Evaluation and Optimization of Absorbed Dose to the Eye Lens in Various Intensity-Modulated Radiation Therapy (IMRT) Techniques for Treatment of Frontal Area Tumors

Document Type : Original Article (s)


1 MSc Student, Department of Medical Physics and Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Medical Physics and Engineering, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Radiation Oncologist, Department of Radiation-Oncology, Isfahan Milad Hospital, Isfahan, Iran


Background: In this study, a comparison was performed between various intensity-modulated radiation therapy (IMRT) techniques for treatment of frontal area tumors in order to achieve the optimal treatment technique considering absorbed dose to the eye lens.Methods: Treatment planning and contouring were performed with TiGRT software for 20 patients with frontal area tumors. Three techniques were compared to each other. Finally, by comparing the dose volume histograms, the average dose received by each organ was determined and the best method was selected.Findings: In all three techniques, isodose curve of 30% passed through the eye, but the important point was that the curves were shifted towards the bottom of the eye with increasing the number of fields.Conclusion: The dose in the second technique was less than the other techniques. In this technique, there are five fields, and the path of the field does not go through the eye directly.


  1. Pourhoseingholi MA, Fazeli Z, Ashtari S, Bavand-Pour FS. Mortality trends of gastrointestinal cancers in Iranian population. Gastroenterol Hepatol Bed Bench 2013; 6(Suppl 1): S52-S57.
  2. Mousavi SM, Gouya MM, Ramazani R, Davanlou M, Hajsadeghi N, Seddighi Z. Cancer incidence and mortality in Iran. Ann Oncol 2009; 20(3): 556-63.
  3. Rafiemanesh H, Rajaei-Behbahani N, Khani Y, Hosseini S, Pournamdar Z, Mohammadian-Hafshejani A, et al. Incidence trend and epidemiology of common cancers in the center of Iran. Glob J Health Sci 2015; 8(3): 146-55.
  4. van den Bent MJ, Weller M, Wen PY, Kros JM, Aldape K, Chang S. A clinical perspective on the 2016 WHO brain tumor classification and routine molecular diagnostics. Neuro Oncol 2017; 19(5): 614-24.
  5. Ligon KL, Wilkinson K, Stiles CD. Pathology and molecular pathology of brain cancer. In: Loda M, Mucci LA, Mittelstadt ML, Van Hemelrijck M, Cotter MB, editors. Pathology and epidemiology of cancer. New York, NY: Springer; 2017. p. 291-311.
  6. Grader E, Bateman A. Introduction to brain anatomy and mechanisms of injury. In: Winson R, Wilson BA, Bateman A, editors. The brain injury rehabilitation workbook. New York, NY: Guilford Press; 2016. p. 15.
  7. Karbalaee M, Shahbazi-Gahrouei D, Tavakoli MB. An approach in radiation therapy treatment planning: A fast, GPU-based Monte Carlo method. J Med Signals Sens 2017; 7(2): 108-13.
  8. Shahbazi-Gahrouei D, Ayat S. Determination of organ doses in radioiodine therapy using Monte Carlo simulation. World J Nucl Med 2015; 14(1): 16-8.
  9. Shahbazi D, Gookizadeh A, Abdollahi M. Comparison of conventional radiotherapy techniques with different energies in treating prostate cancer, employing a designed pelvis phantom. J Med Sci 2008; 8(4): 429-32.
  10. Rezaee V, Shahbazi-Gahrouei D, Monadi S, Saeb M. Evaluation of error doses of treatment planning software using solid anthropomorphic phantom. J Isfahan Med Sch 2016; 34(393): 908-13. [In Persian].
  11. Ezzell GA, Burmeister JW, Dogan N, LoSasso TJ, Mechalakos JG, Mihailidis D, et al. IMRT commissioning: Multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119. Med Phys 2009; 36(11): 5359-73.
  12. Nishimura Y. Intensity-modulated radiation therapy. Gan To Kagaku Ryoho 2014; 41(13): 2539-42. [In Japanese].
  13. Hall EJ. Intensity-modulated radiation therapy, protons, and the risk of second cancers. Int J Radiat Oncol Biol Phys 2006; 65(1): 1-7.
  14. Piroth MD, Pinkawa M, Holy R, Stoffels G, Demirel C, Attieh C, et al. Integrated-boost IMRT or 3-D-CRT using FET-PET based auto-contoured target volume delineation for glioblastoma multiforme--a dosimetric comparison. Radiat Oncol 2009; 4: 57.
  15. Pawlicki T, Luxton G, Le QT, Findley D, Ma CM. Lens dose in MLC-based IMRT treatments of the head and neck. Int J Radiat Oncol Biol Phys 2004; 59(1): 293-9.
  16. MacDonald SM, Ahmad S, Kachris S, Vogds BJ, DeRouen M, Gittleman AE, et al. Intensity modulated radiation therapy versus three-dimensional conformal radiation therapy for the treatment of high grade glioma: a dosimetric comparison. J Appl Clin Med Phys 2007; 8(2): 47-60.