Comparison of dose-volume histograms of IMRT treatment plans for ethmoid sinus cancer computed by advanced treatment planning systems including Monte Carlo

Dose to air cavities contains computational uncertainty. As this dose is clinically irrelevant and optimizing it is meaningless, we recommended extracting the air from the PTV when constructing the PTV-DVH. The planning systems considered reproduce DVHs that are significantly different, especially in the tail region of PTV-DVHs.