SUN Yu, ZHANG Wu, LIU Hao, WU Manli, HAO Yuanxiang
Objective To analyze and compare the effects of four flux smoothness levels of the Monaco planning system on radiotherapy planning for cervical cancer using vise kriterijumska optimizacija i kompromisno resenje (VIKOR). Methods Forty patients with cervical cancer in our hospital were selected as the research subjects. According to the prescribed dose of 50.4 Gy/28 times for PTV, four groups of radiotherapy plans were designed using four flux smoothing modes (OFF, LOW, MEDIUM and HIGH) respectively. After reducing the prescribed dose to 95% of the target area volume, One-way ANOVA was performed using SPSS 27.0 software to compare the differences among the groups, and VIKOR analysis was used for comprehensive evaluation. Results The four groups planned at D98% (the minimum dose received by 98% of the target area volume, and so on for the others), D2%, Dmean (average dose), homogeneity index, conformal index, and bladder V50 (the volume percentage of the organ receiving at least 50 Gy dose, and so on for the others), the Dmean of the bladder, and the probability of normal tissue complication probability (NTCP) of the bladder, small intestine V30, small intestine Dmean, small intestine NTCP, rectal V50, rectal Dmean, rectal NTCP, left femoral head V20, left femoral head Dmean, right femoral head V20, and right femoral head Dmean were no statistically significant differences (P>0.05). The difference in the number of monitor unit (MU) was statistically significant (P<0.05), and MU showed a decreasing trend with the increase of flux smoothness. The VIKOR analysis results showed that the LOW group was the optimal scheme. Conclusion For the design of clinical radiotherapy plans for cervical cancer, all four flux smoothing modes of the Monaco planning system can meet the clinical treatment requirements. With the improvement of flux smoothness, MU shows a gradually decreasing trend. The VIKOR results suggest that the LOW mode can be selected to achieve the optimal dose results.