Measurement and Calculation of Electron Contamination for Radiotherapy Photon Mode

Context: This study was done to review the electron contamination sources and measurement based on dosimetry and simulation techniques for radiotherapy and also to investigate factors affecting electron contamination reduction. Methods: We systematically searched five major indexing databases, including PubMed, Scopus, Embase, ISI web of science, and Cochrane central, using keywords of electron contamination, electron contamination AND measurement, electron contamination AND simulation, and electron contamination AND reduction until Dec 2020. Results: Overall, 35 studies were reviewed, including articles reporting the theory of electron contamination, papers on dosimetry methods to measure electron contamination, studies about simulation methods to assess electron contamination, and articles about reducing electron contamination. The results indicated an increase in electron contamination using a flattering filter, an increase in field size, the presence of prosthesis in the patient's body, and a rise in photon energy. Conclusions: It can be concluded that the excessive delivered doses by electron contamination can cause skin complications, such as erythema, desquamation, and telangiectasia inside or outside the photon field. The amount of electron contamination depends on factors, such as radiation field size, beam energy, and materials placed in the photon path. Electron contamination can be decreased by increasing the source distance to the point of measurement by the dosimeter, applying a lead foil, magnetic deflector, or replacing a portion of air column between patient and radiotherapy system head by helium gas, and also limiting the treatment field.