To investigate the effect of different energies on dose distribution in volumetric-modulated arc therapy (VMAT) plans for head and neck cancer.

Data from nine patients undergoing VMAT plans using 6 MV, 10 MV and dual-energy X-ray beams with the Pinnacle 3 V 9.10 treatment planning system (Philips Medical System, Fitchburg, WI, USA) were analysed for quality using the conformity index (CI) and homogeneity index (HI) for planning target volume (PTV), and for mean and maximum dose to the organs at risk (OARs): parotid glands, brainstem, spinal cord and optic nerves.

There were no clear differences in the HIs of the PTV dose among the different plans. The CIs for 10 MV and dual-energy VMAT plans were superior to that of the 6 MV VMAT plan (0·8 ± 0·3, 0·8 ± 0·3, and 0·7 ± 0·2, respectively; p = 0·001). There were no significant differences in mean/maximum dose to the OARs among the three VMAT plans.

Compared with the 6 MV VMAT plan, the dual-energy VMAT plan slightly increased the coverage of the PTV with the prescribed dose but did not decrease dose to the OARs.

The main objective of this research work is to compare the dosimertic effect on lower and upper oesophagus cancer treatment using 3D conformal radiotherapy as well as to evaluate the doses administered to the organs at risk.

In this study, a cohort of 30 oesophageal cancer patients between the ages of 45 and 67 years registered during March 2017 to February 2018 was considered. These patients were treated through 3D conformal radiotherapy using four-field technique. Beam energy of 15 MV from Varian DHX linear accelerator was used. The given 30 patients were divided into two groups. The 1st group of 15 patients with upper oesophagus cancer was prescribed 5000 cGy doses, and the 2nd group of remaining 15 patients with lower oesophagus cancer was prescribed 4500 cGy. Computed tomography scans of every patient were obtained and then transmitted to Eclipse TPS for generating treatment plans. All radiotherapy plans were evaluated through various dosimetric indices. Statistical analysis software SPSS was utilised to get the values of means standard error and standard deviation of these indices for the treatment plan evaluation.

Uniformity index (UI) calculated for first group of patients showed difference of 7·4% from ideal value. A difference of 7% between ideal and calculated UI value was observed in 2nd group of patients. The values of other dosimetric indices like coverage, homogeneity, moderate dose homogeneity index (mDHI) and radical dose homogeneity index (rDHI) were found in limits specified by the Radiation Therapy and Oncology Group. The maximum difference of 6% was observed between the coverage mean values of 1st and 2nd group treatment plans.

For oesophageal cancer, 3D conformal radiotherapy using four-field treatment plans shows homogeneous distribution of dose around the target and limits the dose to organ at risk.

The data used in brachytherapy planning are obtained from homogeneous mediums. In practice, the heterogeneous tissues and materials affect the dose distribution of brachytherapy. It is aimed to investigate the effect of air cavities on brachytherapy dose distribution using a specially designed device.

In this study, the special device designed with different volumes of air and water to be irradiated and measured at different depths using EBT3 Gafchromic films. EBT3 Gafchromic films were preferred for this study because they can be cut to the shape of the experimental geometry, are water resistance and double directional usability.

In our study, sudden dose increases and decreases were observed at the water–air–water interfaces. Increases were 9, 11·8 and 15% in the 13, 18 and 22 mm apparatus, respectively. These effects were expected and the results were consistent with the literature and within the tolerance limits stated in the clinical dose guidelines. The most important result is that the percent depth–dose curve of the radiation passing through the air to the water and only passing through the water medium is different. The average differences were 1·97, 2·97 and 2·31% for the 13, 18 and 22 mm apparatus, respectively.

Although the effect of heterogeneity may be neglected according to clinical guidelines, it is suggested that the dose effect of heterogeneity is taken into account so that the dose can be estimated sensitively. Brachytherapy plans using dose data without considering air gaps may cause erroneous dose distributions due to heterogeneity of tissue.

To develop a software program to convert physical dose distribution into biological effective dose (BED).

The MATLAB-based BED distribution software program was designed to import the radiotherapy treatment plan from the computer treatment planning system and to convert the physical dose distribution into the BED distribution. The BED calculation was based on the linear-quadratic-linear model (LQ-L model). Besides radiobiological parameters, other specific data could be fed in through the panel. The accuracy of the program was verified by comparing the BED distribution with manual calculation.

This software program was able to import the radiotherapy treatment plans and pull out pixel-wised physical dose for BED calculation, and display the isoBED lines on the computed tomographic (CT) image. The verification of BED dose distribution was performed in both phantom and clinical cases. It revealed that there were no differences between the program and manual BED calculations.

It is feasible and practical to use this in-house BED distribution software program in clinical practices and research work. However, it should be used with caution as the validity of the program depends on the accuracy of the published biological parameters.

In radiation therapy, to spare normal surrounding tissues, either Multileaf Collimators or Cerrobend blocks are used.

The current study focuses on the relative dose distribution under the areas protected by Cerrobend blocks.

A dual-energy linear accelerator and a Cobalt-60 machine were utilised as radiation sources. Several blocks were designed using commercially available materials to shield radiation fields. The relative dose distribution was then evaluated using extended dose range 2 films.

Results showed that the dose distribution under protected areas depends on several parameters including the width and height of protecting blocks, incident photon beam energy, radiation field size and source to surface distance. An increase in Cerrobend block height from 80 to 95 mm significantly decreases the dose at the protected areas.

An increase in the block width and photon energy decreases the relative dose deposition at the protected area. However, electron and neutron contaminations should also be taken into consideration.