The physics of proton therapy has advanced considerably since it was proposed in 1946. Today analytical equations and numerical simulation methods are available to predict and characterize many aspects of proton therapy. This article reviews the basic aspects of the physics of proton therapy, including proton interaction mechanisms, proton transport calculations, the determination of dose from therapeutic and stray radiations, and shielding design. The article discusses underlying processes as well as selected practical experimental and theoretical methods. We conclude by briefly speculating on possible future areas of research of relevance to the physics of proton therapy.

https://iopscience.iop.org/article/10.1088/0031-9155/60/8/R155/pdf

The physics of proton therapy

Track-structure codes in radiation research

A Monte Carlo(MC) code (VMCpro) for treatment planning in proton beam therapy of cancer is introduced. It is based on ideas of the Voxel Monte Carlo algorithm for photons and electrons and is applicable to human tissue for clinical proton energies. In the present paper the implementation of electromagnetic and nuclear interactions is described. They are modeled by a Class II condensed history algorithm with continuous energy loss, ionization, multiple scattering, range straggling, δ-electron transport, nuclear elastic proton nucleus scattering and inelastic proton nucleus reactions. VMCpro is faster than the general purpose MC codes FLUKA by a factor of 13 and GEANT4 by a factor of 35 for simulations in a phantom with inhomogeneities. For dose calculations in patients the speed improvement is larger, because VMCpro has only a weak dependency on the heterogeneity of the calculation grid. Dose distributions produced with VMCpro are in agreement with GEANT4 results. Integrated or broad beam depth dose curves show maximum deviations not larger than 1% or 0.5 mm in regions with large dose gradients for the examples presented here.

A Monte Carlo dose calculation algorithm for proton therapy.

Monte Carlo treatment planning for photon and electron beams

This topical review provides an up-to-date overview of the theoretical and practical aspects of therapeutic kilovoltage x-ray beam dosimetry. Kilovoltage x-ray beams have the property that the maximum dose occurs very close to the surface and thus, they are predominantly used in the treatment of skin cancers but also have applications for the treatment of other cancers. In addition, kilovoltage x-ray beams are used in intra operative units, within animal irradiators and in on-board imagers on linear accelerators and kilovoltage dosimetry is important in these applications as well. This review covers both reference and relative dosimetry of kilovoltage x-ray beams and provides recommendations for clinical measurements based on the literature to date. In particular, practical aspects for the selection of dosimeter and phantom material are reviewed to provide suitable advice for medical physicists. An overview is also presented of dosimeters other than ionization chambers which can be used for both relative and in vivo dosimetry. Finally, issues related to the treatment planning and the use of Monte Carlo codes for solving radiation transport problems in kilovoltage x-ray beams are presented.

https://iopscience.iop.org/article/10.1088/0031-9155/59/6/R183/pdf

Fernando J. C. Baräo

Papers

Advanced Monte Carlo for Radiation Physics, Particle Transport Simulation and Applications