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Original Article | Open Access

Dosimetric and Radiobiological Impact of Flattening Filter-Free Beam and Dose Calculation Algorithm Using RapidArc Plans for Cervical Cancer Treatment

Sumanta Manna1 ( ), Sharad Singh2, Pramod Kumar Gupta2, Ragul T1
Medical Physics, Kalyan Singh Super Specialty Cancer Institute, Lucknow, Uttar Pradesh, INDIA
Radiation Oncology, Kalyan Singh Super Specialty Cancer Institute, Lucknow, Uttar Pradesh, INDIA
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Abstract

Purpose

The aim of this study is to quantify the potential benefits of a flattening filter-free (FFF) beam and implement a dose-computation algorithm for cervical radiotherapy through dosimetric and radiobiological analyses using RapidArc.

Methods

Thirty-three patients were enrolled, and four RapidArc plans were created for each patient using a dual-arc flattening filter and 6-MV FFF photon beams for the two calculation algorithms. Homogeneity index (HI), conformity index (CI), target coverage, monitor units (MUs), and organ-at-risk (OAR) dosimetric characteristics were compared between the plans. Radiobiological characteristics and normal tissue complication probability (NTCP) scores were computed for the OAR using different biological models.

Results

No significant differences were observed in the Dmax, D98%, and CI in the planning target volume (PTV). Both computations estimated a significant difference in V95%, D2%, and HI for the PTV. Furthermore, the FFF beam showed a significant increase in the MUs and a significant reduction in V30% for the femoral heads. The NTCP score showed a significant increase in the late effects on the bladder, rectum, and bowel with FFF beams.

Conclusion

The current study recommends FFF beams for better conformity, comparable dose coverage for the target, and OAR sparing invariable to the dose computation algorithm. The difference in the NTCP score for OAR was minimal with the FFF beam.

Keywords

cervical cancerflattening filter-freeflattening filteranisotropic analytical algorithmAcuros XBdosimetric evaluation

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Precision Radiation Oncology
Volume 7 Issue 3,
September 2023
Pages 197-206
DOI: 10.1002/pro6.1207
Cite this article:
Manna S, Singh S, Gupta PK, et al. Dosimetric and Radiobiological Impact of Flattening Filter-Free Beam and Dose Calculation Algorithm Using RapidArc Plans for Cervical Cancer Treatment. Precision Radiation Oncology, 2023, 7(3): 197-206. https://doi.org/10.1002/pro6.1207

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Received: 06 March 2023
Revised: 28 April 2023
Accepted: 15 May 2023
Published: 17 August 2023
© 2023 The Authors.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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