Abstract
Purpose:IMRT is preferred in the range of 6–10MV X‐rays. Partially adding high energy (>10MV) treatment fields, may provide advantage of both higher and lower energies. To study IMRT dose distribution obtained from treatment plans with single (6MV) and mixed‐energy (6MV and 15MV) for deep seated targets (separation more than 30cm).Methods:Five patients of carcinoma of cervix were studied using eclipse planning system. Two different dynamic IMRT plans were generated for Varian CL2300C/D linear accelerator; one is by using 6MV X‐ray with seven equally spaced coplanar beams. In second plan, 2 lateral oblique fields (gantry angle 102°, 255°) beam energy was modified to 15MV by keeping all other parameters and dose volume constraints constant. Dose prescription for the planning target volume (PTV) was (5040cGy/28f). For plan comparison, dose volume histogram (DVH) was used and PTV coverage index (CI=Target volume covered by prescription dose/Target volume), heterogeneity index (D5/D95), mean dose to organ at risk (OAR) and normal tissue integral dose (NTID, liter‐Gray) was also noted. Total monitor unit (MU) required to deliver a plan was also noted.Results:Mixed‐energy plan showed a better conformity and CI values were 0.942±0.032 and 0.960±0.040 for single‐energy and mixed‐energy plan, respectively. In addition, HI value of mixed energy beam is comparable to that of single energy and the values were within 1.084±0.034 and 1.082±0.032 for single energy and mixed‐energy plan, respectively. Variation in mean dose to bladder, rectum and bowel were within 1.05%, 0.87% and 0.90%. NTID was lesser for mixed‐energy beam due to use of two high‐energy fields. NTID were 1573.40±214.60 and 1510.20±249.80 litre‐Gray for single energy and mixed‐energy plan. MU needed to deliver a plan was similar in both plans and MUs were 238±45 and 237±47.Conclusion:Partial use of 15MV treatment fields in IMRT plan for deep seated targets showed dosimetric advantage over 6MV plan.
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