Neutron dose equivalent and neutron spectra in tissue for clinical linacs operating at 15, 18 and 20 MV

In this work, the dose equivalent due to photoneutrons and the neutron spectra in tissue was calculated for various linacs (Varian Clinac 2100C, Elekta Inor, Elekta SL25 and Siemens Mevatron KDS) operating at energies between 15 and 20 MV, using the Monte Carlo code MCNPX (v. 2.5). The dose equivalent in an ICRU tissue phantom has been calculated for anteroposterior treatments with a detailed simulation of the geometry of the linac head and the coupled electron-photon-neutron transport. Neutron spectra at the phantom entrance and at 1-cm depth in the phantom, depth distribution of the neutron fluence in the beam axis and dose distributions outside the beam axis at various depths have also been calculated and compared with previously published results. The differences between the neutron production of the various linacs considered has been analysed. Varian linacs show a larger neutron production than the Elekta and Siemens linacs at the same operating energy. The dose equivalent due to neutrons produced by medical linacs operating at energies >15 MeV is relevant and should not be neglected because of the additional doses that patients can receive.