Doses delivered to normal brain under different treatment protocols at Brookhaven National Laboratory Page: 1 of 10
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Doses Delivered to Normal Brain Under Different Treatment Protocols at Brookhaven
J. Capala', M. Chadhi, J.A. Coderrb, A.Z. DidA , H.B. Iiu, F.J. Wheeler, D.E. Wdssol,
L. Wielopolski', and A.D. Chanana'
'Medical Department, Brookhaven National Laboratory, Upton, NY 11973, USA
2Department of Radiation Oncology, Beth Israel Medical Center, New York, NY 10003, USA
3Department of Radiation Oncology, State University of New York, Stony Brook, NY 11794, USA
4Idaho National Engineering Laboratory, Idaho Falls, ID 83415, USA
As of October 31, 1996, 23 glioblastoma multiforme patients underwent BNCT under several
treatment protocols at the Brookhaven Medical Research Reactor . For treatment planning and
dosimetry purposes, these protocols may be. divided into four groups (Table 1). The first group
comprises protocols that used an 8-cm collimator  and allowed a peak normal brain dose of 10.5
Gy-Eq to avolume of 1 cm3 were the thermal neutron flux was maximal (even if it happened to be
in the tumor volume). The second group differs from the first in that it allowed a peak normal brain
dose of 12.6 Gy-Eq. The protocols of the third and fourth groups allowed the prescribed peak
normal brain dose of 12.6 Gy-Eq to be outside of the tumor volume, used a 12-cm collimator 
and, respectively, uni- or bilateral irradiations. We describe the treatment planning procedures and
report the doses delivered to various structures of the brain.
Materials and Methods
The treatment planning process involves: 1. Obtaining a contrast-enhanced CT or MRI scan
of the patient's head. Conventional positioning lasers and/or a mechanical isocentric device are
sed4 fr Csa fishing uianguaion points-ortm patients scaip-Scans are carried out With fiducial -
markers located at the triangulation points, which are then used for patient positioning . 2.
Reconstruction of a 3D model of the patient's head with defined anatomical structures (scalp, skull,
brain, sinuses) and regions of interest (tumor = contrast enhanced volume, target = tumor + 2 cm
margin) using a graphical environment provided by the BNCT_Rtpe treatment planning program
. 3. Calculation of the neutron flux and secondary radiation distribution using a 3D Monte Carlo
radiation transport program, rtt MC . 4. Estimation of the absorbed dose distribution assuming
a brain/blood boron concentrations ratio of 1:1 and a tumor/blood boron concentration ratio of 3.5:1
. The dose is expressed in Grey-equivalent . The following biological effectiveness factors
were employed: 1.0.for gamma, 3.2 for high-LET beam components, and 1.3 and 3.8 for boron
neutron capture products in the normal brain and tumor tissue, respectively [7,8] . 5. Identification
of an optimal treatment position, and calculation of the time of neutron irradiation required to
deliver the prescribed peak normal brain doses of 10.5 Gy-Eq (group I) or 12.6 Gy-Eq (groups II,
III and IV); 6. Post-treatment evaluation of the dose distribution using the actual irradiation time
and the 10B concentrations measured in the blood at the beginning, in the middle and at the end of
'Address for correspondence: Jacek Capala, Medical Department, Brookahaven National Laborato ,
building 490, Upton, NY 11973
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Capala, J.; Coderre, J.A. & Liu, H.B. Doses delivered to normal brain under different treatment protocols at Brookhaven National Laboratory, article, December 31, 1996; Upton, New York. (https://digital.library.unt.edu/ark:/67531/metadc689797/m1/1/: accessed March 21, 2019), University of North Texas Libraries, Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.