Effect of lung inhomogeneity on dose distribution during radiotherapy of patient with lung cancer

Background: Presence of inhomogeneities such as lung tissue with low density can perturbs the dose distribution in the path of therapeutic photon beam and causes undesired cold or hot spots. The aim of this study was to investigate the effect of lung tissue inhomogeneities on dose distribution in thorax irradiation. Materials and Methods: The Monte Carlo simulation (MC) code of EGSnrc-based BEAMnrc was used to calculate dose distribution for 6 MV- Siemens Primus linear accelerator (Linac) in a homogenous phantom. Dose perturbation and inhomogeneity corrected factors (ICFs) were calculated due to implementation of lung tissue depended to the lung density and field size. Results: The maximum increased dose in lung tissue with lung density of 0.5 and 0.25gr/cm(3) was 15.9%, 16.2%, 15.6%, 23.8 %, 24.8% and 25.0% for 6 x 6, 10 x 10 and 20 x 20 cm(2) field sizes, respectively. The maximum ICF for these field sizes was 1.16 and 1.25 for lung density of 0.5 and 0.25gr/cm(3), respectively. The maximum dose reduction in lung tissue with density of 0.25 and 0.5gr/cm(3) was 19.5% and 4.2 %, and the related ICF was estimated 0.84 and 0.95, respectively. Conclusion: Involvement of lung tissue in the path of irradiation perturbs the dose distribution which is dependent to the lung density and field size. The ICFs resulted from our MC model could be useful to accurately calculate the dose distribution in radiotherapy of lung abnormalities.