Skip to main content
SpringerLink
Log in

Assessment of skin dose modification caused by application of immobilizing cast in head and neck radiotherapy

  • Scientific Paper
  • Published:
Australasian Physical & Engineering Sciences in Medicine Aims and scope Submit manuscript

Abstract

Skin dose assessment for radiotherapy patients is important to ensure that the dose received by skin is not excessive and does not cause skin reactions. Immobilizing casts may have a buildup effect, and can enhance the skin dose. This study has quantified changes to the surface dose as a result of head and neck immobilizing casts. Medtech and Renfu casts were stretched on the head of an Alderson Rando-Phantom. Irradiation was performed using 6 and 15 MV X-rays, and surface dose was measured by thermoluminescence dosimeters. In the case of 15MV photons, immobilizing casts had no effect on the surface dose. However, the mean surface dose increase reached up to 20 % when 6MV X-rays were applied. Radiation incidence angle, thickness, and meshed pattern of the casts affected the quantity of dose enhancement. For vertical beams, the surface dose increase was more than tangential beams, and when doses of the points under different areas of the casts were analysed separately, results showed that only doses of the points under the thick area had been changed. Doses of the points under the thin area and those within the holes were identical to the same points without immobilizing casts. Higher dose which was incurred due to application of immobilizing casts (20 %) would not affect the quality of life and treatment of patients whose head and neck are treated. Therefore, the benefits of head and neck thermoplastic casts are more than their detriments. However, producing thinner casts with larger holes may reduce the dose enhancement effect.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kelly A, Hardcastle N, Metcalfe P, Cutajar D, Quinn A, Foo K et al (2011) Surface dosimetry for breast radiotherapy in the presence of immobilization cast material. Phys Med Biol 56(4):1001–1013

    Article  PubMed  Google Scholar 

  2. Chiu-Tsao S-T, Chan MF (2010) Evaluation of two-dimensional bolus effect of immobilization/support devices on skin doses: a radiochromic EBT film dosimetry study in phantom. Med Phys 37:3611–3620

    Article  PubMed  Google Scholar 

  3. Heng Siew Ping, Sivamany Kandaiya Minimizing skin toxicity in intensity modulated radiotherapy of head and neck [http://www.researchgate.net/publication/237047156_MINIMIZING_SKIN_TOXICITY_IN_INTENSITY_MODULATED_RADIOTHERAPY_OF_HEAD_AND_NECK]. 2009

  4. Kilic Ayhan KN, Ozkan L, Engin K (2001) The effects of various immobilization devices on buildup and surface doses. Turk onkologi Dergisi 16(4):179–182

    Google Scholar 

  5. De, Puysseleyr A D, Neve, W, De, Wagter, et al. The impact of an Orfit® patient positioning device on beam attenuation and buildup dose 2014.bhpa.eu/wp-content/uploads/…/De_Puysseleyr_Annemieke.pdf [cited 2014]

  6. Bilge H, Yondem S, Kucucuk H, Cakir A, Meral R. Effects of immobilization beds on the dose in the entrance and exit dose region for Co-60, 4, 6 and 15 MV photons. Journal of BUON : official journal of the Balkan Union of Oncology. 2008 Jul-Sep;13(3):385–90. PubMed PMID: 18979554. Epub 2008/11/04. eng

  7. Hadley SWKR, Lam K (2005) Effects of immobilization mask material on surface dose. J Appl Clin Med Phys 6(1):1–7

    Article  PubMed  Google Scholar 

  8. Fontenla DP, Napoli JJ, Hunt M, Fass D, McCormick B, Kutcher GJ (1994) Effects of beam modifiers and immobilization devices on the dose in the buildup region. Int J radiat oncol biol phys 30(1):211–219

    Article  PubMed  CAS  Google Scholar 

  9. Hsu SH, Roberson PL, Chen Y, Marsh RB, Pierce LJ, Moran JM (2008) Assessment of skin dose for breast chest wall radiotherapy as a function of bolus material. Phys Med Biol 53(10):2593–2606

    Article  PubMed  Google Scholar 

  10. Halm EA, Tamri A, Bridier A, Wibault P, Eschwege F (2002) Influence des masques thermoformes de contention sur la dose a la peau en radiotherapie des tumeurs des voies aerodigestives superieures fre (Influence of thermoplastic masks on the absorbed skin dose for head and neck tumor radiotherapy). Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique 6(5):310–319

    Article  Google Scholar 

  11. Lee N, Chuang C, Quivey JM, Phillips TL, Akazawa P, Verhey LJ, Xia P (2002) Skin toxicity due to intensity-modulated radiotherapy for head-and-neck carcinoma. Int J Radiat Oncol Biol Phys 53(3):630–637

    Article  PubMed  Google Scholar 

  12. Quach K, Morales J, Butson M, Rosenfeld AB, Metcalfe P (2000) Measurement of radiotherapy x-ray skin dose on a chest wall phantom. Med Phys 27:1676–1680

    Article  PubMed  CAS  Google Scholar 

  13. Rapley P (2006) Surface dose measurement using TLD powder extrapolation. Med Dosim 31(3):209–215

    Article  PubMed  CAS  Google Scholar 

  14. Khan FM. 2010. In: Physics of Radiation Therapy [http://www.amazon.com/Physics-Radiation-Therapy-Faiz-Khan-ebook/dp/B0050DHKNM]. Lippincott: Williams & Wilkins

Download references

Acknowledgments

The authors thank the office of Vice-President for Research of Mashhad University of Medical Sciences for funding this work. The authors are also grateful to Reza Radiation Oncology Center and Omid hospital for making use of linear accelerators possible.

Author information

Authors and Affiliations

  1. Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Shokouhozaman Soleymanifard & Mohammad Taghi Bahreyni Toossi

  2. Department of Medical Physics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Shokouhozaman Soleymanifard, Mohammad Taghi Bahreyni Toossi & Atefeh vejdani Noghreiyan

  3. Omid Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Shokouhozaman Soleymanifard & Soodabeh Shahidsales

  4. School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran

    Mohsen Khosroabadi

  5. Reza Radiation Oncology Center, Mashhad, Iran

    Fatemeh Varshoee Tabrizi

Authors
  1. Shokouhozaman Soleymanifard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammad Taghi Bahreyni Toossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohsen Khosroabadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Atefeh vejdani Noghreiyan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Soodabeh Shahidsales
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fatemeh Varshoee Tabrizi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohammad Taghi Bahreyni Toossi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Soleymanifard, S., Toossi, M.T.B., Khosroabadi, M. et al. Assessment of skin dose modification caused by application of immobilizing cast in head and neck radiotherapy. Australas Phys Eng Sci Med 37, 535–540 (2014). https://doi.org/10.1007/s13246-014-0283-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13246-014-0283-8

Keywords

Search

Navigation