The incorporation of partial shielding of the spinal cord in a tissue deficit compensator in radiotherapy of the thorax.
A method to determine the shape of a patient by placing radiopaque wires and chains on the skin and taking two isocentric X-ray films is described. The wire locations are reconstructed by X-ray stereo photogrammetry, and a beam's eye view of the wire frame structure can be obtained with reference to the original setup of the "stereo-pair" films. An algorithm for paving between the wires with triangular plates is described which allows the calculation of the tissue deficit distance and compensator thickness. The depth and distance to points on the spinal cord are calculated, and the dose rate is calculated using a standard irregular field computation program. The limit for spinal cord tolerance is specified in terms of the maximum daily dose based on an equivalent dose formula. The additional thickness of compensator, required for the posterior field compensator to satisfy the tolerance limit, is calculated. The technique readily accommodates the kyphotic and scoliotic spine and has been in routine clinical use for seven years.