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Heumann, T.R., Esiashvili, N., Parker, S., Switchenko, J.M., Dhabbaan, A., Goodman, M., Lechowicz, M.J., Flowers, C.R. and Khan, M.K. (2015) Total Skin Electron Therapy for Cutaneous T-Cell Lymphoma Using a Modern Dual-Field Rotational Technique. International Journal of Radiation Oncology, Biology, Physics, 92, 183-191.
https://doi.org/10.1016/j.ijrobp.2014.11.033

has been cited by the following article:

• TITLE: Dual-Fields Rotational Total Skin Electron Therapy: Investigation and Implementation

  AUTHORS: M. Ming Xu, Iris Rusu, Richard P. Garza

  KEYWORDS: Total Skin, Electron Therapy, Stanford 6 Field, McGill Rotation Therapy, In-Vivo Dosimetry

  JOURNAL NAME: International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, Vol.13 No.1, February 18, 2024

  ABSTRACT: Purpose: To present a protocol of a dual-field rotational (DFR) total skin electron therapy (TSET) and to provide an assessment of clinical implementation, dosimetry properties, and skin dose evaluation. Methods and Materials: The DFR-TSET combined the Stanford 6-field and McGill rotational methods. Dual 6 MeV electron beams in high dose total skin electron mode were used for DFR-TSET on a commercial linac. Beam profiles and dosimetric properties were measured using solid phantoms. The dose rate at expanded source-to-surface distance (SSD) was a combination of static rate and rotational rate. In vivo dosimetry of patient skin was performed on patients’ skin using film, metal oxide semiconductor field-effect transistors (MOSFET), and optically stimulated luminescent dosimeters (OSLD). Results: Dual field rotational total skin electron therapy exhibited good (≤±10%) uniformity in the beam profiles in the vertical direction at an extended SSD of 332 cm with a gantry angulation of ±20˚ deviated from the horizontal direction. In-vivo measurements confirmed acceptable uniformity of the patients’ total body surfaces and revealed anatomically self-blocked or shielded areas where underdosing occurred. Conclusions: The clinical implementation of DFR-TSET effectively utilizes the special mode on a linac. This technique provides short beam-on times, uniform dose distribution, large treatment field, and reduced dose of x-ray contamination to the patients. In-vivo measurements indicate satisfactory delivery and dose uniformity of the prescribed dose. Electron boost fields are recommended at normal SSDs to address underdosed areas.