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A verificação de forma independente do cálculo de dose e de unidades monitoras num plano de tratamento de IMRT é um passo importante nos procedimentos de garantia de qualidade da técnica em questão. Atualmente este verificação é baseada apenas em medidas experimentais demoradas e trabalhosas. Neste trabalho foi desenvolvido uma metodologia de cálculo de unidades monitoras de forma independente como uma nova ferramenta para garantir a qualidade e exatidão dos tratamentos de IMRT. Os valores encontrados se aproximam bastante dos valores calculados pelo sistema de planejamento utilizado, de forma que o algoritmo de cálculo desenvolvido apresentou uma concordância dentro de ± 1,8 % para uma geometria simples. Após diversos testes e com os níveis de ação devidamente estabelecidos, a verificação independente da unidade monitora para planos de tratamento de IMRT se tornará uma ferramenta efetiva e eficiente no controle de qualidade que ajuda a identificar e reduzir possíveis erros de tratamento em radioterapia. Como contribuição original deste trabalho, assegura-se aos serviços de Radioterapia a utilização da metodologia desenvolvida como ferramenta de controle de qualidade em tratamentos com IMRT. Em especial aos serviços que não dispõem de recursos econômicos para adquirirem softwares comercialmente disponíveis para o cálculo independente da unidade monitora. / Independent verification of dose calculations and monitor units settings of IMRT treatment plans is an important step in the quality assurance procedure for IMRT technique. At present, the verification is mainly based on experimental measurements, which are time consuming and laborious. In this work an independent methodology of monitor units calculation was developed as a new tool for IMRT treatments quality and precision assurance. The values found are near those calculated by the treatment planning system used, in a manner that the calculation algorithm demonstrated ± 1,8 % concordance in a simple geometry with the system. After several tests and the levels of action well established, the independent monitor units verification for IMRT treatment plans will become an effective and efficient tool in quality assurance, helping identification and the reduction of possible mistakes in radiotherapy treatments. To radiotherapy services is assured the use of the developed methodology as a tool of quality control in IMRT treatments as an original contribution of this work, specially those that do not dispose financial resources to acquire commercially available independent monitor unit calculus software.

A verificação de forma independente do cálculo de dose e de unidades monitoras num plano de tratamento de IMRT é um passo importante nos procedimentos de garantia de qualidade da técnica em questão. Atualmente este verificação é baseada apenas em medidas experimentais demoradas e trabalhosas. Neste trabalho foi desenvolvido uma metodologia de cálculo de unidades monitoras de forma independente como uma nova ferramenta para garantir a qualidade e exatidão dos tratamentos de IMRT. Os valores encontrados se aproximam bastante dos valores calculados pelo sistema de planejamento utilizado, de forma que o algoritmo de cálculo desenvolvido apresentou uma concordância dentro de ± 1,8 % para uma geometria simples. Após diversos testes e com os níveis de ação devidamente estabelecidos, a verificação independente da unidade monitora para planos de tratamento de IMRT se tornará uma ferramenta efetiva e eficiente no controle de qualidade que ajuda a identificar e reduzir possíveis erros de tratamento em radioterapia. Como contribuição original deste trabalho, assegura-se aos serviços de Radioterapia a utilização da metodologia desenvolvida como ferramenta de controle de qualidade em tratamentos com IMRT. Em especial aos serviços que não dispõem de recursos econômicos para adquirirem softwares comercialmente disponíveis para o cálculo independente da unidade monitora. / Independent verification of dose calculations and monitor units settings of IMRT treatment plans is an important step in the quality assurance procedure for IMRT technique. At present, the verification is mainly based on experimental measurements, which are time consuming and laborious. In this work an independent methodology of monitor units calculation was developed as a new tool for IMRT treatments quality and precision assurance. The values found are near those calculated by the treatment planning system used, in a manner that the calculation algorithm demonstrated ± 1,8 % concordance in a simple geometry with the system. After several tests and the levels of action well established, the independent monitor units verification for IMRT treatment plans will become an effective and efficient tool in quality assurance, helping identification and the reduction of possible mistakes in radiotherapy treatments. To radiotherapy services is assured the use of the developed methodology as a tool of quality control in IMRT treatments as an original contribution of this work, specially those that do not dispose financial resources to acquire commercially available independent monitor unit calculus software.

This study investigated the delivery of electron arc treatment with a trapezoidal aperture. The aim of the investigation is to reduce the nonuniformity of the dose distribution, which is caused by the variation of the patient contour from superior to inferior. The characteristics of static electron beam were first investigated. Then a measurement-based algorithm was developed and implemented as a computer program called EarcMU to calculate the monitor units required for delivering the prescribed dose with a trapezoidal aperture. The central axis percentage depth dose was found to be independent of source-to-surface distance (SSD) and the width of the aperture. The inplane profiles of a trapezoidal aperture show that the dose decreases longitudinally from the wide to the narrow end of the trapezoidal aperture. The EarcMU program was verified using two cylindrical water phantoms. The measured dose and the dose calculated by the program agreed within 2.1% in the typical clinical conditions. A simple method was also proposed for determining the trapezoidal aperture for an individual patient. Under the same conditions, the trapezoidal apertures calculated by this method along with the open aperture were used to deliver treatments to several conical phantoms. Significant improvement in the uniformity of dose distribution was observed. On average, the flatness index of the longitudinal dose distribution from superior to inferior decreases dramatically from 8% for open aperture down to 0.58% for trapezoidal aperture. The results are clinically significant, indicating that delivering the electron arc treatment using a trapezoidal aperture can bring more uniform dose to the patient regardless of the change of patient contour from superior to inferior.

This study investigated the delivery of electron arc treatment with a trapezoidal aperture. The aim of the investigation is to reduce the nonuniformity of the dose distribution, which is caused by the variation of the patient contour from superior to inferior. The characteristics of static electron beam were first investigated. Then a measurement-based algorithm was developed and implemented as a computer program called EarcMU to calculate the monitor units required for delivering the prescribed dose with a trapezoidal aperture. The central axis percentage depth dose was found to be independent of source-to-surface distance (SSD) and the width of the aperture. The inplane profiles of a trapezoidal aperture show that the dose decreases longitudinally from the wide to the narrow end of the trapezoidal aperture. The EarcMU program was verified using two cylindrical water phantoms. The measured dose and the dose calculated by the program agreed within 2.1% in the typical clinical conditions. A simple method was also proposed for determining the trapezoidal aperture for an individual patient. Under the same conditions, the trapezoidal apertures calculated by this method along with the open aperture were used to deliver treatments to several conical phantoms. Significant improvement in the uniformity of dose distribution was observed. On average, the flatness index of the longitudinal dose distribution from superior to inferior decreases dramatically from 8% for open aperture down to 0.58% for trapezoidal aperture. The results are clinically significant, indicating that delivering the electron arc treatment using a trapezoidal aperture can bring more uniform dose to the patient regardless of the change of patient contour from superior to inferior.