Improved dose homogeneity in scalp irradiation using a single set-up point and different energy electron beams

Homogeneous irradiation of the entire or a large portion of the superficial scalp poses both technical and dosimetric challenges. Some techniques will irradiate too much of the underlying normal brain while other techniques are either complex and involve field matching problems or may require sophisticated linear accelerator (linac) add-ons such as intensity modulated radiation therapy (IMRT)/electron multileaf collimation. However, many radiotherapy facilities are not equipped with such treatment modalities. We propose a practical treatment technique that can be delivered with a standard linac capable of producing high energy electrons. The proposed technique offers a simple alternative for achieving results equivalent to IMRT. Dose homogeneity throughout the treatment volume is achieved by aiming different energy electron beams at differential areas of the treatment surface to achieve improved dosimetry and rapid treatment delivery, while using a single set-up point. We introduced this treatment technique at our institution to treat superficial cancers of the scalp and other irregular surfaces.