COMPARISON OF THE PERFORMANCE OF MONTE-CARLO AND COLLAPSED CONE ALGORITHMS USED IN MONACO TREATMENT PLANNING SYSTEM IN PREDICTING CARDIOPULMONARY COMPLICATIONS DUE TO THE LEFT BREAST RADIOTHERAPY

The aim of this study was to evaluate the performance of dose calculation
algorithms used in the Monaco treatment planning system to predict cardiopulmonary complications
due to left breast radiotherapy.
Materials & Methods: Three-dimensional dose distribution of 21 patients with left breast cancer was
prepared by two-dose calculation algorithms (CC and MC) with the same unit monitor.
Cardiopulmonary complications due to radiation therapy in these patients were evaluated by different
radiobiological models as well as various parameters extracted from previous studies using MATLAB
software. In this study, MC dose calculation is considered as benchmark data. Algorithms, Friedman
nonparametric test, and Wilcoxon test were used for statistical comparison of the obtained results.
Results: For both 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 in
NTCP for CC and MC algorithms for pulmonary pneumonitis, pericarditis, and cardiac mortality is not
statistically significant by most parameters.
Conclusion: Both dose calculation algorithms estimate the TCP value as acceptable and the NTCP
calculated by these two algorithms is close to the expected NTCP value. The value obtained for TCP,
and NTCP depends on the radiobiological parameters used in the mathematical formula and the amount
of dose extracted from the dose calculation algorithms.