Dose measurement of optic chiasm and parotid organs using OCTAVIUS 4D phantom: a dynamic IMRT method for nasopharyngeal cancer treatment

Abstract

Introduction: In intensity-modulated radiation therapy (IMRT) techniques, although the dose conformity increases, the out-of-field doses would not decrease. This study aimed to assess the dose error calculated by the treatment planning system (TPS) in the out-of-field regions using the dynamic IMRT (D-IMRT) method in nasopharyngeal cancer (NPC) patients. Methods: The out-of-field doses were measured for the chiasm and parotid organs using the D-IMRT technique (6 MV energy) with Monaco TPS. Computed tomography (CT) images of 10 NPC patients (54–77 years, mean: 61.6 ± 12.2 years) were considered and countered using 7-field and 11-field methods. The OCTAVIUS 4D phantom was utilized for dose assessment. Results: According to the OCTAVIUS measurements, the Monaco TPS dose errors ranged from −58.8 to 105.5%. The average dose error for optic chiasm and parotid organs was −25% and 8.5%, respectively, with several cases falling within tolerance (±5%). Conclusion: There were considerable dose calculation errors by Monaco TPS for organs located in out-of-field regions (optic chiasm and parotid) during IMRT for NPC patients. Therefore, accurate dose estimation in the out-of-field regions should be considered in clinical practices.

Keywords

• Optic chiasm
• Parotid
• Intensity-modulated radiation therapy
• Nasopharyngeal cancer
• OCTAVIUS 4D phantom