Results of an independent dosimetry audit for scanned proton beam therapy facilities.

PURPOSE: An independent dosimetry audit based on end-to-end testing of the entire chain of radiation therapy delivery is highly recommended to ensure consistent treatments among proton therapy centers. This study presents an auditing methodology developed by the MedAustron Ion Beam Therapy Center (Austria) in collaboration with the National Physical Laboratory (UK) and audit results for five scanned proton beam therapy facilities in Europe. METHODS: The audit procedure used a homogeneous and an anthropomorphic head phantom. The phantoms were loaded either with an ionization chamber or with alanine pellets and radiochromic films. Homogeneously planned doses of 10Gy were delivered to a box-like target volume in the homogeneous phantom and to two clinical scenarios with increasing complexity in the head phantom. RESULTS: For all tests the mean of the local differences of the absolute dose to water determined with the alanine pellets compared to the predicted dose from the treatment planning system installed at the audited institution was determined. The mean value taken over all tests performed was -0.1±1.0%. The measurements carried out with the ionization chamber were consistent with the dose determined by the alanine pellets with a mean deviation of -0.5±0.6%. CONCLUSION: The developed dosimetry audit method was successfully applied at five proton centers including various "turn-key" Cyclotron solutions by IBA, Varian and Mevion. This independent audit with extension to other tumour sites and use of the correspondent anthropomorphic phantoms may be proposed as part of a credentialing procedure for future clinical trials in proton beam therapy.

Recombination factors for the cylindrical FC65-G ionization chamber in pulsed photon beams and the plane-parallel Roos ionization chamber in pulsed electron beams.

The use of ionization chambers in linac radiotherapy dosimetry requires various corrections to the measured charges, one of these being the recombination correction. The recombination correction factor (k(s)) is generally estimated from the two-voltage analysis (TVA) for each beam quality. However, it is possible that the ionization chamber above some threshold polarizing voltage does not follow the accepted Boag theory very well. Secondly the TVA is time-consuming as the chamber needs to stabilize after each polarizing voltage change and since it must be performed for each beam quality. Another approach consists in using the fact that k(s) is predicted to depend linearly on dose per pulse by Boag theory: determining this relationship once and for all using a multi-voltage analysis (MVA), one also checks the range validity of the Boag theory for the chamber considered. This work presents a thorough analysis of k(s) dependence on dose per pulse of FC65-G (cylindrical) and Roos (plane-parallel) ionization chambers in pulsed photon and electron beams, respectively. Within the uncertainties, the recombination factors are found to be independent of beam quality, and no deviation from the Boag theory is observed within the tested range of polarizing voltages. Before adapting the equations given using the MVA other users should check that their ionization chambers show the same dose per pulse dependence using the TVA for a few beam qualities.