Feasibility of Monte-Carlo algorithm in comparison with collapse-cone dose calculation algorithm of a commercial treatment planning system in the presence of high-density metallic implant: a dosimetric study

Background The number of people with implanted hip prosthesis has grown worldwide. For radiotherapy planning of patients with hip implants, few main challenges are encountered. The aim of the present study was to evaluate the feasibility of different planning algorithms in the presence of high-density metallic implant in the treatment of patients with carcinoma cervix. Results It was found that D-98% were 44.49 +/- 0.11, 44.51 +/- 0.13, 44.39 +/- 0.22, and 44.45 +/- 0.16 Gy for 4FMC6MV (4-field technique calculated with Monte-Carlo algorithm and 6 MV photon energy), 4FMC6MV_WP (4-field technique calculated with Monte-Carlo algorithm and 6 MV photon energy without prosthesis), 4FCC6MV (4-field technique calculated with collapse-cone-convolution algorithm and 6 MV photon energy), and 4FCC6MV_WP (4-field technique calculated with collapse-cone-convolution algorithm and 6 MV photon energy without prosthesis) respectively. Similarly, D-2% were 49.40 +/- 0.84, 49.05 +/- 0.76, 48.97 +/- 0.91, and 48.57 +/- 0.85 Gray (Gy) for 4FMC6MV, 4FMC6MV_WP, 4FCC6MV, and 4FCC6MV_WP respectively. The present study has not suggested any major difference between the Monte-Carlo (MC) and collapse-cone-convolution (CCC) calculation algorithm in the presence of high-Z metallic implants. Volume of bowel receiving 15 Gy dose has shown a significant difference with prosthesis cases. This study investigates that hip prosthesis creates considerable changes in the treatment planning of cervical malignancies. Conclusion CCC algorithm is in good agreement with MC calculation algorithm in the presence of high-density metallic implants in terms of target coverage and avoidance organ sparing except few parameters.