Dosimetric validation of physical and biological indexes from the dose-volume histogram for evaluation of 3D-CRT and IMRT with VMAT treatment plan techniques in cervical tumors from in-house developed software

Document Type : Original Paper


1 1. Thangam Cancer Hospital, Namakkal, Tamilnadu-637001, INDIA. 2. Department of Physics, Jamal Mohamed College (Autonomous), Affiliated to Bharathidasan university, Tiruchirappalli, Tamil Nadu-620020, India.

2 Department of Physics, Jamal Mohamed College (Autonomous), Affiliated to Bharathidasan university, Tiruchirappalli, Tamil Nadu-620020, India.

3 Department of Medical Physics & Regulatory Affairs, Hind Institute of Medical Sciences, Safedabad, Barabanki-225003, UP, India

4 Thangam Cancer Hospital, Namakkal, Tamilnadu-637001, INDIA.

5 Department of Radiation Oncology, Malnad Hospital & Institute of Oncology, Shimoga-577222, India.

6 Department of Radiation oncology, Acharya Harihar PG Insititute of Cancer, Cuttack-753007, India.



Aim: This study aims to investigate the normal tissue complication probability (NTCP) and tumor control probability (TCP) of cervical cancer from Niemierko radiobiological model and compared with LKB model’s effective volume parameter in three different planning techniques such as 3-Dimensional conformal Radiation Therapy (3D-CRT), Intensity Modulated Radiotherapy (IMRT) and Volume Metric Arc Therapy (VMAT).

The physical dose from each voxel in treatment planning was extracted through a dose volume histogram (DVH) text file in in-built software developed using python program. Software was developed by freely available python integrated with an integrated Oracle database to store the outcome results with user-friendly graphical user interface for editing the radiological parameter values and viewing the DVH graph.

Materials and Method: Twenty patients were selected with grade II and Grade III and the treatment plan was initially generated for 3D-CRT, IMRT and Rapid Arc. Dosimetric parameters such as homogeneity index (HI) and conformity index (CI) along with radiobiological parameters such as TCP, NTCP and effective volume (Veff) were compared with three different planning techniques.

Result: The IMRT and VMAT dose delivery techniques improve the efficiency of the treatment of cervical cancer with good coverage of target volume as well as low irradiation of Organ at Risk (OARs) compared with 3D-CRT.

Conclusion: There is no significant difference in effective volume for IMRT and VMAT, which proportionally increases with the advanced planning techniques, causes insignificant complication probability to normal tissues. Other conformalities parameters were showing good agreement for all the three techniques.


Main Subjects

Articles in Press, Accepted Manuscript
Available Online from 13 February 2023
  • Receive Date: 16 August 2022
  • Revise Date: 30 January 2023
  • Accept Date: 13 February 2023
  • First Publish Date: 13 February 2023