A treatment planning system for manifold multi-ion particle therapy

Abstract This paper reports on the design of an open source treatment planning system for optimal multi-ion irradiation of a heterogeneous target with arbitrary spatial dose distributions. The developed TPS features controllable avoidance of dose in organs at risk and optional linear energy transfer enhancement in hypoxic target sub-volumes. The performance of the treatment planning system is evaluated under a variety of conditions in a heterogeneous target to demonstrate the dose uniformity and conformance benefits of treatment achievable with manifold multi-ion therapy versus single-ion or dual-ion therapy.