Clinical application of lying-on-the-floor total skin electron irradiation for frail patients with cutaneous lymphoma: An emphasis on the importance of in vivo dosimetry

Evans, Jaden D.; Haley, Laura; Locher, Sarah E.; Grams, Michael P.; Deufel, Christopher L.; Antolak, John A.; Martenson, James A.

doi:10.1016/j.adro.2016.03.005

Cited by 7 publications

(7 citation statements)

References 7 publications

(18 reference statements)

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“…Two courses were delivered using a lying-on-the floor position due to poor performance status and inability to remain standing throughout the length of treatment. 9,11 Most patients had significant debility and were unable to tolerate eye shields because of an unacceptable risk of falling. Accordingly, eye shields were not routinely used.…”

Section: Methodsmentioning

confidence: 99%

Low-Dose Hypofractionated Total Skin Electron Beam Therapy for Adult Cutaneous T-Cell Lymphoma

Jeans

Stish

et al. 2020

Practical Radiation Oncology

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Purpose: Historically, the standard of care for total skin electron beam therapy (TSEBT) delivered 30 to 36 Gy over 5 to 10 weeks. Given the high risk of relapse, a majority of patients require additional treatments. Therefore, attempts to use a shortened course of TSEBT have been investigated. Methods and Materials: We conducted a single-institution retrospective review to evaluate disease response, control, and toxicity using a low-dose, hypofractionated course of TSEBT (HTSEBT) in patients with mycosis fungoides. Results: Forty patients received 57 courses of HTSEBT. Median dose (Gy)/fractionation was 12/3, spanning a median time of 2.4 weeks. Overall response rate of patients assessed (n Z 54) was 100%. Thirty-one courses (57.4%) resulted in a complete response and 23 courses (42.6%) resulted in a partial response. Cumulative incidence of progressive skin disease at 3 months was 37.2%, at 6 months, 56.9%, and at 1 year, 81.5%. Of the 40 patients treated with a first course of HTSEBT, 31 received subsequent courses of radiotherapy. Cumulative incidence of subsequent treatment was 28.0% at 3 months, 46.8% at 6 months, and 70.0% at 1 year. Patients who underwent repeat courses of HTSEBT continued to have similar treatment responses to repeat courses without increased toxicities. Toxicities from all courses were acceptable with the exception of 1 patient, who experienced grade 4 skin toxicity (moist desquamation requiring hospitalization). Conclusions: Low-dose HTSEBT provides good palliation in patients with cutaneous T-cell lymphoma with a satisfactory response and toxicity profile. HTSEBT allows therapy to be completed in far fewer treatments. Low-dose HTSEBT is an appropriate treatment option for patients unable to come for daily treatment. HTSEBT provides a way to decrease exposure to other patients and staff during public health emergencies such as the coronavirus disease 2019 (COVID-19) pandemic.

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Section: Methodsmentioning

confidence: 99%

Low-Dose Hypofractionated Total Skin Electron Beam Therapy for Adult Cutaneous T-Cell Lymphoma

Jeans

Stish

et al. 2020

Practical Radiation Oncology

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“…In vivo dosimetry was performed to verify that adequate dose was delivered to the inframammary fold using methods previously described. 3 , 4 Briefly, a 2 × 2 cm 2 piece of Gafchromic EBT3 film (Ashland ISP Advanced Materials, Bridgewater, NJ), each wrapped in a single layer of plastic wrap, was taped onto each patient's skin in the inframammary fold after the patient was fitted with the sling. The plastic wrap served to keep the films clean for scanning and analysis, and was discarded after treatment and before analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Film analysis was performed using FILMQA Pro Software (Ashland ISP Advanced Materials), using the methodology described in prior work. 3 , 4 The average dose was taken from a 1 cm × 1 cm region of interest that was centered on each film. Only 1 set of measurements was obtained from each patient.…”

Section: Methodsmentioning

confidence: 99%

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A method to improve dose uniformity during total skin electron beam therapy in patients with pendulous breasts

King

Deufel

Locher

et al. 2017

Advances in Radiation Oncology

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“…While there are many excellent papers [6,20,[28][29][30][31][32][33][34] and an AAPM Task Group Report [35] which provide a vast amount of valuable information relevant to film dosimetry, the process outlined here is meant to be a concise summary of the necessary basic fundamentals that are required for accurate RCF dosimetry. The methods described have been used in our clinic for more than six years, both in routine clinical tasks such as in vivo TSE measurements [36,37] and IMRT QA [14] as well as in research in conventional x-ray [16,21,38] and proton therapy [39] studies. While certainly not the only approach for successful film dosimetry, they should help potential RCF users to implement RCF into clinical practice within a relatively quick timeframe.…”

Section: Introductionmentioning

confidence: 99%

Methodology for radiochromic film analysis using FilmQA Pro and ImageJ

2020

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Radiochromic film (RCF) has several advantageous characteristics which make it an attractive dosimeter for many clinical tasks in radiation oncology. However, knowledge of and strict adherence to complicated protocols in order to produce accurate measurements can prohibit RCF from being widely adopted in the clinic. The purpose of this study was to outline some simple and straightforward RCF fundamentals in order to help clinical medical physicists perform accurate RCF measurements. We describe a process and methodology successfully used in our practice with the hope that it saves time and effort for others when implementing RCF in their clinics. Two RCF analysis software programs which differ in cost and complexity, the commercially available FilmQA Pro package and the freely available ImageJ software, were used to show the accuracy, consistency and limitations of each. The process described resulted in a majority of the measurements across a wide dose range to be accurate within ± 2% of the intended dose using either FilmQA Pro or ImageJ.

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Clinical application of lying-on-the-floor total skin electron irradiation for frail patients with cutaneous lymphoma: An emphasis on the importance of in vivo dosimetry

Cited by 7 publications

References 7 publications

Low-Dose Hypofractionated Total Skin Electron Beam Therapy for Adult Cutaneous T-Cell Lymphoma

Low-Dose Hypofractionated Total Skin Electron Beam Therapy for Adult Cutaneous T-Cell Lymphoma

A method to improve dose uniformity during total skin electron beam therapy in patients with pendulous breasts

Methodology for radiochromic film analysis using FilmQA Pro and ImageJ

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