SU-F-T-154: An Evaluation and Quantification of Secondary Neutron Radiation Dose Due to Double Scatter and Pencil Beam Scanning Proton Therapy.

Proton radiation therapy can deliver high radiation doses to tumors while sparing normal tissue. However, protons yield secondary neutron and gamma radiation that is difficult to detect, small in comparison to the prescribed dose, and not accounted for in most treatment planning systems. The risk for secondary malignancies after proton therapy may be dependent on the quality of this dose. Consequently, there is interest in characterizing the secondary radiation. Previously, we used the dual ionization chamber method to measure the separate absorbed dose from gamma-rays and neutrons secondary to the proton beam1, relying on characterization of ionization chamber response in the unknown neutron spectrum from Monte Carlo simulation. We developed a procedure to use Shieldwerx activation foils, with neutron activation energies ranging from 0.025 eV to 13.5 MeV, to measure the neutron energy spectrum from double scattering (DS) and pencil beam scanning (PBS) protons outside of the treatment volume in a water tank. The activated foils are transferred to a NaI well chamber for gamma-ray spectroscopy and activity measurement. Since PBS treats in layers, the switching time between layers is used to correct for the decay of the activated foils and the relative dose per layer is assumed to be proportional to the neutron fluence per layer. MATLAB code was developed to incorporate the layer delivery and switching time into a calculation of foil activity, which is then used to determine the neutron energy fluence from tabulated foil activation energy thresholds.1. Diffenderfer et. al., Med. Phys., 38(11) 2011.