Comparison of radiation dose calculation differences between uRT-TPS and Monaco-TPS for the same linear accelerator in multiple cancers

doi:10.19401/j.cnki.1007-3639.2024.01.005

Abstract

Abstract:

Background and Purpose: In recent years, domestic radiotherapy equipment and related software have made great progress, and testing the functionality and stability of the equipment and software is an essential step. This paper focused on comparing the differences in intensity-modulated radiation therapy (IMRT) plans dosimetry and organ at risk (OAR) volume calculations for common cancers between uRT-treatment planning system (TPS) and Monaco-TPS, and to evaluate the feasibility of dose calculation for Infinity linac (linear accelerator, Elekta, Sweden) using uRT-TPS. Methods: Twenty cases of rectal cancer, lung cancer, breast cancer and nasopharyngeal carcinoma were selected. The IMRT plans were completed in uRT-TPS and Monaco-TPS. The dose uniformity and conformity, mean dose, maximum dose of planning target volume (PTV) and OAR between two plans under the same prescribed dose of PTV were compared. And the pass rates of two TPS plans validated at the same linear accelerator were compared. Meanwhile, monitor units (MU), source skin distance (SSD) and the volume of OAR in uRT-TPS and Monaco-TPS were compared. Results: Wonderful plans that met the clinical requirements were obtained in uRT-TPS and Monaco-TPS. Comparable uniformity and conformability was received in PTV, and the maximum dose of PTV was reduced by 1.1 Gy for uRT-TPS (P = 0.006). For breast cancer and lung cancer, the dose in lung was lower for Monaco-TPS (P<0.05). For nasopharyngeal carcinoma, the dose indicators that oral cavity and throat in the uRT-TPS was reduced by 9.2% and 5.1%, respectively. The verification results of absolute point dose (<3%) and three-dimensional surface dose (>95%) for both plans met the clinical requirements. The region of interest in uRT-TPS was smaller compared with Monaco-TPS (P<0.05). Conclusion: A comparable IMRT plan was obtained for common tumors in uRT-TPS and Monaco-TPS. It is feasible to calculate the dose of Infinity linac using uRT-TPS.

Key words: Intensity-modulated radiation therapy, uRT-treatment planning system, Monaco-treatment planning system

CLC Number:

R730.55

YANG Yanju, FANG Yingtao, GAO Dadi, WANG Jiazhou, ZHAO Jun, HU Weigang. Comparison of radiation dose calculation differences between uRT-TPS and Monaco-TPS for the same linear accelerator in multiple cancers[J]. China Oncology, 2024, 34(1): 82-89.

Figures/Tables 6

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Cancer	Indicator	OAR
Rectal cancer	V_{20 Gy}, V_{30 Gy}, V_{45 Gy}	Bladder
Rectal cancer	D_mean	Left and right femoral heads
Lung cancer	V_{5 Gy}, V_{20 Gy}, D_mean	Lung-PTV
	D_mean	Heart
	D_max	SC
Breast cancer	V_{20 Gy}, V_{5 Gy}, D_mean	Ipsilateral lung
	V_{5 Gy}	Contralateral lung
	D_mean	Heart
Nasopharyngeal carcinoma	D_max	BS, SC, lens, eyes, OC, ON
	V_{30 Gy}	Left and right parotid
	V_{35 Gy}	Oral cavity
	V_{45 Gy}	Larynx

TPS	PTV D_max	PTV D_mean	PTV D₅	HI	CI	MU
uRT-TPS	59.4±8.2	54.8±6.9	57.5±7.3	0.097±0.070	0.745±0.299	757.5±171.7
Monaco-TPS	60.5±7.7	55.1±7.1	57.8±7.3	0.096±0.070	0.741±0.291	817.4±197.4
P value	0.006	0.191	0.581	0.807	0.290	0.204

Indicator	Monaco-TPS/cm³	uRT-TPS/cm³	P value
PTV	722.882±462.005	718.296±460.728	0.004
Bladder	99.542±35.464	95.868±35.459	0.043
Femoral heads	137.844±21.41	134.955±21.216	0.005
Lung	1979.571±1263.921	1971.379±1253.536	0.008
Heart	616.295±73.778	612.737±76.202	0.022
Spinal cord	45.631±17.454	44.533±16.993	0.028
Lens	0.597±0.432	0.443±0.348	0.013
Eyes	10.947±2.357	10.267±2.057	0.007
Optic nerve	1.364±0.422	0.927±0.215	0.005
SSD	91.986±2.524	91.939±2.505	0.024

Regular structure	MIM/cm³	Monaco-TPS/cm³	uRT-TPS/cm³	Eclipse-TPS/cm³
D1 cylinder	0.81	0.80	0.49	0.51
D3 cylinder	10.63	10.56	8.84	8.47
D6 cylinder	393.87	396.41	392.05	393.03
A1 cuboid	2.19	2.17	1.83	1.84
A3 cuboid	8.82	8.78	7.10	6.82
A6 cuboid	621.01	625.81	619.40	619.90