The dose calculation plays a crucial role in many aspects of contemporary clinical radiotherapy treatment planning process. It therefore goes without saying that the accuracy of the dose calculation is of very high importance. The gold standard for absorbed dose calculation is the Monte-Carlo algorithm.

This first of two papers gives an overview of the main openly available and supported codes that have been widely used for radiotherapy simulations.

The paper aims to provide an overview of Monte-Carlo in the field of radiotherapy and point the reader in the right direction of work that could help them get started or develop their existing understanding and use of Monte-Carlo algorithms in their practice.

It also serves as a useful companion to a curated collection of papers on Monte-Carlo that have been published in this journal.

This work aims to compare the dosimetric performance of three-dimensional conformal radiotherapy (3D-CRT), a relatively available technique in developing countries, to intensity-modulated radiotherapy (IMRT) in the treatment of different stages of nasopharyngeal carcinoma (NPC).

According to the diagnostic stages, 40 NPC patients were divided into two equal groups. Three planning techniques such as 3D-CRT, seven-field IMRT (7F-IMRT) and nine-field IMRT (9F-IMRT) were compared. Dose prescriptions of 70 and 66 Gy were delivered in 35 fractions to gross planning target volume (PTV1) and bilateral retropharyngeal carcinoma (PTV2), respectively.

Stage I dose data for almost all of the three investigated planning techniques obey the international recommendations. The dose delivered to PTV1 and PTV2 for 3D-CRT and 7F-IMRT are statistically similar, whereas 9F-IMRT is significantly better than 3D-CRT. For organs at risk (OARs), the delivered dose is significantly better for 9F-IMRT compared with the other two techniques, whereas 7F-IMRT is significantly better than 3D-CRT.

3D-CRT is an acceptable alternative treatment technique for stage I NPC patients in developing countries suffering from the lack of advanced radiotherapy treatment techniques. 3D-CRT and 7F-IMRT have comparable performance in PTVs, while 9F-IMRT is superior in PTVs and OARs.

Optically stimulated luminescence dosimeters (OSLDs) have a number of advantages in radiation dosimetry making them an excellent dosimeter for in vivo dosimetry. The study aimed to study the dosimetric characteristics of a commercial optically stimulated luminescence (OSL) system by Landauer Inc., before using it for routine clinical practice for in vivo dosimetry in radiotherapy. Further, this study also aimed to investigate the cause of variability found in the literature in a few dosimetric parameters of carbon-doped aluminium oxide (Al2O3:C).

The commercial OSLD system uses Al2O3:C nanoDotTM as an active radiation detector and InLightTM microStar® as a readout assembly. Inter-detector response, energy, dose rate, field size and depth dependency of the detector response were evaluated for all available clinical range of photon beam energies in radiotherapy.

Inter-detector variation in OSLD response was found within 3·44%. After single light exposure for the OSL readout, detector reading decreased by 0·29% per reading. The dose linearity was investigated between dose range 50–400 cGy. The dose response curve was found to be linear until 250 cGy, after this dose, the dose response curve was found to be supra-linear in nature. OSLD response was found to be energy independent for Co60 to 10 MV photon energies.

The cause of variability found in the literature for some dosimetric characteristics of Al2O3:C is due to the difference in general geometry, construction of dosimeter, geometric condition of irradiation, phantom material and geometry, beam energy. In addition, the irradiation history of detector used and difference in readout methodologies had varying degree of uncertainties in measurements. However, the large surface area of the detector placed in the phantom with sufficient build-up and backscatter irradiated perpendicularly to incident radiation in Co60 beam is a good method of choice for the calibration of a dosimeter. Understanding the OSLD response with all dosimetric parameters may help us in estimation of accurate dose delivered to patient during radiotherapy treatment.