title: Pretreatment verification of dose calculation and delivery by means of measurements with PLEXITOM™ phantom.
abstract: OBJECTIVE
  To validate a pretreatment verification method of dose calculation and dose delivery based on measurements with Metaplex PTW phantom.
  
  
  BACKGROUND
  The dose-response relationships for local tumor control and radiosensitive tissue complications are strong. It is widely accepted that an accuracy of dose delivery of about 3.5% (one standard deviation) is required in modern radiotherapy. This goal is difficult to achieve. This paper describes our experience with the control of dose delivery and calculations at the ICRU reference point.
  
  
  METHODS
  The calculations of dose at the ICRU reference point performed with the treatment planning system CMS XiO were checked by measurements carried out in the PLEXITOM™ phantom. All measurements were performed with the ion chamber positioned in the phantom, at the central axis of the beam, at depth equivalent to the radiological depth (at gantry zero position). The source-to-phantom surface distance was always set to keep the source-to-detector distance equal to the reference point depth defined in the ICRU Report 50 (generally, 100 cm). The dose was measured according to IAEA TRS 398 report for measurements in solid phantoms. The measurement results were corrected with the actual accelerator's output factor and for the non-full scatter conditions. Measurements were made for 111 patients and 327 fields.
  
  
  RESULTS
  The average differences between measurements and calculations were 0.03% (SD = 1.4%), 0.3% (SD = 1.0%), 0.1% (SD = 1.1%), 0.6% (SD = 1.8%), 0.3% (SD = 1.5%) for all measurements, for total dose, for pelvis, thorax and H&N patients, respectively. Only in 15 cases (4.6%), the difference between the measured and the calculated dose was greater than 3%. For these fields, a detailed analysis was undertaken.
  
  
  CONCLUSIONS
  The verification method provides an instantaneous verification of dose calculations before the beginning of a patient's treatment. It allows to detect differences smaller than 3.5%.
authors.affiliation: Medical Physics Department, Holycross Cancer Centre, Kielce, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Wołowiec
authors.affiliation: Medical Physics Department, Holycross Cancer Centre, Kielce, Poland ; The Jan Kochanowski University of Humanities and Sciences, Kielce, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Kukołowicz
authors.affiliation: Medical Physics Department, Holycross Cancer Centre, Kielce, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Lis
keywords: PLEXITOM™; Quality control; Radiotherapy; Treatment plan verification