Use of an electron spoiler for radiation treatment of surface skin diseases

Hernández, Víctor; Sánchez-Reyes, A.; Badal, Andreu; Vila, A.; Mur, E.; Pedro, A.; Sanchiz, F.

doi:10.1007/s12094-010-0519-3

Cited by 5 publications

(10 citation statements)

References 19 publications

(20 reference statements)

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“…The method consists in adding an aluminium spoiler at the end of the electron applicator, which results in an optimal radiation beam for skin irradiation. 20 Historically, beam spoilers have been employed in photon therapy to increase the build-up dose near the surface, but their use in conjunction with electron beams in clinical practice after surgery has not been previously evaluated. 20 Between 2007 and 2012, our institution treated 20 keloids in 19 patients using this modality.…”

Section: Aimmentioning

confidence: 99%

“…20 Historically, beam spoilers have been employed in photon therapy to increase the build-up dose near the surface, but their use in conjunction with electron beams in clinical practice after surgery has not been previously evaluated. 20 Between 2007 and 2012, our institution treated 20 keloids in 19 patients using this modality. 21 In what follows, we evaluate our clinical results and discuss them in the light of the existing literature.…”

Section: Aimmentioning

confidence: 99%

“…The area to be irradiated was delimited by a thin (2-mm) lead cover, reducing the visual field from the linear accelerator by at least 1 cm in all directions. This is necessary to reduce the penumbra of the degenerated electron field to an acceptable level for medical practice, see [20] for a detailed explanation. The irradiated area included a 5 mm margin.…”

Section: Fig 1 -A Refractory Ear Lobe Keloid That Received a Previoumentioning

confidence: 99%

See 2 more Smart Citations

Adjuvance in refractory keloids using electron beams with a spoiler: Recent results

Capel

Vilar-Palop²,

Olivé

et al. 2015

Reports of Practical Oncology & Radiotherapy

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Section: Aimmentioning

confidence: 99%

Section: Aimmentioning

confidence: 99%

Section: Fig 1 -A Refractory Ear Lobe Keloid That Received a Previoumentioning

confidence: 99%

See 1 more Smart Citation

Adjuvance in refractory keloids using electron beams with a spoiler: Recent results

Capel

Vilar-Palop²,

Olivé

et al. 2015

Reports of Practical Oncology & Radiotherapy

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“…McKenzie et al used a plastic spoiler in order to match two adjacent electron fields [ 11 ]. Hernández et al studied the application of aluminum spoilers for increasing surface dose of a 6 MeV electron beam [ 12 ]. So-Yeon Park et al compared dosimetry characteristics of a 4 MeV electron beam without spoiler to a 6 MeV electron beam with spoiler [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, using bolus on sloped surfaces and partly bloused fields can cause remarkable dose perturbations and may also produce cold and hot spots below the edge. An alternative is to use an electron beam spoiler to decrease the electron therapeutic depth while increasing the surface dose [ 12 , 15 ]. Studies have revealed that for every treatment unit and for each spoiler material, it is necessary to determine the optimum spoiler thickness by considering the energy of electron beam, depth of tumor and tumor lateral expansion.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Therapeutic Properties of a Low Energy Electron Beam Plus Spoiler for Local Treatment of Mycosis Fungoides: A Monte Carlo Study

et al. 2017

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Background: When using low-energy electron beams for the treatment of skin lesions, such as Mycosis Fungoides (MF), a beam spoiler is used to decrease electron therapeutic depth (R90) while increasing the surface dose.Objective: The aim of this study was to evaluate the characteristics of a 5 MeV electron beam when using a spoiler for the local treatment of MF skin lesions by Monte Carlo (MC) simulation.Methods: A Siemens Primus treatment head and an acrylic spoiler, positioned at the end of applicator, were simulated using BEAMnrc, an EGSnrc user code. The modelled beam was validated by measurement using MP3-M water tank, Roos parallel plate chamber and Semi flex Chamber-31013 (all from PTW, Freiburg, Germany). For different spoiler thicknesses, dose distributions in water were calculated for 2 field sizes and were compared to those for the corresponding open fields.Results: For a 1.3 cm spoiler, therapeutic range changed from 1.5 cm (open field) to 0.5 cm and 0.4 cm for 10 × 10 cm2 and 20 × 20 cm2 field sizes, respectively. Maximum increase in penumbra width was 2.8 and 3.8 cm for 10 × 10 cm2 and 20 × 20 cm2 field sizes, respectively. Maximum increase in bremsstrahlung contamination was %2 in both field sizes.Conclusion: R90 decreased exponentially with increase in spoiler thickness. The effect of field size on penumbra was much larger for spoiled beam compared to the open beam. The results of this research can be applied to optimize the radiation treatment of MF patients in our hospital.

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Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi’s sarcoma in the distal extremities

Kim

Cho

et al. 2020

Sci Rep

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A novel wide-field electron arc technique with a scatterer is implemented for widespread Kaposi's sarcoma (KS) in the distal extremities. Monte Carlo beam modeling for electron arc beams was established to achieve <2% deviation from the measurements, and used for dose calculation. MCbased electron arc plan was performed using CT images of a foot and leg mimicking phantom and compared with in-vivo measurement data. We enrolled one patient with recurrent KS on the lower extremities who had been treated with photon radiation therapy. The 4-and 6-MeV electron arc plans were created, and then compared to two photon plans: two opposite photon beam and volumetric modulated arc with bolus. Compared to the two photon techniques, the electron arc plans resulted in superior dose saving to normal organs beneath the skin region, although it shows inferior coverage and homogeneity for PTV. The electron arc treatment technique with scatterer was successfully implemented for the treatment of widespread KS in the distal extremities with lower radiation exposure to the normal organs beyond the skin lesions, which could be a treatment option for recurrent skin cancer in the extremities. Kaposi's sarcoma (KS) is a superficial tumor that typically occurs in the distal extremities of the hands and feet. Surgical excision is not a recommended treatment method for KS because this tumor is spread sparsely on the skin. Systemic chemotherapy is not indicated for the treatment of multiple superficial tumors without distant metastasis, and it is challenging to treat multiple superficial tumors with local cryotherapy 1. Previous studies have reported that KS responds well to radiation therapy, and so radiation therapy is used to provide palliation with minimal side-effects in all forms of KS 2-5. Megavoltage photon beams are generally used to treat widespread skin cancer. These beams have a build-up characteristic near the surface before reaching electronic equilibrium. To treat superficial skin tumors with a megavoltage photon beam, a layer of scattering material that imitates skin called a bolus is used to increase the radiation dose at the skin surface 6. A previous study has suggested that a simple photon beam technique with various tissue-equivalent boluses such as water or rice could be used in the treatment of skin cancer 7. This technique has the advantage that it can deliver a uniform dose of radiation to widespread lesions. However, megavoltage photon beam treatment will inevitably deliver as much as the prescribed dose to deep-seated normal tissues. This increases the potential for complications such as fibrosis, edema, and joint contracture as a result of increased radiation exposure to underlying normal tissues such as skin, muscles, vasculature, and bones 3,8. Electron beam treatments that use beam spoilers could help overcome this issue. Previous studies have confirmed that this technique is useful in treating flat surfaces because the spoiler increases the surface dose and reduces the electron beam's penetration range 9. Howev...

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Use of an electron spoiler for radiation treatment of surface skin diseases

Cited by 5 publications

References 19 publications

Adjuvance in refractory keloids using electron beams with a spoiler: Recent results

Adjuvance in refractory keloids using electron beams with a spoiler: Recent results

Evaluation of Therapeutic Properties of a Low Energy Electron Beam Plus Spoiler for Local Treatment of Mycosis Fungoides: A Monte Carlo Study

Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi’s sarcoma in the distal extremities

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