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Using asymmetric jaws to junction with previously treated areas

H T Kohut¹, T S Chen

¹Department of Radiation Oncology, Albany Medical College, NY 12208, USA.

Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists

|April 1, 1997

Summary

Asymmetric jaws offer a preferred method for matching radiation therapy portals, potentially avoiding larger hot and cold spots compared to traditional skin gapping techniques. Awareness of treatment planning system limitations and collimator tolerances is crucial for effective implementation.

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Area of Science:

Radiation Oncology
Medical Physics

Background:

Accurate matching of radiation therapy portals is critical for effective treatment and minimizing dose discrepancies.
Conventional methods like skin gapping can lead to significant hot and cold spots at the junction of treatment fields.

Purpose of the Study:

To investigate the feasibility and dosimetric accuracy of using asymmetric jaws for matching previously irradiated portals in radiation therapy.

Main Methods:

Evaluation of isodose plots from a treatment planning system to assess portal matching.
Film dosimetry at 6 cm depth to quantify dose variations at the junction of asymmetric jaw fields.

Main Results:

One treatment planning system indicated a near-perfect match with asymmetric jaws by aligning beam divergence.

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Film analysis revealed a 6% cold spot at the inferior border and a 7% hot spot at the superior border when matching at 6 cm depth.

Asymmetric jaws demonstrated potential to avoid larger dose inhomogeneities compared to skin gapping.

Conclusions:

Asymmetric jaw junctioning in radiation therapy is feasible and may be preferable to skin gapping.
Understanding treatment planning system limitations and collimator tolerances is essential when using asymmetric jaws.
This technique can mitigate substantial hot and cold spots below and above the intended matchpoint.