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Dosimetry for tangential chest wall irradiation

P Fessenden, B B Palos, C J Karzmark

|August 1, 1978

Summary

Tangential beams for chest wall irradiation reduce the skin-sparing effect of megavoltage photons. Using a bolus with these beams, especially metal/tissue interfaces, can alter the skin dose, impacting radiation therapy planning.

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Area of Science:

Medical Physics
Radiation Oncology
Radiotherapy Dosimetry

Background:

Megavoltage photon beams offer skin-sparing benefits in radiation therapy.
Tangential beam techniques for chest wall irradiation can compromise this skin-sparing effect.
Accurate skin dose assessment is crucial for optimizing radiotherapy planning and minimizing side effects.

Purpose of the Study:

To investigate the skin dose distribution when using tangential beams for chest wall irradiation with 4- and 6-MV photons.
To evaluate the impact of bolus application, including metal/tissue interface effects, on skin dose.
To compare different dosimetry methods for measuring skin dose in this clinical scenario.

Main Methods:

Utilized 4- and 6-MV photon beams for tangential chest wall irradiation.
Employed film dosimetry, thermoluminescent dosimeters, and ionization chambers for dose measurements.
Investigated the use of a flexible brass fabric bolus and assessed metal/tissue interface effects.

Main Results:

The skin-sparing effect of megavoltage photons was diminished with tangential beam techniques.
The application of a bolus significantly influenced the skin dose, with notable variations observed.
Metal/tissue interface effects were identified when using a brass fabric bolus, indicating potential dose perturbations.

Conclusions:

Tangential beam irradiation for chest wall treatment necessitates careful consideration of skin dose due to reduced skin-sparing.
Bolus selection and material composition (e.g., metal/tissue interfaces) critically affect surface dose and require thorough dosimetric evaluation.
Accurate skin dose measurement using multiple dosimetry techniques is essential for safe and effective radiotherapy of the chest wall.

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