Background: Different planning methods of IMRT planning techniques (IMRT (DMLC) and RapidArc) vs. stander techniques (three-dimensional radiation therapy (3DCRT)) will be evaluated for prostate cancer patients' planning and verification. Three groups of localized prostate cancer patients are planned and evaluated regarding DVHs and practical radiation dosimetry, and ten 3DCRT plans are assessed statistically for each patient. Results: Plan (7) with parameters of five equally weighted fields with angles of 0°, 45°, 90°, 270°, and 315°and energy of 15MV is the most suitable plan both for PTV coverage and for OAR sparing with a fewer number of fields and fewer number of gantry angles. IMRT complexity involves the requirement of long treatment times and additional effort for planning, safety checks, and quality control before the patient start the treatment and proceed. Conclusions: The selected plan also is more safe on patients up to 7400 cGy than other plans and is easier to be applied compared to IMRT and RapidArc plans, depending on patient geometry. IMRT radiation doses are more effective and can safely be delivered to PTV with little side effects compared with 3D conformal and conventional techniques. RapidArc has the advantage of re-optimizing and small arcs of variable parameters in dose delivery, taking into account the maximum speed of gantry and MLCs.

Background:The intensity-modulated radiotherapy (IMRT) enables personalized treatment; the complexity of this technique increased the need for patient-specific quality assurance (QA). Objective: Comparing three dosimeters that common for patient-specific QA of IMRT. Material and Method: cases were planned at Eclipse treatment planning system (TPS) to receive radiotherapy at Unique VARIAN linear accelerator LINAC; Patient-specific QA was performed with three independent dosimeters: Gafchromic films EPT2, Electronic Portal Image Device (EPID), and PTW 2D array. The absolute dose was measured and analysis of 2D gamma index was performed, then compared with the plan calculated in TPS. Results: Analysis of absolute dose measured have highest difference from dose in Gafchromic film (89.1±4) % while EPID had a lower range (96.6 ± 1.2) and 2Darray showed an agreement up to (99±1.2) for patient specific QA both EBT2 and EPID enable to compare the measured map with TPS calculations, for plan conformity the gafchromic film enable measurement with lower accuracy even with localized brain tumor, the heterogeneity in lung case slightly affect the EPID measurement, this found also with irregular surface of head and neck and increased depth within pelvic case examine. Measurement with 2D array found to be the optimum dosimeter within different conditions. Conclusion: different parameters might affect the accuracy of gafchromic film including film scanning, storing, and calibration curve. EPID has an average deviation appears in beam fluence and 2D array as a 2D ion chamber found to have the most accurate dosimeter, but still time consuming when compared to EPID.

The quality control tests' methods, as well as the criteria for scoring the results, are in full agreement with those specified in the American Association of Physicists in Medicine (AAPM) Report No.4 and IEC 61223-3-1 (AAPM, 1981; IEC 61223-3-1, 1999 (Bouzarjomehri, 2004; Ciraj et al., 2005; Ramanandraibe, 2009; Papadimitriou, 2001; Shahbazi-Gahrouei, 2006). Some investigators focused only patient dose optimization (Brix et al., 2005; Vano& Fernandez, 2007; Seibert, 2004; Williams &Catling, 1998), whereas the others examined both the patient dose and image quality in radiographic devices (Aldrich et al., 2006; Schaefer-Prokop et al., 2008; Geijer, 2002). There are also studies that give reference values for clinical x-ray examinations by measuring phantom dose (Gray et al., 2005) . But there is no any study focused to the dose optimization during quality control tests of x-ray devices. Dose optimization is very important because of the quality and quantity of quality control tests of x-ray equipmentconclusion this study shows that optimization of technical factors may lead to a substantial dose reduction. If the optimized parameters are applied to X-ray equipment during quality control tests, it is possible to determine how much good image quality will be obtained with this optimized parameters and how much dose will be measured when this qualified image is developed. The results show the importance of radiographic staff training about the recommended parameters that are applied to the x-ray units for a qualified quality control system. It is essential to provide relevant education and training to staff in the radiology departments.It can be sure that with such a study the questions on many professional staff's mind will be answered, and the dose and the image characteristics will be parameters that are controlled and managed.

Background: Pelvic bone marrow (PBM) preservation is one of the factors that should be taken into consideration while choosing a technique for radiotherapy of pelvic malignancies. Aim: To dosimetrically compare between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) in PBM preservation in radical treatment of high-risk prostate cancer. Methods: In 26 patients with high-risk prostatic carcinoma, dual arc VMAT and 7 fields IMRT plans were generated. In every patient, two targets were defined, clinical target volume (CTV) including the prostate and seminal vesicles (CTV-PSV) and CTV including pelvic lymph nodes (CTV-LN). The organs at risk delineated were the rectum, urinary bladder, small intestine, bulb of the penis, femoral heads bilaterally and PBM. The dose prescribed to the CTV-PSV was 76 Gy in 38 fractions given over 7.5 weeks and the dose to CTV-LN was 54 Gy in 38 fractions given over 7.5 weeks. Planning target volume (PTV) was created from the CTV with a margin of 5 mm in all direction. For assessment of PBM dose, V10, V20, V30, V40, V50 and mean dose were calculated. The dose volume histogram of PTV and PBM for both techniques was compared. Results: The mean dose of PTV 54 Gy was achieved in both techniques adequately with better sparing of organs at risk with the VAMT technique. The mean dose for PBM in the VMAT technique was significantly less than that in the IMRT (21.7 Gy vs. 25.8 Gy, respectively; p < 0.001). The significant differences in PBM doses were in the range of 20 Gy to 40 Gy. Conclusion: In radical treatment of prostate cancer, VMAT technique can offer comparable conformality to IMRT with better PBM preservation. Awareness of PBM delineation and reduction of its doses using VMAT can help to decrease the hematological toxicity.