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Background: The aim of the study was to answer the question of whether flattening filter (FF) and flattening filter-free (FFF) beams can be used alternately in the volumetric modulated arc therapy (VMAT) treatment technique, regardless of the size of the irradiated volume [small (S) or large (L) planning target volume (PTV)]., Materials and Methods: Two groups of patients were examined: a group with a S-PTV-laryngeal cancer and a group with a L-PTV - gynecological volume. For each patient, two treatment plans were made for beams (energies): FFF-X10MV and FF-X15MV. Then, a statistical analysis, nonparametric test, and independent groups were performed, comparing the beams' impact on the analyzed treatment plans., Results: In the case of laryngeal irradiation (S-PTV), there are no statistically significant differences between the energy used and the assessed parameters of the plan. In the case of gynecological volume (L-PTV), only statistically significant differences were noted for the number of monitor units depending on the energy used. For a large irradiated volume (gynecological case), the use of FFF beams increases the number of monitor units by 39,4% in relation to the FF beam., Conclusions: In the case of gynecological neoplasms, statistically significant differences were found in the number of monitor units. Therefore, in the case of irradiation of L-PTV, it is recommended that flattening-filtering beams are used due to the smaller number of monitors. In the case of S-PTV, no statistically significant differences were found between the types of beams used (FF or FFF) and the treatment plan parameters analyzed in the study., Competing Interests: Conflict of interest: None declared., (© 2023 Greater Poland Cancer Centre.)

Background: The basal cell carcinoma (BCC) is often treated by surgery or radiotherapy using ionizing radiation. While there is an established diagnostic path before treatment and also for the follow-up there are no good noninvasive methods objectifying irradiated area evolution during treatment. The main goal of preliminary studies was to try to answer if there are any useful information that can be derived from temperature effects of high-dose-rate (HDR) brachytherapy in treatment of BCC. Moreover, the temperature gradient was introduced as a physical parameter characterizing the thermal map of the lesion, its surroundings and reference area, which provided information about cancer tissue thermal reaction to brachytherapy., Materials and Methods: Thirty-three patients suffering from BCC were monitored with thermovision during the brachytherapy treatment. All lesions were diagnosed as superficial and were confirmed with histopathology examination., Results: Results of the study showed two groups of patients characterized with two thermal maps and temperature gradient describing the lesion and surrounding area of BCC. The first group was characterized by higher temperature of the lesion than the surrounding tissue temperature (mean dT = 0,41°) whereas the other one, with lower lesion temperature (mean dT = -0.42°). It seems that the temperature changes observed in designated areas before and after therapy may provide physicians with additional information which could be useful in planning the treatment process, especially when considering temperature gradient changes during therapy., Conclusions: Although the data obtained indicate the possibilities of temperature distribution in pre-irradiation cases, further research is required for estimation of clinical effects of treatment., Competing Interests: Conflict of interests None declared., (© 2022 Greater Poland Cancer Centre.)

Background: To properly configure a treatment planning system, a measurement data set is needed, which consists of the values required for its configuration. The aim is to obtain a dosimetric model of the beam that is as compatible as possible with the measured values. The set of required data can be supplemented with optional values. The aim of the study was to assess the influence of optional measurement data on the compliance of the calculations with the measurements., Materials and Methods: Dosimetric measurements, model configuration and dose distribution calculations were performed for the photon radiation beams generated by the VMS TrueBeam ® linear accelerator. Beams were configured on an Eclipse™ v. 15.6 system using the Acuros v. 15.6 algorithm. The measured and calculated data were entered into the Alfard™ software for comparison with the calculated dose distributions. In the last stage, the absolute dose values at the designated points were also compared. The obtained data were statistically analysed with Statistica™ v. 13.3., Results: The work showed that the differences in the shape of the beam profile, depth dose and the dose value in points were not related to the use of optional data. Differences in dose distributions are within the tolerance. It cannot be determined under which conditions the use of optional data has a more favourable effect on the reflection of the actual dose values., Conclusions: The use of optional data in modelling photon radiation beams does not significantly improve the compliance of the calculated and measured dose values., Competing Interests: Conflict of interest None declared., (© 2022 Greater Poland Cancer Centre.)

Background: The comparison between profiles during the commissioning of the treatment planning system is an essential procedure. It is impossible to designate a field size for off-axis, wedged, and FFF beams directly by using the definition of the on-axis symmetric field size. This work proposes the use of different characteristic points as indicators of the field size for commissioning and QA purposes. This work aimed to search for the beam profile's characteristic points and use them for the TPS commissioning purposes., Materials and Methods: The proposal is to use profile inflection points as the beam profile characteristic points. The usage of dedicated software allowed for comparing distances between inflection points and between points of 50% intensity. For the off-axis, wedged, and FFF fields, comparisons were made to the nominal field sizes., Results: Distances between inflection points proved to be different by less than 1 mm from nominal field sizes for all kinds of investigated beams., Conclusions: Inflection points are convenient for comparing the off-axis, wedged, and FFF field sizes because of their independence from profile normalization. With finite accuracy, the inflection points could be used for the above kind of beam sizes designation., Competing Interests: Conflicts of interests K.Ś. acts as Scientific Consultant to Varian Medical Systems Poland. All other co-authors have no conflicts of interest., (© 2021 Greater Poland Cancer Centre.)

Aim: The aim of this study is to answer the question whether the calculated dose distributions for HD and Millennium collimators (Varian Medical Systems) are equivalent for large treatment volumes., Background: Modern biomedical linacs are equipped with multileaf collimators where leaves can be of different widths. Thinner leaves allow better fit to desired (tumor) shape. At the same time, however, the maximum size of the field that can be obtained with the collimator is also reduced. Varian Medical Systems HD and Millennium collimators can be a good sample. They have 40 cm or 22 cm × 40 cm maximal field size at the isocenter, respectively., Materials and Methods: This paper presents the comparison of selected statistical and dosimetric parameters achieved for treatment plans where the beams for a HD collimator had to be merged because of the size of the tumor volume., Results and Discussion: Achieved results show that, independently from irradiated volume, there is no statistically significant difference for calculated dose distributions, integral doses, MU values and coefficients evaluating dose distributions for HD and Millennium collimators., Conclusions: Results show that both types of collimators can be used interchangeably for preparing the treatment plans for large tumor volume without quality reduction of the prepared treatment plan.

Aim: Comparisons of integral dose delivered to the treatment planning volume and to the whole patient body during stereotactic, helical and intensity modulated radiotherapy of prostate., Background: Multifield techniques produce large volumes of low dose inside the patient body. Delivered dose could be the result of the cytotoxic injuries of the cells even away from the treatment field. We calculated the total dose absorbed in the patient body for four radiotherapy techniques to investigate whether some methods have a potential to reduce the exposure to the patient., Materials and Methods: We analyzed CyberKnife plans for 10 patients with localized prostate cancer. Five alternative plans for each patient were calculated with the VMAT, IMRT and TomoTherapy techniques. Alternative dose distributions were calculated to achieve the same coverage for PTV. Integral Dose formula was used to calculate the total dose delivered to the PTV and whole patient body., Results: Analysis showed that the same amount of dose was deposited to the treated volume despite different methods of treatment delivery. The mean values of total dose delivered to the whole patient body differed significantly for each treatment technique. The highest integral dose in the patient's body was at the TomoTherapy and CyberKnife treatment session. VMAT was characterized by the lowest integral dose deposited in the patient body., Conclusions: The highest total dose absorbed in normal tissue was observed with the use of a robotic radiosurgery system and TomoTherapy. These results demonstrate that the exposure of healthy tissue is a dosimetric factor which differentiates the dose delivery methods.