Total skin electron irradiation techniques: a review

Piotrowski, Tomasz; Milecki, Piotr; Skórska, M.; Fundowicz, D.

doi:10.5114/pdia.2013.33379

Cited by 53 publications

(36 citation statements)

References 50 publications

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“…Total skin electron irradiation (TSEI) is one of the most effective treatments of malignant skin diseases, such as mycosis fungoides (MF) and cutaneous lymphomas 1 , 2 , 3 , 4 The goal is to treat the entire body surface to a limited depth with a relatively uniform dose (e.g.,

\pm 10 %

) (5) . In order to deliver the treatment dose at a shallow depth, low‐energy electrons are considered for TSEI, which is commonly performed with a 6 MeV beam.…”

Section: Introductionmentioning

confidence: 99%

Validation of total skin electron irradiation (TSEI) technique dosimetry data by Monte Carlo simulation

Nevelsky

Borzov

Daniel

et al. 2016

J Applied Clin Med Phys

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Total skin electron irradiation (TSEI) is a complex technique which requires many nonstandard measurements and dosimetric procedures. The purpose of this work was to validate measured dosimetry data by Monte Carlo (MC) simulations using EGSnrc‐based codes (BEAMnrc and DOSXYZnrc). Our MC simulations consisted of two major steps. In the first step, the incident electron beam parameters (energy spectrum, FWHM, mean angular spread) were adjusted to match the measured data (PDD and profile) at SSD=100 cm for an open field. In the second step, these parameters were used to calculate dose distributions at the treatment distance of 400 cm. MC simulations of dose distributions from single and dual fields at the treatment distance were performed in a water phantom. Dose distribution from the full treatment with six dual fields was simulated in a CT‐based anthropomorphic phantom. MC calculations were compared to the available set of measurements used in clinical practice. For one direct field, MC calculated PDDs agreed within 3%/1 mm with the measurements, and lateral profiles agreed within 3% with the measured data. For the OF, the measured and calculated results were within 2% agreement. The optimal angle of 17° was confirmed for the dual field setup. Dose distribution from the full treatment with six dual fields was simulated in a CT‐based anthropomorphic phantom. The MC‐calculated multiplication factor (B12‐factor), which relates the skin dose for the whole treatment to the dose from one calibration field, for setups with and without degrader was 2.9 and 2.8, respectively. The measured B12‐factor was 2.8 for both setups. The difference between calculated and measured values was within 3.5%. It was found that a degrader provides more homogeneous dose distribution. The measured X‐ray contamination for the full treatment was 0.4%; this is compared to the 0.5% X‐ray contamination obtained with the MC calculation. Feasibility of MC simulation in an anthropomorphic phantom for a full TSEI treatment was proved and is reported for the first time in the literature. The results of our MC calculations were found to be in general agreement with the measurements, providing a promising tool for further studies of dose distribution calculations in TSEI.PACS number(s): 87.10. Rt, 87.55.K, 87.55.ne

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\pm 10 %

) (5) . In order to deliver the treatment dose at a shallow depth, low‐energy electrons are considered for TSEI, which is commonly performed with a 6 MeV beam.…”

Section: Introductionmentioning

confidence: 99%

Validation of total skin electron irradiation (TSEI) technique dosimetry data by Monte Carlo simulation

Nevelsky

Borzov

Daniel

et al. 2016

J Applied Clin Med Phys

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“…Retrospective reviews (n = 41-180) from recent decades have demonstrated the efficacy of high-dose (≥30 Gy) TSEI in achieving high clinical response rates (1, 4-9). The vast majority of these studies used the large-field/modified Stanford technique, in which the skin surface is irradiated in a discontinuous manner, with the patient changing position six times by 60° during one treatment fraction (10). In contrast, a rotational TSEI technique (RTSEI), in which a patient is automatically rotated at a constant speed about the vertical axis while being irradiated with single or dual fields, allowing for continuous treatment delivery, has been previously described (11).…”

Section: Introductionmentioning

confidence: 99%

Total Skin Electron Therapy for Cutaneous T-Cell Lymphoma Using a Modern Dual-Field Rotational Technique

Heumann

Esiashvili

Parker

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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Purpose To report our experience with rotational total skin electron irradiation (RTSEI) in cutaneous T-cell lymphoma (CTCL), and to examine response by disease stage and race. Methods and Materials We reviewed our outcomes for 68 CTCL patients who received RTSEI (≥30 Gy) from 2000 to 2013. Primary outcomes were complete clinical response (CCR), recurrence-free survival (RFS), and overall survival (OS). Using log–rank tests and Cox proportional hazards, OS and RFS were compared across tumor stages at time of RTSEI with further racial subgroup analysis. Results Median age at diagnosis and at time of radiation was 52 and 56 years, respectively. Median follow-up was 5.1 years, 49% were African American, and 49% were female. At time of treatment, 18, 37, and 13 patients were T stage 2, 3, and 4, respectively. At 6 weeks after RTSEI, overall CCR was 82% (88%, 83%, and 69% for T2, T3, and T4, respectively). Median RFS was 11 months for all patients and 14, 10, and 12 months for stage T2, T3, and T4, respectively. Tumor stage was not associated with RFS or CCR. Maintenance therapy after RTSEI was associated with improved RFS in both crude and multivariable analysis, controlling for T stage. Median OS was 76 months (91 and 59 months for T3 and T4, respectively). With the exception of improved OS in African Americans compared with whites at stage T2, race was not associated with CCR, RFS, or OS. Conclusions These results represent the largest RTSEI clinical outcomes study in the modern era using a dual-field rotational technique. Our observed response rates match or improve upon the standard set by previous outcome studies using conventional TSEI techniques, despite a large percentage of advanced CTCL lesions in our cohort. We found that clinical response after RTSEI did not seem to be affected by T stage or race.

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“…TSEBT is an example of treatment, that may be applied in such cases (8). The dose is delivered using one of various radiation techniques, with six dual field, rotational, and rotary dual techniques among the most common examples (9).…”

Section: Discussionmentioning

confidence: 99%

Total Skin Electron Beam Therapy with Rotary Dual Technique as Palliative Treatment for Mycosis Fungoides

Piotrowski

Fundowicz

Pawlaczyk

2018

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Total skin electron irradiation techniques: a review

Cited by 53 publications

References 50 publications

Validation of total skin electron irradiation (TSEI) technique dosimetry data by Monte Carlo simulation

Validation of total skin electron irradiation (TSEI) technique dosimetry data by Monte Carlo simulation

Total Skin Electron Therapy for Cutaneous T-Cell Lymphoma Using a Modern Dual-Field Rotational Technique

Total Skin Electron Beam Therapy with Rotary Dual Technique as Palliative Treatment for Mycosis Fungoides

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