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ACPSEM ROSG TBE working group recommendations for quality assurance in total body electron irradiation

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Abstract

The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) Radiation Oncology Specialty Group (ROSG) formed a series of working groups in 2011 to develop recommendations for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations are intended to provide guidance for safe work practices and a suitable level of quality control without detailed work instructions. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance to these recommendations. The recommendations are endorsed by the ROSG, and have been subject to independent expert reviews. For the Australian readers, these recommendations should be read in conjunction with the Tripartite Radiation Oncology Reform Implementation Committee Quality Working Group: Radiation Oncology Practice Standards (2011), and Radiation Oncology Practice Standards Supplementary Guide (2011). This publication presents the recommendations of the ACPSEM ROSG Total Body Electron Irradiation Working Group and has been developed in alignment with other international associations. However, these recommendations should be read in conjunction with relevant national, state or territory legislation and local requirements, which take precedence over the ACPSEM recommendations. It is hoped that the users of this and other ACPSEM recommendations will contribute to the development of future versions through the Radiation Oncology Specialty Group of the ACPSEM. This document serves as a guideline for calibration and quality assurance of equipment used for TBE in Australasia.

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Abbreviations

AAPM:

American Association of Physicists in Medicine

ACPSEM:

Australasian College of Physical Scientists and Engineers in Medicine

AP:

Anterior-posterior

Gy:

Gray

HDTSe:

High-dose total skin electron

IVD:

In-vivo dosimetry

LAO:

Left anterior oblique

Linac:

Linear accelerator

LPO:

Left posterior oblique

MDT:

Multi-disciplinary team

MF:

Mycosis fungoides

MOSFET:

Metal-oxide-silicon field-effect transistor

MU:

Monitor unit

OSL:

Optically stimulated luminescence

PA:

Posterior-anterior

PDD:

Percentage depth dose

PMMA:

Polymethyl methacrylate

QA:

Quality assurance

RAO:

Right anterior oblique

RO:

Radiation oncologist

ROMP:

Radiation oncology medical physicist

ROSG:

Radiation Oncology Specialty Group

RPO:

Right posterior oblique

RT:

Radiation therapist

SSD:

Source-to-surface distance

TBE:

Total body electrons

TLD:

Thermoluminescent detector

References

  1. Radiation Oncology Reform Implementation Committee (RORIC) Quality Working Group (2011) Tripartite radiation oncology practice standards. http://www.ranzcr.edu.au/quality-a-safety/radiation-oncology/tripartite-radiation-oncology-practice-standards

  2. Radiation Oncology Reform Implementation Committee (RORIC) Quality Working Group (2011) Tripartite radiation oncology practice standards supplementary guide. http://www.ranzcr.edu.au/quality-a-safety/radiation-oncology/tripartite-radiation-oncology-practice-standards

  3. Reynard EP, Evans MD, Devic S, Parker W, Freeman CR, Roberge D, Podgorsak EB (2008) Rotational total skin electron irradiation with a linear accelerator. J Appl Clin Med Phys 9(4):2793

    Article  PubMed  Google Scholar 

  4. Trautinger F, Knobler R, Willemze R, Peris K, Stadler R, Laroche L, D’Incan M, Ranki A, Pimpinelli N, Ortiz-Romero P, Dummer R, Estrach T, Whittaker S (2006) EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome. Eur J Cancer 42(8):1014–1030. doi:10.1016/j.ejca.2006.01.025

    Article  PubMed  Google Scholar 

  5. Hauswald H, Zwicker F, Rochet N, Uhl M, Hensley F, Debus J, Herfarth K, Bischof M (2012) Total skin electron beam therapy as palliative treatment for cutaneous manifestations of advanced, therapy-refractory cutaneous lymphoma and leukemia. Radiat Oncol 7:118. doi:10.1186/1748-717X-7-118

    Article  PubMed Central  PubMed  Google Scholar 

  6. Skórska M (2014) Total skin electron beam (TSEB) therapy in pediatric patients: a review of the literature. Rep Pract Oncol Radiother 19:109–113

    Article  PubMed Central  PubMed  Google Scholar 

  7. Bao Q et al (2012) A technique for paediatric total skin electron irradiation. Radiat Oncol 7:40

    Article  PubMed Central  PubMed  Google Scholar 

  8. Chin DM, Chow S, Kim YH, Hoppe RT (1999) Total skin electron beam therapy with or without adjuvant topical nitrogen mustard or nitrogen mustard alone as initial treatment of T2 and T3 mycosis fungoides. Int J Radiat Oncol Biol Phys 43:951–958

    Article  Google Scholar 

  9. Micaily B, Vonderheid EC, Brady LW, Andrews C (1985) Total skin electron beam and total nodal irradiation for treatment of patients with cutaneous T-cell lymphoma. Int J Radiat Oncol Biol Phys 11:1111–1115

    Article  CAS  PubMed  Google Scholar 

  10. Mazzeo E, Rubino L, Buglione M, Antognoni P, Magrini SM, Bertoni F, Parmiggiani M, Barbieri P, Bertoni F (2014) The current management of mycosis fungoides and Sézary syndrome and the role of radiotherapy: principles and indications. Rep Pract Oncol Radiother 19(2):77–91. doi:10.1016/j.rpor.2013.07.009

    Article  PubMed Central  PubMed  Google Scholar 

  11. Piotrowski T (2014) Total skin electron irradiation—The technique where the electron beams are still irreplaceable. Rep Pract Oncol Radiother 19(2):69–71. doi:10.1016/j.rpor.2013.11.002

    Article  PubMed Central  PubMed  Google Scholar 

  12. De Moraes FY, de Carvalho HA, Hanna SA, da Silva JLF, Marta GN (2014) Literature review of clinical results of total skin electron irradiation (TSEBT) of mycosis fungoides in adults. Rep Pract Oncol Radiothe 19:92–98. doi:10.1016/j.rpor.2013.08.003

    Article  Google Scholar 

  13. Kamstrup MR, Lindahl LM, Gniadecki R, Iversen L, Skov L, Petersen PM, Loft A, Specht L (2012) Low-dose total skin electron beam therapy as a debulking agent for cutaneous T-cell lymphoma: an open-label prospective phase II study. Br J Dermatol 166(2):399–404. doi:10.1111/j.1365-2133.2011.10670.x

    Article  CAS  PubMed  Google Scholar 

  14. Kaźmierska J (2014) Clinical results of the total skin electron irradiation of the mycosis fungoides in adults. Conventional fractionation and low dose schemes. Rep Pract Oncol Radiother 19:99–103

    Article  PubMed Central  PubMed  Google Scholar 

  15. Hoppe R (2003) Mycosis fungoides: radiation therapy. Dermatol Ther 16:347–354

    Article  PubMed  Google Scholar 

  16. Rosenblatt E, Kuten A, Leviov M, Cederbaum M (1998) Total skin electron irradiation in mycosos fungoides dose and fractionation considerations. Leuk Lymphoma 30(1–2):143–151

    CAS  PubMed  Google Scholar 

  17. American Association of Medical Physics (1987) AAPM report 23: Total skin electron therapy: technique and dosimetry. American Association of Physicists in Medicine, College Park

  18. Earley L, Moeller J, O’Rear J, Leavitt DD (1995) A method for total skin electron treatment for infants. Med Dosim 20(4):243–248. doi:10.1016/0958-3947(95)02010-1

    Article  CAS  PubMed  Google Scholar 

  19. Baugh G, Al-Alawi T, Fletcher CL, Mills JA, Grieve RJ (2011) A preliminary comparison of total skin electron treatment techniques to demonstrate the application of a mid-torso phantom for measurement of dose penetration. Br J Radiol 84(1008):1125–1130. doi:10.1259/bjr/52924135

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Chen Z, Agostinelli AG, Wilson LD, Nath R (2004) Matching the dosimetry characteristics of a dual-field Stanford technique to a customized single-field Stanford technique for total skin electron therapy. Int J Radiat Oncol Biol Phys 59(3):872–885. doi:10.1016/j.ijrobp.2004.02.046

    Article  PubMed  Google Scholar 

  21. Piotrowski T, Malicki J (2006) The rotary dual technique for total skin irradiation in the treatment of mycosis fungoides—a description of the applied method. Rep Pract Oncol Radiother 11(1):29–37. doi:10.1016/S1507-1367(06)71047-1

    Article  Google Scholar 

  22. Hensley FW, Major G, Edel C, Hauswald H, Bischof M (2014) Technical and dosimetric aspects of the total skin electron beam technique implemented at Heidelberg University Hospital. Rep Pract Oncol Radiother 19(2):135–143. doi:10.1016/j.rpor.2013.07.002

    Article  PubMed Central  PubMed  Google Scholar 

  23. Ulutin HC, Beyan C, Pak Y (2002) Total skin electron beam therapy for cutaneous T-cell lymphoma: Turkish experience with translational technique. Haematologia (Budap) 32(4):397–403

    Google Scholar 

  24. Anacak Y, Arican Z, Drumea K, Rosenblatt E, Tamir A, Chetver L, Stein M, Deroma RB, Kuten A (2002) Total skin electron irradiation in mycosis fungoides: comparison between a modified christie hospital translational technique and the stanford technique. Leuk Lymphoma 43(11):2093–2097. doi:10.1080/1042819021000016177

    Article  CAS  PubMed  Google Scholar 

  25. Hsieh C-H, Shueng P-W, Lin S-C, Tien H-J, Shiau A-C, Chou Y-H, Wu M-H, Wang J-Y, Chen C-K, Chen Y-J (2013) Helical irradiation of the total skin with dose painting to replace total skin electron beam therapy for therapy-refractory cutaneous CD4+ T-Cell Lymphoma. BioMed Res Int 2013:11. doi:10.1155/2013/717589

    Google Scholar 

  26. Evans MDC, Hudon C, Podgorsak EB, Freeman CR (2014) Institutional experience with a rotational total skin electron irradiation (RTSEI) technique—a three decade review (1981–2012). Rep Pract Oncol Radiother 19:120–134

    Article  PubMed Central  PubMed  Google Scholar 

  27. Podgorsak EB, Pla C, Pla M, Lefebvre PY, Heese R (1983) Physical aspects of a rotational total skin electron irradiation. Med Phys 10:159–168

    Article  CAS  PubMed  Google Scholar 

  28. Piotrowski T, Milecki P, Skórska M, Fundowicz D (2013) Total skin electron irradiation techniques: a review. Postep Derm Alergol 30:50–55

    Article  Google Scholar 

  29. Diamantopoulos S, Platoni K, Dilvoi M, Nazos I, Geropantas K, Maravelis G, Tolia M, Beli I, Efstathopoulos E, Pantelakos P, Panayiotakis G, Kouloulias V (2011) Clinical implementation of total skin electron beam (TSEB) therapy: a review of the relevant literature. Phys Med 27(2):62–68. doi:10.1016/j.ejmp.2010.09.001

    Article  CAS  PubMed  Google Scholar 

  30. Shouman T, El-Taher Z (2004) Total skin electron therapy: a modified technique for small room linear accelerator. J Egypt Natl Cancer Inst 16(4):202–209

    Google Scholar 

  31. Marinello G, Jaffre F, Slosarek K, le Bourgeois J (1998) Total skin electron irradiation. Rep Pract Oncol Radiother 3(1):19–22

    Article  Google Scholar 

  32. Van Dyk J (ed) (1999) The modern technology in radiation oncology. Medical Physics Publishing, Madison Ch 17B Special Techniques in Radiotherapy: Total Skin Electron Irradiation by Podgorsak EB and Podgorsak MB

    Google Scholar 

  33. Gerbi BJ, Khan FM, Deibel FC, Kim TH (1989) Total skin electron arc irradiation using a reclined patient position. Int J Radiat Oncol Biol 17:397–404

    Article  CAS  Google Scholar 

  34. Friedman RB, Schmidt-Ullrich RK, Lu J, Ali MM (1996) Cutaneous T-cell lymphoma, total skin electron beam irradiation—a comparison of rotational and stationary field techniques. Int J Radiat Oncol Biol 36(1):356

    Article  Google Scholar 

  35. Jones GW, Kacinski BM, Wilson LD, Willemze R, Spittle M, Hohenberg G, Handl-Zeller L, Trautinger F, Knobler R, Group ECLP (2002) Total skin electron radiation in the management of mycosis fungoides: consensus of the European Organization for Research and Treatment of Cancer (EORTC) Cutaneous Lymphoma Project Group. J Am Acad Dermatol 47(3):364–370

    Article  PubMed  Google Scholar 

  36. Desai KR, Pezner RD, Lipsett JA, Vora NL, Luk KH, Wong JYC, Chan SL, Findley DO, Hill LR, Marin LA, Archambeau JO (1988) Total skin electron irradiation for mycosis fungoides: relationship between acute toxicities and measured dose at different anatomic sites. Int J Radiat Oncol Biol Phys 15(3):641–645. doi:10.1016/0360-3016(88)90306-9

    Article  CAS  PubMed  Google Scholar 

  37. Weaver RD, Gerbi BJ, Dusenbery KE (1995) Evaluation of dose variation during total skin electron irradiation using thermoluminescent dosimeters. Int J Radiat Oncol Biol Phys 33(2):475–478. doi:10.1016/0360-3016(95)00161-Q

    Article  CAS  PubMed  Google Scholar 

  38. Piotrowski T, Fundowicz D, Pawlaczyk M, Malicki J (2003) Thermoluminescent dosimetry in rotary-dual technique of the total skin electron irradiation. Neoplasma 50(2):125–130

    CAS  PubMed  Google Scholar 

  39. Antolak JA, Cundiff JH, Ha CS (1998) Utilization of thermoluminescent dosimetry in total skin electron beam radiotherapy of mycosis fungoides. Int J Radiat Oncol Biol 40:101–108

    Article  CAS  Google Scholar 

  40. Guidi G, Gottardi G, Ceroni P, Costi T (2014) Review of the results of the in vivo dosimetry during total skin electron beam therapy. Rep Pract Oncol Radiother 19:144–150

    Article  PubMed Central  PubMed  Google Scholar 

  41. Hussein S (2003) Time dose fractionation in total skin electron therapy. Radiat Oncol 69(Supp 1):S39

    Google Scholar 

  42. Specht MD et al (2015) Modern radiation therapy for primary cutaneous lymphomas: field and dose guidelines from the international lymphoma radiation oncology group. Int J Radiat Oncol Biol 92:32–39

    Article  Google Scholar 

  43. Jones GW, Rosenthal D, Wilson LD (1999) Total skin electron radiation for patients with erythrodermic cutaneous T-cell lymphoma (mycosis fungoides and the Sézary syndrome). Cancer 85(9):1985–1995. doi:10.1002/(SICI)1097-0142(19990501)85:9

    CAS  PubMed  Google Scholar 

  44. Lindahl LM, Kamstrup MR, Petersen PM, Wirén J, Fenger-Grøn M, Gniadecki R, Iversen L, Specht L (2011) Total skin electron beam therapy for cutaneous T-cell lymphoma: a nationwide cohort study from Denmark. Acta Oncol 50(8):1199–1205

    Article  PubMed  Google Scholar 

  45. Morris SL, McGovern M, Bayne S, Wain M, Child F, Whittaker S (2013) Results of a 5-week schedule of modern total skin electron beam radiation therapy. Int J Radiat Oncol Biol Phys 86(5):936–941. doi:10.1016/j.ijrobp.2013.04.042

    Article  PubMed  Google Scholar 

  46. Khan FM (2010) The physics of radiation therapy, 4th edn. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  47. American Association of Medical Physics (1991) Report of task group 25: clinical electron-beam dosimetry. Med Phys 18(1):73

    Article  Google Scholar 

  48. Diamantopoulos S et al (2014) First treatment of mycosis fungoides by total skin electron beam (TSEB) in Greece. Rep Pract Oncol Radiother 19:114–119

    Article  PubMed Central  PubMed  Google Scholar 

  49. NCRP Report No 151. NCRP Scientific Committee 46-13 on design of facilities for medical radiation therapy and the American Association of Physicists in Medicine (AAPM) Task Group 57. structural shielding design and evaluation for megavoltage X- and gamma-ray radiotherapy facilities, National Council on Radiation Protection and Measurements, 1992

  50. McGinley PH (2002) Shielding Techniques for Radiation Oncology Facilities, vol 2. Medical Physics Publishing, Madison

    Google Scholar 

  51. El-Khatib E, Hussein S, Nikolic M, Voss NJS, Parsons C (1995) Variation of electron beam uniformity with beam angulation and scatterer position for total skin irradiation with the Stanford technique. Int J Radiat Oncol Biol 33:469–474

    Article  CAS  Google Scholar 

  52. Chen Z, Agostinelli A, Nath R (1998) On the use of unshielded cables in ionization chamber dosimetry for total-skin electron therapy. Phys Med Biol 43(3):539–546

    Article  CAS  PubMed  Google Scholar 

  53. Radiation Oncology physics: a handbook for teachers and students. E.B. Podgorsak Technical Editor, International Atomic Energy Agency, Vienna, 2005

  54. American Association of Medical Physics (2009) Report of task group 142: quality assurance of medical accelerators. Med Phys 36(9):4197–4212. doi:10.1118/1.3190392

    Article  Google Scholar 

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Acknowledgments

The authors would like to acknowledge the work done by ACPSEM ROSG for implementation of the concept of the recommendation papers and organisation of the Radiation Oncology working groups.

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Correspondence to Raelene Nelligan.

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Nelligan, R., Baldwin, Z., Ostwald, T. et al. ACPSEM ROSG TBE working group recommendations for quality assurance in total body electron irradiation. Australas Phys Eng Sci Med 38, 479–492 (2015). https://doi.org/10.1007/s13246-015-0371-4

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