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Improved dose homogeneity in scalp irradiation using a single set-up point and different energy electron beams

R Yaparpalvi, MS, D P Fontenla, PhD and J J Beitler, MD, MBA

Department of Radiation Oncology, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York, USA



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  		Figure 1. Idealistic beam's-eye-view of the treatment surface and conceptual description of the proposed treatment technique.

 


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  		Figure 2. The patient's scalp at initial presentation.

 


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  		Figure 3. The applicator insert used for the 16 MeV electron beam. The central block represents the surface treated by the 12 MeV electron beam.

 


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  		Figure 4. The circular 12 MeV electron beam field used in the phantom study.

 


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  		Figure 5. The centrally shielded concentric circular 16 MeV electron beam field used in the phantom study.

 


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  		Figure 6. Representative patient isodose distributions obtained in the sagittal and coronal planes.

 


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  		Figure 7. A comparison of in-phantom calculated and measured dose profile for the open circular 12 MeV electron beam field.

 


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  		Figure 8. A comparison of calculated and measured dose profiles at different depths in the phantom for the centrally shielded concentric circular 16 MeV electron beam field.

 


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  		Figure 9. A comparison of calculated and measured dose profiles at different depths in the phantom for a combination of 12 MeV and 16 MeV electron beam fields.

 


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  		Figure 10. The patient's scalp 4 months following completion of radiation therapy.

 


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  		Figure 11. A comparison of in-phantom measured dose profiles obtained by positioning the 3.5 mm thick polystyrene tray on the electron applicator compared with on the phantom.

 




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