Effects of heterogeneities in dose distributions under nonreference conditions: Monte Carlo simulation vs dose calculation algorithms.

The purpose of this study is to evaluate the performance of dose calculation algorithms used in radiotherapy treatment planning systems (TPSs) in comparison with Monte Carlo (MC) simulations in nonelectronic equilibrium conditions. MC simulations with PENELOPE package were performed for comparison of doses calculated by pencil beam convolution (PBC), analytical anisotropy algorithm (AAA), and Acuros XB TPS algorithms. Relative depth dose curves were calculated in heterogeneous water phantoms with layers of bone (1.