Skin Dose Impact from Vacuum Immobilization Device and Carbon Fiber Couch in Intensity Modulated Radiation Therapy for Prostate Cancer
Journal
Medical Dosimetry
Journal Volume
34
Journal Issue
3
Pages
228-232
Date Issued
2009
Author(s)
Abstract
To investigate the unexpected skin dose increase from intensity-modulated radiation therapy (IMRT) on vacuum cushions and carbon-fiber couches and then to modify the dosimetric plan accordingly. Eleven prostate cancer patients undergoing IMRT were treated in prone position with a vacuum cushion. Two under-couch beams scattered the radiation from the vacuum cushion and carbon-fiber couch. The IMRT plans with both devices contoured were compared with the plans not contouring them. The skin doses were measured using thermoluminescent dosimeters (TLDs) placed on the inguinal regions in a single IMRT fraction. Tissue equivalent thickness was transformed for both devices with the relative densities. The TLD-measured skin doses (59.5 ± 9.5 cGy and 55.6 ± 5.9 cGy at left and right inguinal regions, respectively) were significantly higher than the calculated doses (28.7 ± 4.7 cGy; p = 2.2 × 10-5 and 26.2 ± 4.3 cGy; p = 1.5 × 10-5) not contouring the vacuum cushion and carbon-fiber couch. The calculated skin doses with both devices contoured (59.1 ± 8.8 cGy and 55.5 ± 5.7 cGy) were similar to the TLD-measured doses. In addition, the calculated skin doses using the vacuum cushion and a converted thickness of the simulator couch were no different from the TLD-measured doses. The recalculated doses of rectum and bladder did not change significantly. The dose that covered 95% of target volume was less than the prescribed dose in 4 of 11 patients, and this problem was solved after re-optimization applying the corrected contours. The vacuum cushion and carbon-fiber couch contributed to increased skin doses. The tissue-equivalent-thickness method served as an effective way to correct the dose variations. ? 2009 American Association of Medical Dosimetrists.
Subjects
Couch; Intensity-modulated radiation therapy; Prostate cancer; Skin; Vacuum immobilization device
SDGs
Other Subjects
carbon fiber; adult; aged; article; body posture; cancer patient; clinical article; dosimetry; external beam radiotherapy; human; intensity modulated radiation therapy; photon therapy; priority journal; prostate cancer; radiation dose; radiation dose distribution; radiation shield; simulator; skin toxicity; thermoluminescence dosimeter; treatment planning; vacuum; vacuum immobilization device; Beds; Body Burden; Carbon; Equipment Design; Equipment Failure Analysis; Humans; Immobilization; Male; Organ Specificity; Prostatic Neoplasms; Radiometry; Radiotherapy Dosage; Radiotherapy, Conformal; Skin; Vacuum
Type
journal article