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. 2022 Jan;198(1):47-55.
doi: 10.1007/s00066-021-01859-1. Epub 2021 Nov 2.

Sweeping-beam technique with electrons for large treatment areas as total skin irradiation : Dosimetric and technical aspects of a modified Stanford technique

Michael Schöpe  1 , Jacob Sahlmann  2 , Kathleen Lorenz  2 , Anne Findeisen  2 , Thomas Barthel  2 , Gunther Klautke  2
Affiliations

Sweeping-beam technique with electrons for large treatment areas as total skin irradiation : Dosimetric and technical aspects of a modified Stanford technique

Michael Schöpe et al. Strahlenther Onkol. 2022 Jan.

Abstract

Purpose: Total skin electron beam therapy (TSEBT) is still a technical and therapeutic challenge today. Thus, we developed TSEBT using a sweeping-beam technique.

Methods: For treatment delivery, a linear accelerator Versa HD (ELEKTA, Stockholm, Sweden) with high-dose-rate electrons (HDRE) was used with a dose rate of 9000 MU/min. Dosimetry quality assurance was performed by multiple measurements with film dosimetry, 2D array, and Roos chamber.

Results: Clinical experience shows that treatment durations of 75 to 90 min are usual for the Stanford technique without using HDRE. With this new sweeping-beam irradiation technique, the total treatment time of a daily fraction could be reduced to 20 min while keeping over- and underdosing low. The treatment area is about 60 cm × 200 cm and the dose distribution is uniform within 2% and 5% in vertical and horizontal directions, respectively. Initially, the electron energy of 6 MeV is reduced to 3.2 MeV by 1‑cm polymethylmethacrylat (PMMA) scatter and the irradiation conditions of a source-surface distance (SSD) of 350 cm. The photon contamination drops to under 1%.

Conclusion: These results show that the mean dose to total skin varies between 1.3 and 1.8 Gy. The sweeping-beam technique with electrons has a homogeneous dose distribution in connection with a short treatment time.

Keywords: High-dose-rate electrons; In situ film dosimetry; Mycosis fungoides; Total skin electron beam therapy (TSEBT); Total skin electron irradiation (TSEI).

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