Dosimetric and Radiobiological Impact of Flattening Filter‐Free Beam and Dose Calculation Algorithm Using RapidArc Plans for Cervical Cancer Treatment

Abstract Purpose The aim of this study is to quantify the potential benefits a flattening filter‐free (FFF) beam and implement dose‐computation algorithm for cervical radiotherapy through dosimetric radiobiological analyses using RapidArc. Methods Thirty‐three patients were enrolled, four RapidArc plans created each patient dual‐arc filter 6‐MV FFF photon beams two calculation algorithms. Homogeneity index (HI), conformity (CI), target coverage, monitor units (MUs), organ‐at‐risk (OAR) characteristics compared between plans. Radiobiological normal tissue complication probability (NTCP) scores computed OAR different biological models. Results No significant differences observed in D max, 98% , CI planning volume (PTV). Both computations estimated difference V 95% 2% HI PTV. Furthermore, showed increase MUs reduction 30% femoral heads. NTCP score late effects on bladder, rectum, bowel with beams. Conclusion current recommends better conformity, comparable dose coverage target, sparing invariable computation algorithm. was minimal beam.