{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:33:50Z","timestamp":1777908830163,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,3,20]],"date-time":"2014-03-20T00:00:00Z","timestamp":1395273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":530,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aip.org"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec><jats:title><jats:bold>Purpose:<\/jats:bold><\/jats:title><jats:p>To investigate the feasibility of using intermediate energy 2 MV x\u2010rays for extracranial robotic intensity modulated radiation therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Methods:<\/jats:bold><\/jats:title><jats:p>Two megavolts flattening filter free x\u2010rays were simulated using the Monte Carlo code MCNP (v4c). A convolution\/superposition dose calculation program was tuned to match the Monte Carlo calculation. The modeled 2 MV x\u2010rays and actual 6 MV flattened x\u2010rays from existing Varian Linacs were used in integrated beam orientation and fluence optimization for a head and neck, a liver, a lung, and a partial breast treatment. A column generation algorithm was used for the intensity modulation and beam orientation optimization. Identical optimization parameters were applied in three different planning modes for each site: 2, 6 MV, and dual energy 2\/6 MV.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Results:<\/jats:bold><\/jats:title><jats:p>Excellent agreement was observed between the convolution\/superposition and the Monte Carlo calculated percent depth dose profiles. For the patient plans, overall, the 2\/6 MV x\u2010ray plans had the best dosimetry followed by 2 MV only and 6 MV only plans. Between the two single energy plans, the PTV coverage was equivalent but 2 MV x\u2010rays improved organs\u2010at\u2010risk sparing. For the head and neck case, the 2MV plan reduced lips, mandible, tongue, oral cavity, brain, larynx, left and right parotid gland mean doses by 14%, 8%, 4%, 14%, 24%, 6%, 30% and 16%, respectively. For the liver case, the 2 MV plan reduced the liver and body mean doses by 17% and 18%, respectively. For the lung case, lung V20, V10, and V5 were reduced by 13%, 25%, and 30%, respectively. V10 of heart with 2 MV plan was reduced by 59%. For the partial breast treatment, the 2 MV plan reduced the mean dose to the ipsilateral and contralateral lungs by 27% and 47%, respectively. The mean body dose was reduced by 16%.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Conclusions:<\/jats:bold><\/jats:title><jats:p>The authors showed the feasibility of using flattening filter free 2 MV x\u2010rays for extracranial treatments as evidenced by equivalent or superior dosimetry compared to 6 MV plans using the same inverse noncoplanar intensity modulated planning method.<\/jats:p><\/jats:sec>","DOI":"10.1118\/1.4868464","type":"journal-article","created":{"date-parts":[[2014,3,21]],"date-time":"2014-03-21T00:30:38Z","timestamp":1395361838000},"update-policy":"https:\/\/doi.org\/10.1063\/aip-crossmark-policy-page","source":"Crossref","is-referenced-by-count":11,"title":["Feasibility of using intermediate x\u2010ray energies for highly conformal extracranial radiotherapy"],"prefix":"10.1002","volume":"41","author":[{"given":"Peng","family":"Dong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Demarco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaley","family":"Woods","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salime","family":"Boucher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A.","family":"Low","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Sheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004032\u2010199511000\u201000004"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/51\/10\/012"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360\u20103016(86)90277\u20104"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1259\/0007\u20101285\u201063\u2010748\u2010278"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1120\/1.1432862"},{"key":"e_1_2_6_7_1","first-page":"316","article-title":"The stereotaxic method and radiosurgery of the brain","volume":"102","author":"Leksell L.","year":"1951","journal-title":"Acta Chir. 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