Fetus dose calculation during proton therapy of pregnant phantoms using MCNPX and MCNP6.2 codes

Radiotherapy of pregnant cancer patients is not common, but when applied accurate assessment of the fetus dose is required, especially since the treatment planning systems are not able and do not allow accurate assessment of out-of-field doses. Proton therapy significantly reduces out-of-field doses, such as dose to the fetus, when compared to the photon radiotherapy techniques and as such could be promising for pregnant cancer patients. Within this study Monte Carlo calculations are performed on the three different computational phantoms representing pregnant women, all in second trimester of pregnancy. Simplified proton beam to the pregnant women brain was modelled, and the total dose equivalent (normalized per target dose) to the fetus was calculated. Between MCNPX and MCNP6.2 code versions we observed up to 6% difference. In this work 3 groups participated and the variation between the groups was 8% and 12% for MCNPX and MCNP6.2, respectively. Depending on the phantom used in the calculations the fetal dose was between 0.4 and 0.8 μSv/Gy. Major contribution to the total dose came from the neutrons, with only 20% of the dose coming from photons, while other particles have negligible contributions. Results of the total dose equivalent differ by factor of two, when different phantoms were used, due to geometrical and anatomical characteristics of mother and fetus position.