Abstract

Purposes: The goal of this study was to use Monte Carlo (MC) simulation to examine the dosimetric effects of the air cavity on JO-IMRT dose distribution at air-tissues interfaces in head-and-neck (H&N) patients.

Methods: The EGSnrc - MC code system was used to calculate the dose reductions in air-tissue interface region for single field irradiations with 1×1, 2×2, 3×3, 4×4, and 5×5 cm2 in solid acrylic phantoms (30×30×20 cm3) and seven fields in a JO-IMRT plan. With phantom, the PDD values in both with and without an air cavity (15×4×4 cm3) which is 2.5 cm away from the anterior surface of phantom were used to evaluate. With the JO-IMRT plan, the dose-volume histograms (DVH), slice by slice isodose, and the gamma index using global methods implemented in PTW-VeriSoft with 3%/3 mm criteria were used to evaluate.

Results: The study results indicate that the dose reductions in the air-tissue interface region of the phantom are strongly dependent on field size. The average percentage dose reductions at 1 mm from the air-water interface for the field size 1×1, 2×2, 3×3, 4×4, and 5×5 cm2 are 62.04%, 52.34%, 40.71%, 26.72%, and 19.85%, respectively. Additionally, the mean MC dose in the PTV (65.58 Gy) of patients were lower than the TPS predicted dose (71.41 Gy).

Conclusions: From this study, we conclude that the dose reduction in near air-tissue interfaces is a significant effect on JO-IMRT dose distribution in head-and-neck (H&N) patients.