Dosimetric comparison of different multileaf collimators in volumetric modulated arc therapy for malignant pleural mesothelioma

Malignant mesothelioma is a very serious disease. The contemporary treatment in operable cases involves a combination of neoadjuvant chemotherapy, extrapleural pneumonectomy, and postoperative radical radiation therapy. In these patients, intensity modulated radiation therapy (IMRT) techniques are used to achieve a better therapeutic ratio [1–5]. However, most cases are inoperable due to various reasons and require radical or palliative radiation therapy. In this study, a newer radiotherapy technique, volumetric modulated arc therapy (VMAT), was evaluated for the treatment of inoperable malignant pleural mesothelioma (MPM) patients. We compared the impact of two different multileaf collimator (MLC) widths on VMAT plans for MPM. All VMAT plans were generated for two Elekta commercial MLC devices using the Monaco treatment planning system (version 5.0, Elekta AB, Sweden).