Comparison of pencil beam–based homogeneous vs inhomogeneous target dose planning for stereotactic body radiotherapy of peripheral lung tumors through Monte Carlo–based recalculation

Dosimetric differences between local failure and local controlled non‐small cell lung cancer patients treated with stereotactic body radiotherapy: A matched‐pair study

“…One of the planning factors is the algorithm used for dose calculation. Previous studies have shown that the use of PB dose results in an over‐estimation of the actual planned dose by approximately 10% . To evaluate the potential impact of tumour underdosing with PB calculation for local failure, we performed a matched‐pair study in which patients with and without local failure were paired and matched for other clinical factors in a population all treated with a dose of 50 Gy in five fractions using the same treatment planning and delivery technique.…”

“…Previous studies have shown that the use of PB dose results in an over-estimation of the actual planned dose by approximately 10%. [9][10][11][12][13][14][15] To evaluate the potential impact of tumour underdosing with PB calculation for local failure, we performed a matched-pair study in which patients with and without local failure were paired and matched for other clinical factors in a population all treated with a dose of 50 Gy in five fractions using the same treatment planning and delivery technique. Cases of local failure were successfully matched to control subjects while accounting for similar lengths of follow-up time and similar clinical features.…”

“…In particular, the inaccuracy of early dose calculation algorithms such as pencil beam (PB) relative to modern methods could have led to lower doses delivered in some cases, resulting in a potentially higher risk of local failure. Studies have shown significant differences in target dose coverage between the clinical plans calculated with pencil beam (PB) algorithms and recalculated plans with more accurate algorithms, such as superposition‐convolution based or Monte Carlo (MC) algorithms . Our institution has over a decade of experience with SBRT treatment for NSCLC with excellent local control rate .…”

“…Studies have shown significant differences in target dose coverage between the clinical plans calculated with pencil beam (PB) algorithms and recalculated plans with more accurate algorithms, such as superposition-convolution based or Monte Carlo (MC) algorithms. [9][10][11][12][13][14][15] Our institution has over a decade of experience with SBRT treatment for NSCLC with excellent local control rate. 5,16 Our initial planning approach utilised PB dose calculation with the BrainLAB iPlan system (BrainLAB AG, Feldkirchen, Germany).…”