International Journal of Radiation Research

en Flattened photon beams, an obsolete feature in modern linear accelerators Radiation Biology Radiation Biology تحقيق بديع Original Research <div style="text-align: justify;">Background: With the advent of Intensity Modulated Radiotherapy (IMRT) and recently, Volumetric Modulated Arc Therapy (VMAT), treatment planning using Flattening Filter Free (FFF) beams can meet all of the energy requirements in radiation therapy clinics. Manufacturers of linear accelerators no longer need to install a flattening filter (FF) in gantry head. This study aims to provide evidence of the superiority of FFF to FF through both dosimetric measurements and clinical treatment plans. Materials and Methods: A 50×50×50cm3 water phantom was created in the RayStation treatment planning system (TPS) for dosimetry comparisons. Flat beam profiles were generated using FFF beam through an optimization process for 10×10 to 30×30cm2 field sizes. Next, a comparison of treatment plans was made using 21 Head and Neck and 14 Lung/Mediastinum treatment sites using 6MV and 6MV-FFF beams. Results: Using FFF beams, profiles with flatness and symmetry identical to or better than those of the flattened beams were produced. At the very edge of the optimized plans for FFF beams, horns had the highest gamma index deviation <1.5% of the normalized dose. For clinical plans evaluated, most of the mean doses to organs-at-risk (OAR) volumes receiving 5% to 30% of the prescription dose were reduced with FFF beams. Conclusion: These results indicate the feasibility of delivering flat beams with FFF quality and producing treatment plans with equal or higher qualities in PTV coverage while achieving better sparing of OAR which will allow escalation of target dose if desired. Plus, removing FF will simplify the gantry head and reduces quality assurance and machine maintenance efforts.  </div>     radioactive Flattening filter free, linac, VMAT, sliding window. 845 850 http://ijrr.com/browse.php?a_code=A-10-1-987&slc_lang=en&sid=1 E.I. Parsai ishmael.parsai@gmail.com 7900319475328460022674 7900319475328460022674 Yes Department of Radiation Oncology, University of Toledo Medical Center, 1325 Conference Drive, Toledo, OH 43614, USA E. Salari 7900319475328460022675 7900319475328460022675 No Department of Radiation Oncology, University of Toledo Medical Center, 1325 Conference Drive, Toledo, OH 43614, USA D. Shvydka 7900319475328460022676 7900319475328460022676 No Department of Radiation Oncology, University of Toledo Medical Center, 1325 Conference Drive, Toledo, OH 43614, USA J. Wan 7900319475328460022677 7900319475328460022677 No Advanced Radiation Physics Service, Inc. Toledo, Ohio Metropolitan Area, Toledo, OH 43614, USA