Handmade Patient-Specific Bolus Combined With Photon Radiation Therapy for Skin Cancer.

Area of Science:

• Radiation Oncology
• Medical Physics
• Dermatologic Surgery

Background:

• Skin cancer is the most common cancer in Iran.
• Radiation therapy (RT) is vital for treating skin cancers in critical areas.
• Evaluating handmade boluses for 6 MV photon RT in skin cancer is essential.

Observation:

• Two patients with lip squamous cell carcinoma (SCC) and nasal basal cell carcinoma (BCC) received RT with handmade boluses.
• Dosimetric verification using EBT2 Gafchromic film assessed radiation dose accuracy.
• Measured doses were slightly higher than planned (3.9% for SCC, 3.48% for BCC), indicating high accuracy.

Findings:

• Patient-specific, handmade boluses reduced air gaps and improved dose delivery accuracy compared to commercial options.
• Consistent bolus positioning minimized interfraction setup variations, lowering dose standard deviations.
• Prior research shows patient-specific boluses can reduce air gaps by over 72%.

Implications:

• Handmade boluses are effective for skin cancer RT with 6 MV photons.
• This approach offers an accessible solution for enhancing RT precision in resource-constrained environments.
• The study supports the use of handmade boluses for precise skin cancer treatment.