Out-of-Field Dose Calculation by a Commercial Treatment Planning System and Comparison by Monte Carlo Simulation for Varian TrueBeam(®)

PURPOSE: The calculation accuracy of treatment planning systems (TPSs) drops drastically when the points outside the field edges are considered. The real accuracy of a TPS and linear accelerator (linac) combination for regions outside the field edge is a subject which demands more study. In this study, the accuracy of out-of-field dose calculated by a TPS, used with a TrueBeam(®) (TB) linac, is quantified. MATERIALS AND METHODS: For dose calculation, Eclipse™ version 13.7 commissioned for TB machine was used. For comparison, Monte Carlo (MC) methods, as well as the measurements, were used. The VirtuaLinac, a Geant 4-based MC program which is offered as a cloud solution, is used for the generation of input phase-space (PS) files. This PS file was imported into PRIMO (PENELOPE based MC program) for the simulation of out-of-field dose. RESULTS: In this study, the accuracy of the out-of-field dose calculated by a TPS for a TB linac was estimated. As per the results in comparison with MC simulations, the TPS underestimated the dose by around 45% on an average for the off-axis-distance range considered in this study. As the off-axis distance increased, the underestimation of the dose also increased. CONCLUSION: In this work, it was observed that the TPS underestimates doses beyond the edges of treatment fields for a clinical treatment executed on a TB machine. This indicates that the out-of-field dose from TPSs should only be used with a clear understanding of the inaccuracy of dose calculations beyond the edge of the field.