Monte Carlo simulation study on the dose and dose-averaged linear energy transfer distributions in carbon ion radiotherapy

Ishikawa, Akihisa; Koba, Yusuke*; Furuta, Takuya   ; Chang, W.*; Yonai, Shunsuke*; Matsumoto, Shinnosuke*; Hashimoto, Shintaro  ; Hirai, Yuta*; Sato, Tatsuhiko   

At the Heavy Ion Medical Accelerator in Chiba (HIMAC), a series of retrospective studies are ongoing in patients treated with carbon ion radiotherapy (CIRT) to obtain the knowledge to improve tumor control and reveal the mechanism of the low risk of secondary cancer after CIRT. Dose-averaged linear energy transfer (LET) is generally used as a measure of treatment effectiveness or biological effects in such retrospective studies; however, it is conventionally evaluated from the relative biological effectiveness (RBE)-LET fitted function used in the treatment planning system. In this study, we calculated the physical doses and their linear energy transfer (LET) distributions for a series of treatment plans for a homogeneous rectangular phantom and a human body phantom with typical CIRT beams using Monte Carlo (MC) simulation. The LET was then deduced from the MC simulation and compared with the corresponding data obtained using the conventional method. The comparison suggested that the two types of LET agreed well with each other, except around the distal end of the spread-out Bragg peak, where the MC simulation yielded significantly higher LET values than that of the conventional method. This is because the RBE-LET fitted function adopted in the conventional method ignores the contribution of the high-LET components, causing an overkill effect. Furthermore, an MC simulation was conducted to determine the material composition of water and realistic materials from the CT number in the planned image. The profiles of physical dose and LET were in good agreement for both techniques. These results indicate the possibility of enhancing the efficiency of retrospective studies of CIRT using MC simulations in the future.