An interpretation of some biological results obtained in range-modulated negative pion beams

Recent biological date show little change in relative biological effectiveness (RBE) across the peak region of range-modulated pion beams in contrast to previous works which showed increasing RBE with depth. These biological results are shown to be consistent with each other and with previously measured microdosimetric data. The differences are attributed to differences in the lateral spread of the beams. Large lateral distributions result in an increased dose as a result of neutrons emitted in pion "stars" an effect that is quantified using a high-energy neutron transport code. For a large beam which is of the type used in therapy, the neutron dose is as much as 50% of the total "star" dose and of the high linear energy transfer (LET) dose, this percentage increasing peak volume. Preliminary measurements are in agreement with the calculated results. The rapid increase in neutron dose with field size should be an important factor in pion treatment planning.