title: Secondary neutron spectrum from 250-MeV passively scattered proton therapy: measurement with an extended-range Bonner sphere system.
abstract: OBJECTIVE
  Secondary neutrons are an unavoidable consequence of proton therapy. While the neutron dose is low compared to the primary proton dose, its presence and contribution to the patient dose is nonetheless important. The most detailed information on neutrons includes an evaluation of the neutron spectrum. However, the vast majority of the literature that has reported secondary neutron spectra in proton therapy is based on computational methods rather than measurements. This is largely due to the inherent limitations in the majority of neutron detectors, which are either not suitable for spectral measurements or have limited response at energies greater than 20 MeV. Therefore, the primary objective of the present study was to measure a secondary neutron spectrum from a proton therapy beam using a spectrometer that is sensitive to neutron energies over the entire neutron energy spectrum.
  
  
  METHODS
  The authors measured the secondary neutron spectrum from a 250-MeV passively scattered proton beam in air at a distance of 100 cm laterally from isocenter using an extended-range Bonner sphere (ERBS) measurement system. Ambient dose equivalent H*(10) was calculated using measured fluence and fluence-to-ambient dose equivalent conversion coefficients.
  
  
  RESULTS
  The neutron fluence spectrum had a high-energy direct neutron peak, an evaporation peak, a thermal peak, and an intermediate energy continuum between the thermal and evaporation peaks. The H*(10) was dominated by the neutrons in the evaporation peak because of both their high abundance and the large quality conversion coefficients in that energy interval. The H*(10) 100 cm laterally from isocenter was 1.6 mSv per proton Gy (to isocenter). Approximately 35% of the dose equivalent was from neutrons with energies ≥20 MeV.
  
  
  CONCLUSIONS
  The authors measured a neutron spectrum for external neutrons generated by a 250-MeV proton beam using an ERBS measurement system that was sensitive to neutrons over the entire energy range being measured, i.e., thermal to 250 MeV. The authors used the neutron fluence spectrum to demonstrate experimentally the contribution of neutrons with different energies to the total dose equivalent and in particular the contribution of high-energy neutrons (≥20 MeV). These are valuable reference data that can be directly compared with Monte Carlo and experimental data in the literature.
authors.affiliation: Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Howell
authors.affiliation: Department of Nuclear Engineering, Idaho State University, Pocatello, Idaho 83201.
authors.forename: E A
authors.initials: EA
authors.lastname: Burgett
mesh_terms: D000388:Air; D009502:Neutrons; D061766:Proton Therapy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D011829:Radiation Dosage; D011874:Radiometry / Q000295:instrumentation* / Q000379:methods; D013057:Spectrum Analysis / Q000295:instrumentation* / Q000379:methods; D035501:Uncertainty