Dosimetry for ocular proton beam therapy at the Harvard Cyclotron Laboratory based on the ICRU Report 59

The Massachusetts General Hospital, the Harvard Cyclotron Laboratory (HCL), and the Massachusetts Eye and Ear Infirmary have treated almost 3000 patients with ocular disease using high-energy external-beam proton radiation therapy since 1975. The absorbed dose standard for ocular proton therapy beams at HCL was based on a fluence measurement with a Faraday cup (FC). A majority of proton therapy centers worldwide, however, use an absorbed dose standard that is based on an ionization chamber (IC) technique. The ion chamber calibration is deduced from a measurement in a reference 60Co photon field together with a calculated correction factor that takes into account differences in a chamber's response in 60Co and proton fields. In this work, we implemented an ionization chamber-based absolute dosimetry system for the HCL ocular beamline based on the recommendations given in Report 59 by the International Commission on Radiation Units and Measurements. Comparative measurements revealed that the FC system yields an absorbed dose to water value that is 1.1% higher than was obtained with the IC system. That difference is small compared with the experimental uncertainties and is clinically insignificant. In June of 1998, we adopted the IC-based method as our standard practice for the ocular beam.