Hostname: page-component-6766d58669-bp2c4 Total loading time: 0 Render date: 2026-05-19T23:01:33.114Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of thermoplastic Klarity mask use during intensity-modulated radiation therapy for head and neck carcinoma

Published online by Cambridge University Press:  08 January 2018

Khaldoon Radaideh
Khaldoon Radaideh*
Affiliation:
Radiologic Technology Department, College of Applied Medical Sciences, Al-Qassim University, Buraydah, Saudi Arabia
*
†Correspondence to: Dr Khaldoon Radaideh, Radiologic Technology Department, College of Applied Medical Sciences, Al-Qassim University, P.O. Box 6699, Buraydah 51452, Saudi Arabia. Tel: 00966 54 733 2755. E-mail: khaldoonmah1@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim

To evaluate the Klarity® Mask with respect to skin doses and toxicity secondary to head and neck cancer radiation treatment.

Materials and methods

This prospective study included five nasopharyngeal cancer patients who underwent intensity-modulated radiation therapy and monitored for skin toxicity. An anatomical Perspex head and neck phantom was designed and used. All patients’ treatment plans were separately transferred to the phantom. Dosimetric measurements were performed using chip-shaped thermoluminescent dosimeters (LiF:Mg,Ti TLDs) which were distributed at certain target points on the phantom. Phantom was irradiated twicely with and without a Klarity® Mask. Three fractions for each patient plan were obtained and compared with treatment planning system (TPS) doses as guided by computed tomography.

Results

The Klarity mask used for patient immobilisation increased the surface dose by 10·83% more than that without the mask. The average variations between skin dose measurements with and without the Klarity mask for all patients’ plans ranged from 10·26 to 11·83%. TPS overestimated the surface dose by 19·13% when compared with thermoluminescent dosimeters that measured the direct skin dose.

Conclusions

Klarity immobilisation mask increases skin doses, as a consequence, surface dose measurements should be monitored and must be taken into account.

Keywords

anthropomorphic phantomdosimetryIMRTskin toxicityThermoplastic Klarity mask

Information

Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 17 , Issue 2 , June 2018 , pp. 171 - 178
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1. Weltens, C, Kesteloot, K, Vandevelde, G, Van den Bogaert, W. Comparison of plastic and Orfit® masks for patient head fixation during radiotherapy: precision and costs. Int J Radiat Oncol Biol Phys 1995; 33 (2): 499–507.Google Scholar
2. Hess, C F, Kortmann, R, Jany, R, Hamberger, A, Bamberg, M. Accuracy of field alignment in radiotherapy of head and neck cancer utilizing individualized face mask immobilization: a retrospective analysis of clinical practice. Radiother Oncol 1995; 34 (1): 69–72.Google Scholar
3. Bahl, A, Ghosal, S, Kapoor, R, Bhattacharya, T, Sharma, S C. Clinical implications of thermoplastic mask immobilization on acute effects of radiotherapy in head and neck cancers. J Postgrad Med 2012; 46 (4): 187–189.Google Scholar
4. Radaideh, K M, Matalqah, L M. Predictors of radiation-induced skin toxicity in nasopharyngeal cancer patients treated by intensity-modulated radiation therapy: a prospective study. J Radiother Pract 2016; 15 (3): 276–282.Google Scholar
5. Lee, N, Chuang, C, Quivey, J M et al. Skin toxicity due to intensity-modulated radiotherapy for head-and-neck carcinoma. Int J Radiat Oncol Biol Phys 2002; 53 (3): 630–637.Google Scholar
6. Hadley, S W. Effects of immobilization mask material on surface dose. J Appl Clin Med Phys 2005; 6 (1): 1–7.Google Scholar
7. Zhen, H, Nedzi, L, Chen, S, Jiang, S, Zhao, B. SU-E-T-541: bolus effect of thermoplastic masks in IMRT and VMAT head and neck treatments. Med Phys 2014; 41 (6): 352.Google Scholar
8. Amiel Halm, E, Tamri, A, Bridier, A, Wibault, P, Eschwège, F. Influence des masques thermoformés de contention sur la dose à la peau en radiothérapie des tumeurs des voies aérodigestives supérieures. Cancer Radiothérapie 2002; 6 (5): 310–319.Google Scholar
9. Póltorak, M, Fujak, E, Kukolowicz, P. Effect of the thermoplastic masks on dose distribution in the build-up region for photon beams. Pol J Med Phys Eng 2016; 22 (1): 1–4.Google Scholar
10. Ali, I, Matthiesen, C, Algan, O et al. Quantitative evaluation of increase in surface dose by immobilization thermoplastic masks and superficial dosimetry using gafchromic EBT film and Monte Carlo calculations. J Xray Sci Technol 2010; 18 (3): 319–326.Google Scholar
11. Fiorino, C, Cattaneo, G M, del Vecchio, A et al. Skin dose measurements for head and neck radiotherapy. Med Phys 1992; 19 (5): 1263–1266.Google Scholar
12. Dogan, N, Glasgow, G P. Surface and build-up region dosimetry for obliquely incident intensity modulated radiotherapy 6 MV X rays. Med Phys 2003; 30 (12): 3091–3096.Google Scholar
13. Court, L E, Tishler, R B, Allen, A M, Xiang, H, Makrigiorgos, M, Chin, L. Experimental evaluation of the accuracy of skin dose calculation for a commercial treatment planning system. J Appl Clin Med Phys 2008; 9 (1): 29–35.Google Scholar
14. Lamb, A, Blake, S. Investigation and modelling of the surface dose from linear accelerator produced 6 and 10 MV photon beams. Phys Med Biol 1998; 43 (5): 1133–1146.Google Scholar
15. Panettieri, V, Barsoum, P, Westermark, M, Brualla, L, Lax, I. AAA and PBC calculation accuracy in the surface build-up region in tangential beam treatments. Phantom and breast case study with the Monte Carlo code penelope. Radiother Oncol 2009; 93 (1): 94–101.Google Scholar
16. Chung, H, Jin, H, Dempsey, J F et al. Evaluation of surface and build-up region dose for intensity-modulated radiation therapy in head and neck cancer. Med Phys 2005; 32 (8): 2682–2689.Google Scholar
17. Lanson, J H, Essers, M, Meijer, G J, Minken, A W H, Uiterwaal, G J, Mijnheer, B J. In vivo dosimetry during conformal radiotherapy. Requirements for and findings of a routine procedure. Radiother Oncol 1999; 52 (1): 51–59.Google Scholar
18. Kron, T. Applications of thermoluminescence dosimetry in medicine. Radiat Prot Dosimet 1999; 85 (1–4): 333–340.Google Scholar
19. Oliveira, F, Amaral, L, Costa, A, Netto, T. Treatment verification and in vivo dosimetry for total body irradiation using thermoluminescent and semiconductor detectors. Radiat Meas 2014; 71: 374–378.Google Scholar
20. Radaideh, K M, Matalqah, L, Tajuddin, A A, Sabar, B, Abdel Munem, E. A custom made phantom for dosimetric audit and quality assurance of three-dimensional conformal radiotherapy. J Sains Nuk Malay 2012; 24 (1): 48–58.Google Scholar
21. Radaideh, K M, Matalqah, L, Tajuddin, A A, Fabian, L, Bauk, S. Preliminary dosimetric evaluation of a designed head and neck phantom for intensity modulated radiation therapy (IMRT). Int J Med Med Sci 2012; 11 (2): 236–244.Google Scholar
22. Radaideh, K M, Matalqah, L M, Tajuddin, A A, Lee, W I F, Bauk, S, Munem, E M E A. Development and evaluation of a perspex anthropomorphic head and neck phantom for three dimensional conformal radiation therapy (3D-CRT). J Radiother Pract 2013; 12 (3): 272–280.Google Scholar
23. Henson, B S, Eisbruch, A, D’Hondt, E, Ship, J A. Two-year longitudinal study of parotid salivary flow rates in head and neck cancer patients receiving unilateral neck parotid-sparing radiotherapy treatment. Oral Oncol 1999; 35 (3): 234–241.Google Scholar
24. Braam, P M, Terhaard, C H J, Roesink, J M, Raaijmakers, C P J. Intensity-modulated radiotherapy significantly reduces xerostomia compared with conventional radiotherapy. Int J Radiat Oncol Biol Phys 2006; 66 (4): 975–980.Google Scholar
25. Li, Y, Taylor, J M G, Ten Haken, R K, Eisbruch, A. The impact of dose on parotid salivary recovery in head and neck cancer patients treated with radiation therapy. Int J Radiat Oncol Biol Phys 2007; 67 (3): 660–669.Google Scholar
26. Lee, J H, Yeh, C Y, Hsu, S M, Shi, M Y, Chen, W L, Wang, C F. Simple dose verification system for radiotherapy radiation. Radiat Meas 2008; 43 (2–6): 954–958.Google Scholar
27. Harris, C K, Elson, H R, Lamba, M A S, Foster, A E. A comparison of the effectiveness of thermoluminescent crystals LiF:Mg,ti, and LiF:Mg,cu,P for clinical dosimetry. Med Phys 1997; 24 (9): 1527–1529.Google Scholar
28. Kinhikar, R A, Murthy, V, Goel, V, Tambe, C M, Dhote, D S, Deshpande, D D. Skin dose measurements using MOSFET and TLD for head and neck patients treated with tomotherapy. Appl Radiat Isot 2009; 67 (9): 1683–1685.Google Scholar
29. Chuang, C F, Verhey, L J, Xia, P. Investigation of the use of MOSFET for clinical IMRT dosimetric verification. Med Phys 2002; 29 (6): 1109–1115.Google Scholar
30. Koenig, T R, Wolff, D, Mettler, F A, Wagner, L K. Skin injuries from fluroscopically guided procedures. E. Characteristics of radiation injury. Am J Roentgenol 2001; 177: 3–11.Google Scholar
31. Mettler, F A Jr, Koenig, T R, Wagner, L K, Kelsey, C A. Radiation injuries after fluoroscopic procedures. Semin Ultrasound CT MRI 2002; 23 (5): 428–442.Google Scholar
32. Hadley, S W. Effects of immobilization mask material on surface dose. J Appl Clin Med Phys 2005; 6 (1): 1–7.Google Scholar