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Introduction: Monte Carlo (MC) is considered to be the most accurate method to calculate dose distribution in radiation therapy. However, the limitation of MC simulations is the long calculation time to reach the desired statistical uncertainty in the dose calculation as well as in clinical practice. To overcome the above limitations, Variance reduction techniques (VRTs) has developed and shorten the calculation time while maintaining accuracy. Therefore, the purpose of this study is the application of VRTs in code EGSnrc to find the optimal method for accelerator simulation and calculated dose distribution using MC method. Methods: The linear Accelerator HPD Siemens Primus at the General Hospital of Dong Nai had been simulated by using BEAMnrc code and several variance reduction techniques such as: range rejection, photon forcing, bremsstrahlung photon splitting (uniform, selective and direction)... These VRTs were used under the same set of input parameters as histories of 2x108, photon energy of 6 MV, structure, size and material of the phantom… The computational efficiency ε is calculated by the following equation ε = 1/T.σ2 where T is the CUP time of calculation and  σ2 is an estimate of the variance, for evaluating and selecting the VRT which gives the best computational efficiency. Results: The results showed a good agreement between the calculated dose and measured ones when applying different VRTs. These techniques were significantly reduced uncertainty in simulation compared the analog cases. Specifically, the efficiency of DBS and UBS improved by more than 90 times and 15 times compared with the analog instances, respectively. Rang rejection and photon forcing techniques also haveimproved the efficiency of simulation, but not significantly. Conclusions: The application of the VRTs for EGSnrc increase the efficiency of the simulation. VRTs is a powerful tool that should be applied for the simulation by code EGSnrc to improve calculation efficiency by reducing simulation time and its variance. Our results show that the direction bremsstrahlung splitting (DBS) gives thebest computational efficiency.

The goal of radiation therapy is twofold: maximize the possibility of destroy malignant cells while minimizing the damage to healthy tissue. The introduction of intensity modulated radiation therapy (IMRT) technique has brought improvements in this goal. Multi-leaf collimator (MLC) is a useful tool for IMRT. However, the use of MLC is not necessarily mandatory. The Panther Treatment Planning System version 4.6, Prowess Inc., enables the implementation of this technique for accelerator without MLC (the socalled Jaws-Only IMRT technique). This study aims to evaluate the results of application of Jaws-only IMRT technique for nasopharyngeal carcinoma patients at Dong Nai general hospital. Twenty five patients were randomly selected for this study. For each patient, two plans were generated: 3D-CRT (Three-Dimensional Radiation Treatment) and JO-IMRT. The dose distributions, dose-volume histograms (DVH), conformity indexes (COIN), homogeneity indexes (HI) were used to compare between these two plans and find out the best plan. Pretreatment verifications were performed for all patients' plans using ion chamber (Farmer Type Chamber FC65-P, IBA), detector array (MapCHECK2, Sun Nuclear Corporation and Octavius 4D 1500, PTW). The average deviation between measurement and calculation for point dose was 2.3±1.1 %, within limit dose constraint. For detector array measurements, the gamma index with 3 % dose difference and 3 mm was higher than 95 %. The results showed that the JO-IMRT technique had generated better dose distribution in the target volume and reduced dose to healthy tissues compared to 3D-CRT.