Comparison of Monte Carlo and Collapsed Cone algorithms performance used in the Monaco treatment planning system in prediction of Cardiac and Pulmonary complications in left- breast cancer radiotherapy

Objective: The aim of this study was to evaluate the performance of dose calculation algorithms used in the Monaco treatment planning system to predict cardiac and pulmonary complications due to left breast radiation therapy. Methods: Three-dimensional dose distribution of ۲۱ patients with left breast cancer was prepared by dose calculation algorithms CC and MC with the same monitor unit. Cardiac and pulmonary complications due to radiation therapy in these patients by different radiobiological models as well as parameters Various extracts from previous studies were examined using MATLAB software. In this study, MC dose calculation is considered as benchmark data. non-parametric Friedman test and Wilcoxon test were used for statistical comparison of the obtained results. Results: A good agreement was observed between the NTCP values obtained by MC and CC algorithms, and this result is true for TCP values. For two dose calculation algorithms, the value of TCP was estimated to be acceptable, with the same parameter being higher for the Poisson model than for the Niemierko model. The difference between NTCP for CC and MC algorithms is not statistically significant for most parameter sets (PValue<۰.۰۱). The results of this study for cardiovascular complications show a high correlation between CC and MC algorithms for different parameters and endpoints. Conclusion: In this study, we have tried to investigate the possible clinical implications of the two CC and MC dose calculation algorithms used in the clinic by comparing different NTCP models/parameters. Dose calculation algorithms estimate the acceptable value of TCP and the NTCP calculated for both CC and MC algorithms. The value obtained for NTCP depends on the radiobiological parameters used in the mathematical formula and the amount of dose extracted from the dose calculation algorithms.

Keywords:

Dose calculation algorithms , TCP , NTCP , Radiobiological Models , Breast Cancer