Application analysis of flux smoothness modes in the Monaco system: balancing dose safety and equipment operating costs in cervical cancer radiotherapy
10.13491/j.issn.1004-714X.2026.03.008
- VernacularTitle:Monaco系统中通量平滑度分机模式的应用分析：宫颈癌放疗剂量安全性与设备运行成本的平衡策略
- Author:
Yongjuan SU
1
;
Yuhua GAO
1
;
Shaolin MA
1
;
Chao GUO
1
;
Cai TANG
1
Author Information
1. Department of Oncology, Baoding Second Central Hospital (Baoding Key Laboratory of Tumor Targeted andImmunotherapy), Baoding 072750, China.
- Publication Type:OriginalArticles
- Keywords:
Cervical cancer;
Intensity-modulated radiotherapy;
Flux smoothness;
Equipment loss rate;
Treatment efficiency;
Cost-effectiveness of operation
- From:
Chinese Journal of Radiological Health
2026;35(3):354-361
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of low, mid, and high flux smoothness modes on plan quality, treatment efficiency, equipment loss, and clinical economic benefits in fixed-field intensity-modulated radiotherapy for cervical cancer, and establish a decision-making model for parameter optimization and economic benefits. Methods Fifteen patients with cervical cancer undergoing radiotherapy were selected. Using the Monaco system and adjusting only the flux smoothness parameter, low, mid, and high plans were designed for each patient. Dosimetric differences were compared for the target volume (D2, D98, Dmean, homogeneity index, conformity index) and organs at risk (small intestine, rectum, colon, bladder, femoral head). The number of segments, monitor units, and their correlations with treatment efficiency and equipment loss were analyzed, as well as the potential impact on clinical costs. Results There were statistically significant differences in the three groups' planned target areas D2, D98, Dmean, CI, HI, and the dose parameters of organs at risk (P<0.001), but the absolute differences were all lower than the clinical tolerance limits in the ICRU 83 report (±3% – ±5%), with an effect size d<0.5 (except for the small intestine with d = 0.51). There was no clinical significance. Compared with the mid mode, the high mode had a 13.3% reduction in the number of subfields (effect size d = 0.85), a 11.6% reduction in machine jumps (d = 1.0), and a 13.0% reduction in treatment time. Based on the mid mode, the relative loss rate of the accelerating tube in the high mode was 11.6%, the theoretical risk change rate of equipment failure was 12.7%, and the accelerating tube lifespan was extended by approximately 1.2 years. Comprehensive economic benefits: Calculated based on 1,200 treatments per year, the annual cost savings are approximately 920,000 yuan. Conclusion Adoption of the high flux smoothness mode in fixed-field intensity-modulated radiotherapy for cervical cancer using the Monaco system can significantly enhance treatment efficiency and reduce operating costs while ensuring dosimetric quality. It is recommended for routine clinical use.
