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Monte Carlo simulations were used to predict the dose enhancement ratio (DER) using the flattening-filter-free (FFF) and flattening-filter (FF) photon beams in prostate nanoparticle-enhanced radiotherapy, with multiple variables such as nanoparticle material, nanoparticle concentration, prostate size, pelvic size, and photon beam energy. A phantom mimicking the patient's pelvis with various prostate and pelvic sizes was used. Macroscopic Monte Carlo simulation using the EGSnrc code was used to predict the dose at the prostate or target usi