Quantitative Assessment of Delivered Dose in Carbon Ion Spatially Fractionated Radiotherapy (C-SFRT) and Biological Response to C-SFRT.

Objective Applying carbon ion beams, which have high linear energy transfer and low scatter within the human body, to Spatially Fractionated Radiation Therapy (SFRT) could benefit the treatment of deep-seated or radioresistant tumors. This study aims to simulate the dose distributions of spatially fractionated beams (SFB) to accurately determine the delivered dose and model the cell survival rate following SFB irradiation. Approach Dose distributions of carbon ion beams are calculated using the Triple Gaussian Model. The sensitive volume of the detector used in measurements was also considered. If the measurements and simulations show good agreement, the dose distribution and absolute dose delivered by SFB can be accurately estimated. Three types of dose distributions were delivered to human salivary gland cells (HSGc-C5): uniform dose distribution (UDD), and one-dimensional (1D) grid-like dose distributions (GDD) with 6 mm and 8 mm spacing. These provided high (Peak-to-Valley Dose Ratio, PVDR=4.0) and low (PVDR=1.64) dose differences between peak and valley doses, respectively. Linear-Quadratic (LQ) model parameters for HSGc-C5 were derived from the UDD and cell survival fractions (SF) were simulated for 1D GDD using these values. Main results Good agreement was observed between measurements and simulations when accounting for detector volume. However, the TPS results overestimated dose in steep gradient region, likely due to the 2.0 mm calculation grid size. LQ parameters for HSGc-C5 were α = 0.34 and β = 0.057. The 1D GDD with 6 mm spacing showed good agreement between simulations and experiments, but the 8.0 mm spacing resulted in lower experimental cell survival. Significance We successfully simulated grid-like dose distributions and conducted SF simulations. The results suggest potential cell-killing effects due to high-dose differences in SFB. .