Chen Li,Huang Xiaoyan,Cao Wufei,Yao Xinghong,Chen Along.The differences between Monte Carlo calculated dose-to-medium and dose-to-water for lung cancer IMRT[J].Chinese Journal of Radiological Medicine and Protection,2015,35(9):670-673
The differences between Monte Carlo calculated dose-to-medium and dose-to-water for lung cancer IMRT
Received:January 28, 2015  
DOI:10.3760/cma.j.issn.0254-5098.2015.09.007
KeyWords:Lung cancer  Intensity-modulated radiotherapy  Monte Carlo algorithm  Dose-to-medium  Dose-to-water
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Author NameAffiliationE-mail
Chen Li Department of Radiation Onclology, Sun Yat-sen Universiry Cancer Center
State Key Laboratory of Oncology in South China
Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China 
 
Huang Xiaoyan Department of Radiation Onclology, Sun Yat-sen Universiry Cancer Center
State Key Laboratory of Oncology in South China
Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China 
huangxiaoy@sysucc.org.cn 
Cao Wufei Department of Radiation Onclology, Sun Yat-sen Universiry Cancer Center
State Key Laboratory of Oncology in South China
Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China 
 
Yao Xinghong Department of Radiation Onclology, Sun Yat-sen Universiry Cancer Center
State Key Laboratory of Oncology in South China
Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China 
 
Chen Along Department of Radiation Onclology, Sun Yat-sen Universiry Cancer Center
State Key Laboratory of Oncology in South China
Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China 
 
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Abstract::
      Objective To investigate the differences between Monte Carlo (MC) calculated dose-to-water (Dw) and dose-to-medium (Dm) for lung cancers treated with intensity-modulated radiotherapy (IMRT). Methods A total of 10 lung carcinoma patients with 5-field IMRT treatment plans were stratified sampling randomly selected for this study, which were performed on Monaco treatment planning system (TPS) with MC algorithm. Using the patients' own CT images as quality assurance (QA) phantoms, two kinds of QA plan were calculated, one was the Dm, and another was the Dw plan. Dose volume histogram (DVH) parameters and the subtraction of two plans were used to evaluate the spatial distribution of the difference between the Dm and Dw. Results Differences between dose-volume indices computed with Dm and Dw for the PTV65 and PTV50 doses (D50%, D98% and D2%) were -0.3%,-0.2%,0.3% and 0.1%,-0.6%,0.4%, respectively, of which the D50% of PTV65 and D98% of PTV50 had statistical difference (t=-2.536, -3.776, P<0.05). For normal tissues, spinal cord, heart, lung and esophagus, the D50% differences between Dm and Dw were 0.3%, 1.1%, -0.2% and -0.1%, of which the Dm of spinal cord and heart were slightly lower than the Dw (t=2.535, 3.254, P<0.05). For the D2% of the normal tissues, the differences were 0.3%, -0.6%, -0.7% and 0.6%, the differences were statistically significant (t=2.311, -4.105, -3.878, 6.214, P<0.05). All the differences were within 2%. Meanwhile planned subtraction analysis showed the differences between the Dm and Dw varied very much with the other body parts of the patient, especially for bone tissues, and the two doses were significant difference (>5%). Conclusion In the course of clinical application, the relative differences between Dm and Dw for lung cancers MC calculations should be noted when considering the dose limitations of bone tissue.
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