions: With the present experimental settings, the probability was approximately 1 power-on reset per 50 Gy, which was below the dose level (60-80 Gy) generally used in proton radiotherapy. Further quantitative analysis in various settings is needed to establish guidelines regarding proton radiotherapy for cancer patients with ICDs.
URI: http://hdl.handle.net/2241/116746
Rights: © 2012 Hashimoto et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Text Version: publisher
Appears in Collections:橋本 孝之 (Hashimoto Takayuki)
磯辺 智範 (Isobe Tomonori)
熊田 博明 (Kumada Hiroaki)
夛田 浩 (Tada Hiroshi)
奥村 敏之 (Okumura Toshiyuki)
坪井 康次 (Tsuboi Koji)
榮 武二 (Sakae Takeji)
青沼 和隆 (Aonuma Kazutaka)
櫻井 英幸 (Sakurai Hideyuki)
Radiation oncology

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