Evaluating the effect of nuclear interactions on proton dose distributions through convolution methods

Cancer is a disease that causes almost 10 million deaths each year. Currently, there is no perfect treatment for it. However, there is a promising treatment called proton radiotherapy. This works almost the same as one of the older cancer treatments called photon radiotherapy. However, radiotherapy with protons has an advantage in comparison with radiotherapy with photons. This advantage lies in the way the protons lose their energy when going through tissue. The protons deliver most of their dose in a very small region. Cause of this advantage, proton radiotherapy can deliver a lot of dose into the tumour while minimizing the dose delivered into healthy tissue. But this advantage can change into a disadvantage when the location of the tumour moves a few millimeters. Therefore ideally a scan is taken each time the patient comes in, so the location of the tumour is known very accurately. After the scan it is best to immediately create a treatment plan and do the treatment session. But creating a treatment plan takes to much time to be able to do that. Mainly, this is because the calculation of the dose distribution is not fast enough. This report studies a faster method for the calculation of the dose distribution. The method is derived by the Medical Physics \& Technology group from TU Delft. This method is currently not accurate enough to use for treatment planning. The problem of the method is that the dose due to nuclear interactions is not included correctly. The goal of this report is to make the method more accurate by adding the nuclear dose caused by secondary particles formed due to inelastic nuclear interactions to the dose calculated by the existing method.The nuclear dose is calculated using a convolution of a kernel with the proton flux. The nuclear dose of the following secondary particles is calculated: alpha particles, deuteron particles and secondary protons. Adding the nuclear dose caused by these three secondary particles increased the accuracy of the model by 0.36 percent. However adding the nuclear dose calculation increased the time needed to calculate the dose distribution with 18625 percent. By calculating the convolution using the fast Fourier transform this could be decreased by a factor of 11. However adding the nuclear dose calculation to the fast method increases the time needed to calculate the dose distribution too much. Therefore the calculation of the dose distribution is not fast enough to scan a patient and immediately start with the best possible treatment plan using the fast method with the nuclear dose calculation added.