Dosimetric evaluation of simultaneous multi-energy (2–18 MV) and intensity optimization for IMRT and VMAT

This study presents the first assessment of the feasibility and potential clinical value of simultaneous optimization of beam intensity and more than two photon energies for IMRT and VMAT plans, producing optimized ME fluence maps that require subsequent conversion into clinically deliverable treatment plans. The findings demonstrate that ME optimization can enhance OAR sparing without compromising target coverage, supporting its promise for future clinical application.