Evaluation of various boluses in dose distribution for electron therapy of the chest wall with an inward defect

Dosimetric Comparison of Superflab and Specially Prepared Bolus Materials Used in Radiotherapy Practice

OBJECTIVE

This study compares standard commercial bolus material (Superflab) to custom prepared silicone dental impression material (CDIM) and play dough material (PDM) with respect to dosimetric properties and applicability by using ion chamber measurement and calculated dose values.

MATERIALS AND METHODS

The CDIM bolus was prepared by mixing dental impression silicone material with enough water to maintain a density of about 1.0 g/cm3. The prepared bolus material is applied on an RW3 solid phantom by covering 10x10 cm2 area with 0.5-1 cm thickness. Ion chamber measurements were performed separately with and without bolus material application. The setup was scanned in CT and the same procedure was repeated in the TPS using the scan data, in which the Pencil Beam Convolution dose calculation algorithm was used. To compare the effect of bolus material on tissue, the Superflab bolus and CDIM bolus were applied with 1 cm of thickness on postmastectomy scar and dose calculations on TPS were performed.

RESULTS

After comparison of the dosimetric values for Superflab, CDIM and PDM, we obtained statistically meaningful results between superflab and CDIM. For PDM, the results obtained with TPS and ion chamber measurements indicated that, it is not suitable to use in radiotherapy application due to its material properties. For the simulated skin dose values obtained at five random points on the scar tissue, the comparison of Superflab and CDIM TPS calculation results were not statistically significant.

CONCLUSION

The CDIM is easy to prepare and apply on irregular mastectomy scar tissue and it prevents formation of air gaps in the application surface. Especially for curved anatomical regions such as scar tissue, inclusion of the bolus material in treatment planning protocol will reduce dose uncertainty in application. It is safe to use CDIM as an alternative to Superflab in radiotherapy application, whereas PDM is not useful in clinical practice due to its material properties.

[Basic Study on Visibility and Water Equivalency of a New Colorless Transparent Bolus for Electron Radiotherapy]

Boluses used in electron radiotherapy need to have radiation field visibility and water equivalence. In this report, we have examined field visibility and water equivalence of a new colorless transparent bolus. We examined field visibility, water equivalence, and dose profile. Field visibility was evaluated by comparison to conventional bolus. Water equivalence was investigated by a measured fluence scaling factor. The dose profile was measured by using radiochromic film with the bolus and an ionization chamber in water. We confirmed that the irradiation field could clearly be seen through the transparent colorless bolus. The bolus did not cast a field edge as compared with the conventional bolus. The fluence scaling factor was less than 0.8% as compared to water. We confirmed that the colorless transparent bolus was treated as a water equivalent material. The percentage depth dose (PDD) measured by using radiochromic film with the bolus matched the PDD measured with an ionization chamber in water. R₅₀ was less than 1 mm as compared to PDD measured with an ionization chamber. It was confirmed that the colorless transparent bolus can use to set up patient without losing visibility on flat ground planes. The fluence scaling factor and dose profile measured by using the bolus matched the results measured in water. Therefore, the new colorless transparent bolus has feasibility to improve patient setup efficiency and can improve calculation accuracy by using the fluence scaling factor.