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Title: A Highly Reproducible Bolus Immobilization Technique for the Treatment of Scalp Malignancies

Abstract

Radiation treatment of scalp malignancies can be a challenge due to the multiple curved surfaces to which homogenous dose must be delivered. The most readily available techniques utilize linear accelerator-based technique of opposed lateral electron field abutting opposed lateral photon field with central blocking. Bolus material is used to achieve adequate skin dose. Although plans to add bolus material often occur in the virtual setting during treatment planning, the practical aspects of reproducibly maintain the bolus material along curved surfaces during the day-to-day patient setup can be a challenge. We present a case of a patient with squamous cell carcinoma of the scalp with neck node involvement treated with surgery followed by adjuvant radiotherapy. We demonstrate a unique immobilization technique that maintains the bolus material on the aquaplast mesh adherent to the patient's scalp as well as the neck. TomoTherapy with daily megavoltage computed tomography (CT) scan was utilized to verify the daily bolus position. We were able to maintain a 95% reproducibility rate. This technique reliably maintains the bolus material on the desired locations with minimum adjustments and manipulation by the therapist and is a technique that can be universally adapatable for conventional radiotherapy or intensity modulated radiation therapymore » (IMRT) techniques.« less

Authors:
; ;  [1]
  1. Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (United States)
Publication Date:
OSTI Identifier:
21045994
Resource Type:
Journal Article
Journal Name:
Medical Dosimetry
Additional Journal Information:
Journal Volume: 33; Journal Issue: 1; Other Information: DOI: 10.1016/j.meddos.2007.04.005; PII: S0958-3947(07)00085-4; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0958-3947
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; COMPUTERIZED TOMOGRAPHY; CT-GUIDED RADIOTHERAPY; LINEAR ACCELERATORS; NECK; PATIENTS; RADIATION DOSES; SKIN; SURGERY

Citation Formats

Lin, Steven H, Latronico, Diane, Teslow, Terrance, and Bajaj, Gopal K. A Highly Reproducible Bolus Immobilization Technique for the Treatment of Scalp Malignancies. United States: N. p., 2008. Web. doi:10.1016/j.meddos.2007.04.005.
Lin, Steven H, Latronico, Diane, Teslow, Terrance, & Bajaj, Gopal K. A Highly Reproducible Bolus Immobilization Technique for the Treatment of Scalp Malignancies. United States. https://doi.org/10.1016/j.meddos.2007.04.005
Lin, Steven H, Latronico, Diane, Teslow, Terrance, and Bajaj, Gopal K. 2008. "A Highly Reproducible Bolus Immobilization Technique for the Treatment of Scalp Malignancies". United States. https://doi.org/10.1016/j.meddos.2007.04.005.
@article{osti_21045994,
title = {A Highly Reproducible Bolus Immobilization Technique for the Treatment of Scalp Malignancies},
author = {Lin, Steven H and Latronico, Diane and Teslow, Terrance and Bajaj, Gopal K.},
abstractNote = {Radiation treatment of scalp malignancies can be a challenge due to the multiple curved surfaces to which homogenous dose must be delivered. The most readily available techniques utilize linear accelerator-based technique of opposed lateral electron field abutting opposed lateral photon field with central blocking. Bolus material is used to achieve adequate skin dose. Although plans to add bolus material often occur in the virtual setting during treatment planning, the practical aspects of reproducibly maintain the bolus material along curved surfaces during the day-to-day patient setup can be a challenge. We present a case of a patient with squamous cell carcinoma of the scalp with neck node involvement treated with surgery followed by adjuvant radiotherapy. We demonstrate a unique immobilization technique that maintains the bolus material on the aquaplast mesh adherent to the patient's scalp as well as the neck. TomoTherapy with daily megavoltage computed tomography (CT) scan was utilized to verify the daily bolus position. We were able to maintain a 95% reproducibility rate. This technique reliably maintains the bolus material on the desired locations with minimum adjustments and manipulation by the therapist and is a technique that can be universally adapatable for conventional radiotherapy or intensity modulated radiation therapy (IMRT) techniques.},
doi = {10.1016/j.meddos.2007.04.005},
url = {https://www.osti.gov/biblio/21045994}, journal = {Medical Dosimetry},
issn = {0958-3947},
number = 1,
volume = 33,
place = {United States},
year = {Tue Apr 01 00:00:00 EDT 2008},
month = {Tue Apr 01 00:00:00 EDT 2008}
}