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Clinical step\u2010and\u2010shoot IMRT treatment plans were designed for delivery on a Siemens ONCOR accelerator with 82\u2010leaf multileaf collimators (MLCs). Plans were optimized to achieve the same clinical objectives by applying the same beam energy and the same number and direction of beams. The analysis of performance was based on isodose distributions, dose\u2010volume histograms (DVHs) for planning target volume (PTV), the relevant organs at risk (OARs), as well as mean dose , maximum dose , 95% dose , volume of patient receiving 2 and 5 Gy, total number of segments, monitor units per segment (MU\/Segment), and the number of MU\/cGy. Treatment delivery time and conformation number were two other evaluation parameters that were considered in this study. Collectively, the Prowess and KonRad plans showed a significant reduction in the number of MUs that varied between 1.8% and 61.5% for the different cases, compared to XiO. This was reflected in shorter treatment delivery times. The percentage volumes of each patient receiving 2 Gy and 5 Gy were compared for the three TPSs. The general trend was that KonRad had the highest percentage volume, Prowess showed the lowest . The KonRad achieved better conformality than both of XiO and Prowess. Based on the present results, the three treatment planning systems were efficient in IMRT, yet XiO showed the lowest performance. The three TPSs achieved the treatment goals according to the internationally approved standards.<\/jats:p>","DOI":"10.1120\/jacmp.v13i2.3742","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T22:41:28Z","timestamp":1488235288000},"page":"124-135","source":"Crossref","is-referenced-by-count":6,"title":["A comparison of three commercial IMRT treatment planning systems for selected pediatric cases"],"prefix":"10.1002","volume":"13","author":[{"given":"Ismail","family":"Eldesoky","sequence":"first","affiliation":[{"name":"Children's Cancer Hospital Cairo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehab M.","family":"Attalla","sequence":"additional","affiliation":[{"name":"Children's Cancer Hospital Cairo"},{"name":"National Cancer Institute Cairo University Cairo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael M.","family":"Elshemey","sequence":"additional","affiliation":[{"name":"Department of Biophysics, 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