Dosimetric Comparison of Primo Monte Carlo Simulation and Eclipse Treatment Planning System for Glioblastoma Radiotherapy Treatment Planning

Rizanov, Ufairah Mahadisa (2026) Dosimetric Comparison of Primo Monte Carlo Simulation and Eclipse Treatment Planning System for Glioblastoma Radiotherapy Treatment Planning. S1 thesis, Andalas University.

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Abstract

Accurate radiotherapy planning is crucial to optimize the dose to the tumour while minimizing exposure to healthy organs. The Eclipse Treatment Planning System (TPS) with the Analytical Anisotropic Algorithm (AAA) is widely used clinically, yet it has limitations in heterogeneous regions and high-dose gradient areas. This study aims to compare the dose distribution calculated by Eclipse TPS (AAA) with Monte Carlo (MC) simulations using PRIMO software in glioblastoma patients treated with Intensity Modulated Radiation Therapy (IMRT). This study utilized DICOM data from four glioblastoma patients planned with Eclipse TPS using 6 MV photon beams. The process began with the modelling and validation of the Clinac CX LINAC in PRIMO against measured data, which was successfully achieved with a gamma passing rate of 98.9% using 2%/2 mm criteria. Due to the unavailability of the MLC80 type used in Eclipse TPS within PRIMO, the treatment plan parameters from Eclipse were manually re-entered with MLC120 substitution for the re-simulation. The evaluation was performed by analyzing the dose distribution, Dose Volume Histogram (DVH), Homogeneity Index (HI), and Conformity Index (CI). The results showed that the HI values obtained from PRIMO and Eclipse TPS were in relatively good agreement, whereas the CI values from PRIMO were lower than those from Eclipse TPS due to differences in dose calculation algorithms and the use of MLC120 as a substitute for MLC80. PRIMO simulations also revealed that several organs at risk, particularly the brainstem and optic nerves, received doses approaching or exceeding tolerance limits, thus providing additional information for treatment plan evaluation. Keywords: Analytical Anisotropic Algorithm, glioblastoma, IMRT, Monte Carlo, PRIMO.

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