Skin dose effects of postmastectomy chest wall radiation therapy using brass mesh as an alternative to a bolus.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 157-157
Author(s):  
Erin Healy ◽  
Shawnee Anderson ◽  
Jing Cui ◽  
Laurel Beckett ◽  
Allen M. Chen ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Skin Reaction ◽  
Chest Wall ◽  
Radiation Treatment ◽  
Skin Toxicity ◽  
In Vivo Dosimetry ◽  
Skin Dose ◽  
Tissue Equivalent ◽  
Dose Effects

157 Background: The use of brass mesh as an alternative to a bolus is relatively uncommon in post-mastectomy chest wall radiation therapy (PMRT). This study aimed to characterize the skin dose effects of using 2mm fine brass mesh as an alternative to the traditional tissue-equivalent bolus during chest wall PMRT. Methods: Data was collected from patients who received PMRT using brass mesh at UC Davis Medical Center’s Department of Radiation Oncology between January 2008 and June 2011. Several patient characteristics including age, body habitus, and ethnicity were analyzed along with several disease and treatment characteristics to determine whether or not they had an impact on the skin reaction observed during radiation treatment. In addition to assessing skin toxicity visually using standardized National Cancer Institute scores (NCIS), surface doses were measured for 16 of the 48 patients (33%) to quantify radiation exposure to the chest wall. Results: 48 female patients aged 28-83 received PMRT using brass mesh. As expected, the severity of skin toxicity increased with subsequent doses of radiation with all patients beginning treatment with no skin reaction (NCIS = 0) and the majority of patients completing treatment with either faint to moderate erythema (N = 19, 40%, NCIS = 1) or moderate to brisk erythema (N = 23, 48%, NCIS = 2). In vivo dosimetry analysis revealed surface doses between 81% and 110% of the prescribed dose, with an average of 99% of the prescribed radiation dose being delivered and a standard deviation of 10%. Conclusions: For post-mastectomy chest wall radiation therapy, brass mesh is an effective alternative to the tissue-equivalent bolus. The brass mesh achieved moderate erythema in the majority of patients at the end of treatment and the surface dose was validated using in vivo dosimetry.

Skin dose effects of postmastectomy chest wall radiation therapy using brass mesh as an alternative to tissue equivalent bolus

2013 ◽  
Vol 3 (2) ◽  
pp. e45-e53 ◽  
Author(s):  
Erin Healy ◽  
Shawnee Anderson ◽  
Jing Cui ◽  
Laurel Beckett ◽  
Allen M. Chen ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Chest Wall ◽  
Skin Dose ◽  
Tissue Equivalent ◽  
Dose Effects

scholarly journals A prospective feasibility study of a 1-mm bolus for postmastectomy radiotherapy

2020 ◽  
Author(s):  
Terufumi Kawamoto ◽  
Naoto Shikama ◽  
Chie Kurokawa ◽  
Naoya Hara ◽  
Masaki Oshima ◽  
...  
Keyword(s):  
Chest Wall ◽  
Medical Information ◽  
Skin Toxicity ◽  
University Hospital ◽  
In Vivo Dosimetry ◽  
Postmastectomy Radiotherapy ◽  
Thermoluminescent Dosimeters ◽  
Tissue Equivalent

Abstract BackgroundThere remains wide variation in the use of chest wall boluses for postmastectomy radiotherapy (PMRT). Therefore, we aimed to prospectively evaluate the use of a 1-mm-thick daily tissue-equivalent bolus in patients who received PMRT using thermoluminescent dosimeters (TLDs) and skin toxicity assessment.Materials and MethodsWe collected data from patients with a 1-mm-thick daily bolus during PMRT at The Juntendo University Hospital. The surface dose was measured in vivo under the 1-mm-thick bolus on the chest wall. We assessed the acute skin toxicity weekly during PMRT, and 1, 2, 4, and 12 weeks after the completion of PMRT.ResultsA total of 19 patients aged 32 − 79 years old received PMRT from July 2019 to January 2020. All patients completed the protocol treatment without interruptions, and the median follow-up was 32 weeks. In vivo dosimetry analysis revealed surface doses between 77% and 113% of the prescribed dose, with a mean of 92% of the prescribed radiation dose, and a standard deviation of 7% being delivered. Grade 2 dermatitis was found in 10 patients (53%), and Grade 3 dermatitis was found in one patient (5%). All cases of Grade 2 and 3 dermatitis were improved 4 weeks after PMRT. There were no cases of Grade 4 dermatitis and no chest wall recurrences during the treatment or follow-up period.ConclusionsThe 1-mm-thick daily bolus is a feasible regimen for PMRT, with appropriate dose buildup and acceptable skin toxicity without treatment interruptions.Trial registrationThe University Hospital Medical Information Network Clinical Trials Registry, UMIN000035773. Registered 1 July 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000040622

scholarly journals A prospective feasibility study of a 1-mm bolus for postmastectomy radiotherapy

2020 ◽  
Author(s):  
Terufumi Kawamoto ◽  
Naoto Shikama ◽  
Chie Kurokawa ◽  
Naoya Hara ◽  
Masaki Oshima ◽  
...  
Keyword(s):  
Chest Wall ◽  
Medical Information ◽  
Skin Toxicity ◽  
Toxicity Assessment ◽  
University Hospital ◽  
In Vivo Dosimetry ◽  
Postmastectomy Radiotherapy ◽  
Treatment Interruptions

Abstract Background: The optimal chest wall bolus regimen for postmastectomy radiotherapy (PMRT) remains unknown. We aimed to prospectively evaluate the use of a 1-mm-thick daily tissue-equivalent bolus in patients who received PMRT using thermoluminescent dosimeters (TLDs) and skin toxicity assessment.Materials and Methods: Patients with a 1-mm-thick daily bolus during PMRT were prospectively enrolled at The Juntendo University Hospital. The surface dose was measured in vivo under the 1-mm-thick bolus on the chest wall. We assessed the acute skin toxicity weekly during PMRT, and 1, 2, 4, and 12 weeks after the completion of PMRT.Results: A total of 19 patients aged 32−79 years old received PMRT from July 2019 to January 2020. All patients completed the protocol treatment without interruptions, and the median follow-up was 32 weeks. In vivo dosimetry analysis revealed surface doses between 77% and 113% of the prescribed dose, with a mean of 92% of the prescribed radiation dose, and a standard deviation of 7% being delivered. Grade 2 dermatitis was found in 10 patients (53%), and Grade 3 dermatitis was found in one patient (5%). All cases of Grade 2 and 3 dermatitis were improved 4 weeks after PMRT. There were no cases of Grade 4 dermatitis and no chest wall recurrences during the treatment or follow-up period.Conclusions: The results confirmed the feasibility of using the 1-mm-thick daily bolus for PMRT, with appropriate dose buildup and acceptable skin toxicity without treatment interruptions.Trial registration: The University Hospital Medical Information Network Clinical Trials Registry, UMIN000035773. Registered 1 July 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000040622

A skin dose prediction model based on in vivo dosimetry and ultrasound skin bridge measurements during intraoperative breast radiation therapy

Brachytherapy ◽  
2019 ◽  
Vol 18 (5) ◽  
pp. 720-726 ◽  
Author(s):  
N. Patrik Brodin ◽  
Keyur J. Mehta ◽  
Amar Basavatia ◽  
Lee C. Goddard ◽  
Jana L. Fox ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Prediction Model ◽  
In Vivo Dosimetry ◽  
Skin Dose ◽  
Dose Prediction ◽  
Model Based

scholarly journals A prospective feasibility study of a 1-mm bolus for postmastectomy radiotherapy

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Terufumi Kawamoto ◽  
Naoto Shikama ◽  
Chie Kurokawa ◽  
Naoya Hara ◽  
Masaki Oshima ◽  
...  
Keyword(s):  
Chest Wall ◽  
Medical Information ◽  
Skin Toxicity ◽  
Toxicity Assessment ◽  
University Hospital ◽  
In Vivo Dosimetry ◽  
Postmastectomy Radiotherapy ◽  
Treatment Interruptions

Abstract Background The optimal chest wall bolus regimen for postmastectomy radiotherapy (PMRT) remains unknown. We aimed to prospectively evaluate the use of a 1-mm-thick daily tissue-equivalent bolus in patients who received PMRT using thermoluminescent dosimeters (TLDs) and skin toxicity assessment. Methods Patients with a 1-mm-thick daily bolus during PMRT were prospectively enrolled at The Juntendo University Hospital. The surface dose was measured in vivo under the 1-mm-thick bolus on the chest wall. We assessed the acute skin toxicity weekly during PMRT, and 1, 2, 4, and 12 weeks after the completion of PMRT. Results A total of 19 patients aged 32–79 years old received PMRT from July 2019 to January 2020. All patients completed the protocol treatment without interruptions, and the median follow-up was 32 weeks. In vivo dosimetry analysis revealed surface doses between 77 and 113% of the prescribed dose, with a mean of 92% of the prescribed radiation dose, and a standard deviation of 7% being delivered. Grade 2 dermatitis was found in 10 patients (53%), and Grade 3 dermatitis was found in one patient (5%). All cases of Grade 2 and 3 dermatitis were improved 4 weeks after PMRT. There were no cases of Grade 4 dermatitis and no chest wall recurrences during the treatment or follow-up period. Conclusions Results confirmed the feasibility of using a 1-mm-thick daily bolus for PMRT, exhibiting an appropriate dose buildup and acceptable skin toxicity without treatment interruptions. Trial registration The University Hospital Medical Information Network Clinical Trials Registry, UMIN000035773. Registered 1 July 2019.

scholarly journals A Prospective Feasibility Study of a 1-mm bolus for Postmastectomy Radiotherapy

2020 ◽  
Author(s):  
Terufumi Kawamoto ◽  
Naoto Shikama ◽  
Chie Kurokawa ◽  
Naoya Hara ◽  
Masaki Oshima ◽  
...  
Keyword(s):  
Chest Wall ◽  
Medical Information ◽  
Skin Toxicity ◽  
Toxicity Assessment ◽  
University Hospital ◽  
In Vivo Dosimetry ◽  
Postmastectomy Radiotherapy ◽  
Treatment Interruptions

Abstract Background: The optimal chest wall bolus regimen for postmastectomy radiotherapy (PMRT) remains unknown. We aimed to prospectively evaluate the use of a 1-mm-thick daily tissue-equivalent bolus in patients who received PMRT using thermoluminescent dosimeters (TLDs) and skin toxicity assessment.Methods: Patients with a 1-mm-thick daily bolus during PMRT were prospectively enrolled at The Juntendo University Hospital. The surface dose was measured in vivo under the 1-mm-thick bolus on the chest wall. We assessed the acute skin toxicity weekly during PMRT, and 1, 2, 4, and 12 weeks after the completion of PMRT.Results: A total of 19 patients aged 32−79 years old received PMRT from July 2019 to January 2020. All patients completed the protocol treatment without interruptions, and the median follow-up was 32 weeks. In vivo dosimetry analysis revealed surface doses between 77% and 113% of the prescribed dose, with a mean of 92% of the prescribed radiation dose, and a standard deviation of 7% being delivered. Grade 2 dermatitis was found in 10 patients (53%), and Grade 3 dermatitis was found in one patient (5%). All cases of Grade 2 and 3 dermatitis were improved 4 weeks after PMRT. There were no cases of Grade 4 dermatitis and no chest wall recurrences during the treatment or follow-up period.Conclusions: The results confirmed the feasibility of using the 1-mm-thick daily bolus for PMRT, with appropriate dose buildup and acceptable skin toxicity without treatment interruptions.Trial registration: The University Hospital Medical Information Network Clinical Trials Registry, UMIN000035773. Registered 1 July 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000040622

Diode in Vivo Dosimetry for Patients Receiving External Beam Radiation Therapy

10.37206/88 ◽  
2005 ◽  
Author(s):  
Ellen Yorke ◽  
Rodica Alecu ◽  
Li Ding ◽  
Doracy Fontenla ◽  
Andre Kalend ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
In Vivo Dosimetry ◽  
External Beam ◽  
Beam Radiation

Implementation of an in vivo radiochromic film QA procedure

2016 ◽  
Author(s):  
◽  
Jason Stanford
Keyword(s):  
Quality Assurance ◽  
Radiation Treatment ◽  
Radiochromic Film ◽  
In Vivo Dosimetry ◽  
Patient Specific ◽  
Attractive Alternative ◽  
Quality Assurance Procedure ◽  
Imaging Device ◽  
Treatment Techniques

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT REQUEST OF AUTHOR.] Advance treatment techniques, such as IMRT and dynamic conformal arc delivery, are novel radiation treatment procedures at the forefront of accurate and precise radiotherapy. However, the risk of suboptimal treatment resulting in injury is far greater with these techniques due to their complexity. An in vivo quality assurance system is the most appropriate validation of the delivered dose to the patient from these techniques. The intent of this research is to propose an in vivo dosimetry quality assurance procedure using radiochromic film. This research proved that radiochromic in vivo dosimetry is a viable method of detecting spatial patient specific errors in radiotherapy; however, the process is time consuming and not sensitive enough for dosimetric errors associated with weight change. Although time consuming, in vivo radiochromic dosimetry is an attractive alternative for small cancer centers and developing countries without the large startup capital to acquire the electronic portal imaging device necessary for EPID in vivo dosimetry.

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