The pencil-beam algorithm is valid only when elementary Gaussian beams are small enough compared to the lateral heterogeneity of a medium, which is not always true in actual radiotherapy with protons and ions. This work addresses a solution for the problem. We found approximate self-similarity of Gaussian distributions, with which Gaussian beams can split into narrower and deflecting daughter beams when their sizes have overreached lateral heterogeneity in the beam-transport calculation. The effectiveness was assessed in a carbon-ion beam experiment in the presence of steep range compensation, where the splitting calculation reproduced a detour effect amounting to about 10% in dose or as large as the lateral particle disequilibrium effect. The efficiency was analyzed in calculations for carbon-ion and proton radiations with a heterogeneous phantom model, where the beam splitting increased computing times by factors of 4.7 and 3.2. The present method generally improves the accuracy of the pencil-beam algorithm without severe inefficiency. It will therefore be useful for treatment planning and potentially other demanding applications.

A model for beam customization with collimators and a range-compensating filter based on the phase-space theory for beam transport is presented for dose distribution calculation in the treatment planning of radiotherapy with protons and heavier ions. Independent handling of pencil beams in conventional pencil-beam algorithms causes unphysical collimator-height dependence in the middle of large fields, which is resolved by the framework comprised of generation, transport, collimation, regeneration, range-compensation and edge-sharpening processes with a matrix of pencil beams. The model was verified to be consistent with measurement and analytic estimation at a submillimeter level in the penumbra of individual collimators with a combinational-collimated carbon-ion beam. The model computation is fast, accurate and readily applicable to pencil-beam algorithms in treatment planning with the capability of combinational collimation to make the best use of the beam-customization devices.

A new variant of the pencil-beam (PB) algorithm for dose distribution calculation for radiotherapy with protons and heavier ions, the grid-dose spreading (GDS) algorithm, is proposed. The GDS algorithm is intrinsically faster than conventional PB algorithms due to approximations in convolution integral, where physical calculations are decoupled from simple grid-to-grid energy transfer. It was effortlessly implemented to a carbon-ion radiotherapy treatment planning system to enable realistic beam blurring in the field, which was absent with the broad-beam (BB) algorithm. For a typical prostate treatment, the slowing factor of the GDS algorithm relative to the BB algorithm was 1.4, which is a great improvement over the conventional PB algorithms with a typical slowing factor of several tens. The GDS algorithm is mathematically equivalent to the PB algorithm for horizontal and vertical coplanar beams commonly used in carbon-ion radiotherapy while dose deformation within the size of the pristine spread occurs for angled beams, which was within 3 mm for a single 150-MeV proton pencil beam of 30 degrees incidence, and needs to be assessed against the clinical requirements and tolerances in practical situations.

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