In Vitro Evaluation of Head and Neck Radiation Shields Used to Reduce Exit Dose

Purpose: To determine the optimal thickness of protective oral radiation shields composed of an acrylic resin stent and a lead shield, which are used in head and neck radiotherapy to minimize undesired normal tissue radiomorbidity. Materials and Methods: Intraoral acrylic resin stents and lead shields of different thicknesses were inserted into a specially designed human mandible phantom with thermoluminescent lithium fluoride dosimeter chips (TLD-100) placed on the buccal and lingual sites and exposed to irradiation of different energies. Fifty-cGy irradiation was performed and TLD-100 dose measurements were obtained for each irradiation type, acrylic resin stent thickness, and lead shield thickness. Results: Acrylic resin stents with a 2-mm lead shield reduced 20% and 15% of the normal tissue dose for Co-60 and 6 MV X photon radiations, respectively, whereas the stents with a 4-mm lead shield achieved a higher reduction of the normal tissue dose (30% and 23% for Co-60 and 6 MV X photons, respectively). Conclusion: In protective oral radiation shields, acrylic resin stent thickness has little effect on the reduction of normal tissue dose, but lead shield thickness significantly effects the reduction of normal tissue dose.