Comparison of dose distributions in target areas and organs at risk in conformal and VMAT techniques and dose verifications with the use of thermoluminescence dosimetry

The aim of the present study is to compare dose distributions and their verification in target areas and organs at risk (OAR) in conformal and volumetric modulated arc therapy (VMAT) techniques. Proper verification procedures allow the removal of the major sources of errors, such as incorrect application of a planning system, its insufficient or cursory commissioning, as well as an erroneous interpretation of the obtained results. Three target areas (head and neck, chest, and pelvic) were selected and the treatment was delivered based on plans made using collapsed cone convolution and Monte Carlo algorithms with 6-MV photon beams, adopting conformal and VMAT techniques, respectively. All the plans were prepared for the anthropomorphic phantom. Dose measurements were performed with TL detectors made of LiF phosphor doped with magnesium and titanium (LiF:Mg,Ti). This paper presents the results of TL measurements and calculated doses, as well as their deviations from the treatment planning system (TPS) in the three planned target areas. It was established that the algorithms subject to analysis differ, particularly in dose calculations for highly inhomogeneous regions (OAR). Aside from the need to achieve the dose intended for the tumour, the choice of irradiation technique in teleradiotherapy should be dictated by the degree of exposure to individual critical organs during irradiation. While nothing deviated beyond the bounds of what is acceptable by international regulatory bodies in plans from TPS, clinically one must be more cautious with the OAR areas.