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A Helical tomotherapy as a robust low-dose treatment alternative for total skin irradiation

Haraldsson, André LU ; Engleson, Jens LU ; Bäck, Sven Å.J. LU ; Engelholm, Silke and Engström, Per E. LU (2019) In Journal of Applied Clinical Medical Physics 20(5). p.44-54
Abstract

Mycosis fungoides is a disease with manifestation of the skin that has traditionally been treated with electron therapy. In this paper, we present a method of treating the entire skin with megavoltage photons using helical tomotherapy (HT), verified through a phantom study and clinical dosimetric data from our first two treated patients. A whole body phantom was fitted with a wetsuit as bolus, and scanned with computer tomography. We accounted for variations in daily setup using virtual bolus in the treatment plan optimization. Positioning robustness was tested by moving the phantom, and recalculating the dose at different positions. Patient treatments were verified with in vivo film dosimetry and dose reconstruction from daily imaging.... (More)

Mycosis fungoides is a disease with manifestation of the skin that has traditionally been treated with electron therapy. In this paper, we present a method of treating the entire skin with megavoltage photons using helical tomotherapy (HT), verified through a phantom study and clinical dosimetric data from our first two treated patients. A whole body phantom was fitted with a wetsuit as bolus, and scanned with computer tomography. We accounted for variations in daily setup using virtual bolus in the treatment plan optimization. Positioning robustness was tested by moving the phantom, and recalculating the dose at different positions. Patient treatments were verified with in vivo film dosimetry and dose reconstruction from daily imaging. Reconstruction of the actual delivered dose to the patients showed similar target dose as the robustness test of the phantom shifted 10 mm in all directions, indicating an appropriate approximation of the anticipated setup variation. In vivo film measurements agreed well with the calculated dose confirming the choice of both virtual and physical bolus parameters. Despite the complexity of the treatment, HT was shown to be a robust and feasible technique for total skin irradiation. We believe that this technique can provide a viable option for Tomotherapy centers without electron beam capability.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
fungoides, helical, mycosis, skin, tomotherapy, total skin irradiation
in
Journal of Applied Clinical Medical Physics
volume
20
issue
5
pages
11 pages
publisher
American College of Medical Physics
external identifiers
  • scopus:85065866613
  • pmid:31033159
ISSN
1526-9914
DOI
10.1002/acm2.12579
language
English
LU publication?
yes
id
49bd20e6-86ef-4214-83a1-8b46bc584ba6
date added to LUP
2019-06-11 14:48:58
date last changed
2020-01-28 11:10:17
@article{49bd20e6-86ef-4214-83a1-8b46bc584ba6,
  abstract     = {<p>Mycosis fungoides is a disease with manifestation of the skin that has traditionally been treated with electron therapy. In this paper, we present a method of treating the entire skin with megavoltage photons using helical tomotherapy (HT), verified through a phantom study and clinical dosimetric data from our first two treated patients. A whole body phantom was fitted with a wetsuit as bolus, and scanned with computer tomography. We accounted for variations in daily setup using virtual bolus in the treatment plan optimization. Positioning robustness was tested by moving the phantom, and recalculating the dose at different positions. Patient treatments were verified with in vivo film dosimetry and dose reconstruction from daily imaging. Reconstruction of the actual delivered dose to the patients showed similar target dose as the robustness test of the phantom shifted 10 mm in all directions, indicating an appropriate approximation of the anticipated setup variation. In vivo film measurements agreed well with the calculated dose confirming the choice of both virtual and physical bolus parameters. Despite the complexity of the treatment, HT was shown to be a robust and feasible technique for total skin irradiation. We believe that this technique can provide a viable option for Tomotherapy centers without electron beam capability.</p>},
  author       = {Haraldsson, André and Engleson, Jens and Bäck, Sven Å.J. and Engelholm, Silke and Engström, Per E.},
  issn         = {1526-9914},
  language     = {eng},
  number       = {5},
  pages        = {44--54},
  publisher    = {American College of Medical Physics},
  series       = {Journal of Applied Clinical Medical Physics},
  title        = {A Helical tomotherapy as a robust low-dose treatment alternative for total skin irradiation},
  url          = {http://dx.doi.org/10.1002/acm2.12579},
  doi          = {10.1002/acm2.12579},
  volume       = {20},
  year         = {2019},
}