Log file-based patient dose calculations of double-arc VMAT for head-and-neck radiotherapy

Purpose: The log file-based method cannot display dosimetric changes due to linac component miscalibration because of the insensitivity of log files to linac component miscalibration. The purpose of this study was to supply dosimetric changes in log file-based patient dose calculations for double-arc volumetric-modulated arc therapy (VMAT) in head-and-neck cases. Methods and materials: Fifteen head-and-neck cases participated in this study. For each case, treatment planning system (TPS) doses were produced by double-arc and single-arc VMAT. Miscalibration-simulated log files were generated by inducing a leaf miscalibration of ±0.5 mm into the log files that were acquired during VMAT irradiation. Subsequently, patient doses were estimated using the miscalibration-simulated log files. Results: For double-arc VMAT, regarding planning target volume (PTV), the change from TPS dose to miscalibration-simulated log file dose in D_mean was 0.9 Gy and that for tumor control probability was 1.4%. As for organ-at-risks (OARs), the change in D_mean was <0.7 Gy and normal tissue complication probability was <1.8%. A comparison between double-arc and single-arc VMAT for PTV showed statistically significant differences in the changes evaluated by D_mean and radiobiological metrics (P < 0.01), even though the magnitude of these differences was small. Similarly, for OARs, the magnitude of these changes was found to be small. Conclusions: Using the log file-based method for PTV and OARs, the log file-based method estimate of patient dose using the double-arc VMAT has accuracy comparable to that obtained using the single-arc VMAT.