External dosimetry audit for quality assurance of carbon‐ion radiation therapy clinical trials

Purpose The QA team of the Japan carbon‐ion radiation oncology study group (J‐CROS) was organized in 2015 to enhance confidence in the accuracy of clinical dosimetry and ensure that the facility QA procedures are adequate. The team conducted onsite dosimetry audits in all the carbon‐ion radiation therapy centers in Japan. Materials and Methods A special phantom was fabricated for the onsite dosimetry audit. Target volumes such as the GTV, CTV, and PTV were contoured to the obtained CT images, and two plans with different isocenter depths were created. The dose at the isocenter was measured by an ionization chamber, in the onsite audit and compared with the calculated dose. Results For all the centers, the average of the percentage ratio between the measured and calculated doses (measured/calculated) was 0.5% (−2.7% to +2.6%) and the standard deviation, 1.7%. In all the centers, the beams were within the set tolerance level of 3%. Conclusions The audit demonstrated that the dose at a single point in the water phantom was within tolerance, but it is a big step to say that all doses are correct. In addition, this external dosimetry audit encouraged centers to improve the quality of their dosimetry systems.