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The air gap between bolus and skin affects dose distribution in helical and direct tomotherapy

Published online by Cambridge University Press:  15 May 2020

Hiroaki Akasaka Open the ORCID record for Hiroaki Akasaka [Opens in a new window] ,
Yuya Oki ,
Kazufusa Mizonobe ,
Kazuyuki Uehara ,
Hiroshi Mayahara ,
Aya Harada ,
Naoki Hashimoto ,
Keiji Kitatani ,
Tomonori Yabuuchi  and
Takeaki Ishihara
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Hiroaki Akasaka*
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan Division of Radiation Oncology, Kobe University Graduate School of Medicine, Chuo-ku Kobe, Hyogo, Japan
Yuya Oki
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan
Kazufusa Mizonobe
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan
Kazuyuki Uehara
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan
Hiroshi Mayahara
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan
Aya Harada
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan
Naoki Hashimoto
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan
Keiji Kitatani
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan
Tomonori Yabuuchi
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan
Takeaki Ishihara
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo, Japan
Kazuma Iwashita
Affiliation:
Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo, Japan
Daisuke Miyawaki
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo, Japan
Naritoshi Mukumoto
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo, Japan
Ai Nakaoka
Affiliation:
Division of Radiation Oncology, Kobe University Graduate School of Medicine, Chuo-ku Kobe, Hyogo, Japan
Ryohei Sasaki
Affiliation:
Division of Radiation Oncology, Kobe University Hospital, Chuo-ku Kobe, Hyogo, Japan
*
Author for correspondence: Hiroaki Akasaka, Division of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Chuo-ku Kobe, Hyogo650-0046, Japan. Tel: +81 78 304 4100. Fax: +81 78 304 0041. E-mail: akasaka@harbor.kobe-u.ac.jp
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Abstract

Aim:

To modify the final dose delivered to superficial tissues and to modulate dose distribution near irradiated surface, different boluses are used. Air gaps often form under the bolus affecting dose distribution. This study aimed to evaluate the effect of an air gap under the bolus radiation on dose delivery.

Materials and methods:

To evaluate the impact of the air gap, both helical tomotherapy (HT) and direct tomotherapy (DT) were performed in a simulation study.

Results:

The maximum dose to bolus in DT plans was bigger than that used in HT plans. The maximum dose delivered to the bolus depended on the air gap size. However, the maximum dose to bolus in all HT plans was within the acceptable value range. Acceptable value was set to up to 107% of the prescription dose. In the simulation performed in this study, the acceptable air gap under bolus was up to 15 mm and below 5 mm in HT and DT plans, respectively.

Conclusions:

HT technique is a good choice, but DT technique can be also used if the bolus position can be reproduced accurately. Thus, the reproducibility of the bolus position between planning and treatment is very important.

Keywords

air gapbolusIMRTradiotherapytomotherapyVMAT
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 20 , Issue 3 , September 2021 , pp. 294 - 299
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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