Abstract
Purpose Previous studies have reported an under-response of PRESAGE in a proton beam as a Result of the extremely high LET in the distal end of the spread out Bragg peak (SOBP). This work is a preliminary investigation to quantify the effect of the formulation, specifically the concentration of halocarbon radical initiator relative to leuco dye, on radical recombination resulting in LET dependence. Methods The traditional PRESAGE formulation developed by Heuris Pharma was altered to constitute radical initiator concentrations of 5, 15, and 30% (low, medium, and high) by weight with all other components balanced to maintain proportionality. Chloroform was specifically examined in this study and all dosimeters were made in-house. Cylindrical PRESAGE dosimeters (3.5cm diameter and 6cm length) were made for each formulation and irradiated by a 200-MeV proton beam to 500 cGy across a 2cm SOBP. Dosimeters were read out using the DMOS optical-CT scanner. The dose distributions were analyzed and dose profiles were used to compare the relative dose response to find the stability across the high-LET region of the SOBP. LET dependence was measured by the variation to ion chamber measurements for the final 25% of the SOBP (∼0.5cm) prior to the distal-90 of each profile. Results Relative to ion chamber data, all PRESAGE dosimeters showed an under-response at the distal end of the SOBP. The medium concentration formulation matched most closely with an average 8.3% under-response closely followed by the low concentration at 12.2% and then the high concentration at 22.8%. In all three cases, the highest points of discrepancy were in the distal most regions. Conclusion The radical initiator concentration in PRESAGE can be tailored to reduce the LET dependence in a proton beam. This warrants further study to quantify comprehensively the effect of concentration of different halocarbon radical initiators on LET dependency. Grant number 5RO1CA100835.