Evaluation of Dosimetric Characterization of Homemade Bolus for Radiation Therapy

Abstract

The bolus is also known a tissue compensation that has material similar to body tissue and placed directly onto the skin surface for radiation therapy. This study aims to characterize and evaluate the synthesized homemade bolus using Natural Rubber, Paraffin Candle, Play-Doh, and Paraffin Wax Pure for radiation therapy using a photon beam. Several dosimetry properties of the synthesized of the bolus, including relative electron density (RED), transmission factor, attenuation coefficient, and percentage of surface dose (PSD), were investigated. All the synthesized bolus made with the same dimension of 11×11 cm2 with the thickness is 1 cm. CT-Scan was used to measure relative electron density (RED) where as LINAC 2300iX with energies 6 and 10 MV were used to evaluate percentage of surface dose. The RED value of all bolus material is in accordance with the provisions of bolus as a tissue compensation of the human body, which is almost the same as the value of HU in breast organs, skin, fat and adult bones. Large transmission factors and attenuation coefficients of each bolus correspond to bolus from paraffin candles as the default bolus of the hospital. The maximum bolus dose value increases when compared to measurements without bolus.

Paraffin gauze bolus as tissue compensator in photon irradiation for mycosis fungoides – regarding a case study

“…Furthermore, paraffin gauze is not included in any of the existent studies regarding the dosimetric properties of handmade bolus. [11][12][13][19][20][21][22] Paraffin gauze bolus proved to be an inexpensive, convenient and effective method for superficial cancer therapies when uneven body contours are involved. This material also possesses the main features that are intended for a bolus.…”

“…This material also possesses the main features that are intended for a bolus. 12,13 Unwanted dose heterogeneity 23,24 owing to the presence of an air gap between the bolus and the patient's skin was satisfactorily accomplished by the paraffin gauze, due to the flexibility and capacity of the paraffin to infiltrate into all the folds of the patient's skin. It has, however, some limitations as it is a time-consuming method that may be too laboured-intensive to be applied for fractionated radiation schemes.…”

“…Materials used as bolus vary from commercial to handmade, as plasticine, natural rubber, paraffin wax, Play-Doh®, propylene glycol, water-soaked gauze sponges, aquaplast, gels, and polypropylene. [11][12][13] No strong evidence exists regarding the best bolus, so the choice is determined by institutional preferences, availability and the characteristics of the area to be irradiated. In our institution, for irregular surfaces whose RT treatment requires bolus, we use paraffin gauze.…”

Analisis Dosis Serap Bolus Berbahan Campuran Beeswax dan Petroleum Jelly Dalam Radioterapi Menggunakan Elektron 6 MeV Pada LINAC

“…Pada penelitian ini nilai RED bolus pada ketebalan 0,2 cm hingga 0,8 cm memiliki nilai RED yang lebih rendah dari nilai RED payudara yaitu sebesar 0,976 (Sutanto, et al, 2018), tetapi pada ketebalan 1,0 cm memiliki nilai RED yang setara dengan jaringan payudara. Berdasarkan hasil penelitian yang dilakukan oleh (Carina, et al, 2019) bolus plastisin memiliki nilai RED di antara jaringan otot hingga hati dengan nilai sebesar 1,04 hingga 1,05. Hal ini menunjukkan bahwa nilai RED bolus platisin lebih tinggi dibandingkan dengan nilai RED bolus campuran beeswax dan petroleum jelly.…”

Comparison of Absorbed Dose in Plasticine Bolus and Silicone Rubber Bolus

“…The bolus used should have several characteristics including good elasticity, the absence of air bubbles on the surface of the bolus, when radiation is irradiated, it does not change shape and is also non-toxic. At this time, research on bolus materials continues to be developed using various materials such as natural rubber, superflab, plasticine, playdoh, paraffin wax, and silicone rubber (Endarko et al, 2020;Aras et al, 2020;Carina et al, 2020). The most commonly used bolus is a bolus made of plasticine, but this bolus has a rigid structure that can cause an air gap and is difficult to return to its original shape if pressed (Junaedi et al, 2016).…”