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Methods of bolusing the tracheostomy stoma.
J J Beitler1, R Yaparpalvi, C Della Biancia
1Department of Radiation Oncology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467-2490, USA. JBeitler92@alumni.gsb.columbia.edu
Summary
Radiation therapy for subglottic cancer can be optimized using Aquaplast to cover the tracheostomy stoma. This method avoids the discomfort and complications associated with plastic tracheostomy tubes, improving patient outcomes.
Area of Science:
- Radiation oncology
- Medical physics
- Head and neck cancer treatment
Background:
- The tracheostomy stoma is a potential site for cancer recurrence in patients with subglottic cancer.
- Accurate radiation dosimetry is crucial to avoid underdosing the posterior wall of the tracheostomy stoma with anterior photon fields.
- Conventional methods using plastic tracheostomy tubes can cause patient discomfort, trauma, and interfere with vocalization.
Purpose of the Study:
- To investigate the dosimetry of the tracheostomy stoma region during radiation therapy.
- To evaluate alternative methods for covering the tracheostomy stoma to ensure adequate radiation dose delivery.
Main Methods:
- A phantom model simulating the tracheostomy stoma was used.
- Film dosimetry and thermoluminescent dosimeters were employed to measure radiation dose at the posterior wall.
- Various materials, including plastic tracheostomy tubes, bolus, and Aquaplast, were tested for their dosimetric properties.
Main Results:
- Aquaplast, in thicknesses of 3 mm and 6 mm, delivered 93% and 100% of the prescribed radiation dose to the posterior tracheal wall, respectively.
- These results indicate effective dose delivery to the critical posterior wall region.
Conclusions:
- Temporary plastic tracheostomy tubes are unnecessary for patients undergoing external radiation therapy for subglottic cancer.
- Aquaplast provides a superior alternative, offering improved positioning accuracy, reduced trauma, and compatibility with respiratory and vocalization functions.