Magnetic fields with photon beams: Monte Carlo calculations for a model magnetic field

Strong transverse magnetic fields can produce very large dose enhancements and reductions in localized regions of a patient under irradiation by a pho ton beam. We have suggested a model magnetic field which can be expected to produce such large dose enhancements and reductions, and we have carried o ut EGS4 Monte Carlo calculations to examine this effect for a 6x6 cm(2) pho ton beam of energy 15, 30, or 45 MV penetrating a water phantom. Our model magnetic field has a nominal (center) strength Ed ranging between 1 and 5 T , and a maximum strength within the geometric beam which is 2.2xB(o). For a ll three beam energies, there is significant dose enhancement for B-0=2 T w hich increases greatly for B-0=3 T, but stronger magnetic fields increase t he enhancement further only for the 45-MV beam. Correspondingly, there is m ajor reduction in the dose just distal to this region of large dose enhance ment, resulting from secondary electrons and positrons originating upstream which are depositing energy in the dose-enhancement region rather than con tinuing further into the patient. The dose peak region is fairly narrow tin depth), but the magnetic field can be shifted along the longitudinal axis to produce a flat peak region of medium width (similar to2 cm) or of large width (similar to4 cm), with rapid dose dropoffs on either side. For the 30 -MV beam with B-0=3 T, we found a dose enhancement of 55% for the narrow-wi dth configuration, 32% for the medium-width configuration, and 23% for the large-width configuration; for the 45-MV beam with B-0=3 T, the enhancement s were quite similar, but for the 15-MV beam they were considerably less. F or all of these 30-MV configurations, the dose reductions were similar to 3 0%, and they were similar to 40% for the 45-MV configurations. (C) 2000 Ame rican Association of Physicists in Medicine. [S0094-2405(00)00912-3].