A Technique for Total Skin Electron Therapy (TSET) of an Anesthetized Pediatric Patient

Overview

Journal J Appl Clin Med Phys

Specialties Biophysics
General Medicine

Date 2018 Sep 30

PMID 30267453

Citations 3

Authors

Tomas Kron

Grace Donahoo

Peta Lonski

Greg Wheeler

Affiliations

Soon will be listed here.

Abstract

Purpose: Total skin electron therapy (TSET) is a technique to treat cutaneous lymphomas. While TSET is rarely required in pediatric patients, it poses particular problems for the delivery. It was the aim of the present work to develop a method to deliver TSET to young children requiring anesthetics during treatment.

Methods: A customized cradle with a thin window base and Poly(methyl-methacrylate) (PMMA) frame was built and the patient was treated in supine position. Two times six fields of 6 MeV electrons spaced by 60° gantry angles were used without electron applicator and a field size of 36 × 36 cm . The two sets of six fields were matched at approximately 65% surface dose by rotating the patient around an axis 30 cm distance from beam central axis, effectively displacing the two sets of fields in sup/inf direction by 60 cm. Electron energy was degraded using a 12 mm PMMA block on the gantry. Focus to skin distance was maximized by displacing the patient in opposite direction of the beam resulting in a different couch position for each field.

Results: A 2-yr-old patient was treated in 12 fractions of 1.5 Gy over 2.4 weeks. Dose to skin was verified daily using thermoluminescence dosimetry and/or radiochromic film. The treatment parameters were adjusted slightly based on in vivo dosimetry resulting in a dose distribution for most of the treatment volume within ±20% of the prescribed dose. Six areas were boosted using conventional electron therapy.

Conclusion: TSET can be delivered to pediatric patients using a customized couch top on a conventional linear accelerator.

Citing Articles

Patient Dose Analysis Using GafchromicTM EBT3 Film: A Retrospective Study with a Four Dual-Field Technique in Total Skin Electron Therapy.

Sundaramoorthy D, Chandrasekaran A Asian Pac J Cancer Prev. 2023; 24(7):2505-2513.

PMID: 37505785 PMC: 10676495. DOI: 10.31557/APJCP.2023.24.7.2505.

Total Skin Treatment with Helical Arc Radiotherapy.

Nien H, Hsieh C, Shueng P, Tien H Int J Mol Sci. 2023; 24(5).

PMID: 36901922 PMC: 10002962. DOI: 10.3390/ijms24054492.

In vivo monitoring of total skin electron dose using optically stimulated luminescence dosimeters.

Kairn T, Wilks R, Yu L, Lancaster C, Crowe S Rep Pract Oncol Radiother. 2020; 25(1):35-40.

PMID: 31889918 PMC: 6931195. DOI: 10.1016/j.rpor.2019.12.011.

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