Out-of-Field Dose Measurement by TLD Dosimetry and Estimation of Radiation-Induced Secondary Cancer Risk of Thyroid and Breast from Head Radiotherapy

Radiation therapy, the most common form of cancer treatment, can result in late complications, such as secondary breast and thyroid cancers.

This study aimed to evaluate the risk of secondary cancers using two radiobiological models of Excess Absolute Risk (EAR) and Excess Relative Risk (ERR) in patients with brain cancer undergoing radiotherapy for improved survival rates of cancer patients.

In this expository cross-sectional study, 45 patients under the age of 40 years underwent Whole Brain Radiotherapy (WBRT) using a compact accelerator in Shahid Ramezanzadeh Hospital, Yazd, Iran. Out-of-field organ dose measurement was performed using a Thermoluminescent Dosimeter (TLD) to determine the dose to thyroid and breast tissues. The risk of secondary cancers in these organs was calculated 3, 5, 10, 15, and 20 years after radiation therapy.

The mean values of thyroid cancer risk in men and women were 0.418±0.509 and 0.274±0.306, respectively. ERR values of breast cancer in 3-, 5-, 10-, 15-, and 20-year women undergoing radiation therapy were 1.084±2.938, 0.594±1.407, 0.248±0.497, 0.138±0.248, and 0.091±0.148, respectively. EAR values of breast cancer in 3-, 5-, 10-, 15-, and 20-year women following radiation therapy were 0.064±0.060, 0.077±0.071, 0.119±0.100, 0.178±0.248, and 0.259±0.178, respectively. 

After irradiation, the risk of secondary cancer is affected by factors, such as the patient’s age and gender. The secondary thyroid cancer is higher than that of other organs, such as the breast, in the patients undergoing WBRT.