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Double enhancement effect of a surface dose with tungsten rubber bolus in photon radiotherapy for keloids and superficial tumors

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Abstract

To clarify the dosimetric characteristics of a real-time variable shape rubber-containing tungsten (STR) bolus in a clinical plan and investigate the efficacy of the STR bolus in photon radiotherapy for keloids and other superficial tumors. A 5 mm gel bolus or 1 mm STR bolus was placed on a solid water phantom. Tangential irradiation was performed using a TomoTherapy Radixact-X9 and 6 MV X-ray flattening-filter-free beam, and the surface dose was measured with radiochromic film. Clinical-like plans (TomoDirect; TD and TomoHelical; TH) were applied with the same geometry and the dose distributions were measured. The increase in surface dose by the build-up effect and backscatter was 37.7% and 8.0% for the gel bolus, and 40.5% and 26.4% for the STR bolus, respectively. In the TD and TH plans, the increase in surface dose was 27.4% and 48.3% for the gel bolus, and 39.0% and 63.2% for the STR bolus. Similary, changes in the sagittal plane dose were − 3.9% and 6.1% for the gel bolus, and − 6.3% and 6.9% for the STR bolus. The STR bolus effectively increased the surface dose by the build-up effect and backscatter in photon radiotherapy for keloids and other superficial tumors.

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Acknowledgements

The authors thank Ashleigh Cooper, PhD, from Edanz Group (https://en-author-services.edanzgroup.com/ac) for editing a draft of this manuscript.

Funding

This work was supported partly by Japan Society for the Promotion of Science (JSPS) KAKENHI (Grant No. 19K08211).

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Authors and Affiliations

  1. Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, 377-2 Onohigashi, Osakasayama, Osaka, 589-8511, Japan

    Yusuke Sakai, Hajime Monzen, Mikoto Tamura & Kenji Nakamura

  2. Department of Radiotherapy, Takarazuka City Hospital, 4-5-1 Kohama, Takarazuka, Hyogo, 665-0827, Japan

    Yusuke Sakai & Kenji Nakamura

  3. Department of Radiation Oncology, Faculty of Medicine, Kindai University, 377-2 Onohigashi, Osakasayama, Osaka, 589-8511, Japan

    Yasumasa Nishimura

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  1. Yusuke Sakai
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Contributions

HM and YS designed the conceptual ideas. YS and KN performed the experiments and analyzed the data. The first draft of the manuscript was written by YS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hajime Monzen.

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Hajime Monzen received a research donation from Hayakawa Rubber Co., Ltd.

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Sakai, Y., Monzen, H., Tamura, M. et al. Double enhancement effect of a surface dose with tungsten rubber bolus in photon radiotherapy for keloids and superficial tumors. Phys Eng Sci Med 46, 179–184 (2023). https://doi.org/10.1007/s13246-022-01208-1

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