Beam data requirements of the Clinac 4 for three-dimensional treatment planning with wedged fields

To calculate dose distributions in off-axis planes for wedged fields, some commercial radiotherapy treatment planning systems use the Milan and Bentley method and simply modify the transverse principal-plane profile in the wedge direction with the value of its orthogonal open-field profile at the off-axis distance. For the Clinac 4 this simple modification may introduce serious distortions in off-axis dose distributions. The error can be considerably reduced if the basic beam data are supplemented with longitudinal principal-plane profiles and depth doses measured for the largest wedged field (14 X 32 cm2). These added data enable the determination of position-dependent effective attenuation coefficients of the wedges and hence, with the model proposed here, the calculation of transverse off-axis and longitudinal profiles as required. Even for very large field sizes and off-axis distances, the maximum deviation of generated profiles from measured ones varies from about 1% to the worst case of slightly above 4%. This procedure requires little extra computer time and data storage. The computed profiles are of sufficient accuracy for 3-dimensional treatment planning.