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

Published online by Cambridge University Press:  28 February 2023

André M. Pires Open the ORCID record for André M. Pires [Opens in a new window] ,
Fátima Borges ,
Anabela G. Dias Open the ORCID record for Anabela G. Dias [Opens in a new window] ,
Lencart Joana Open the ORCID record for Lencart Joana [Opens in a new window] ,
Marisa Matos  and
Joana Gonçalves
André M. Pires*
Affiliation:
Radiation Oncology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal
Fátima Borges
Affiliation:
Medical Physics Service, Portuguese Institute of Oncology of Porto, Porto, Portugal
Anabela G. Dias
Affiliation:
Medical Physics Service, Portuguese Institute of Oncology of Porto, Porto, Portugal Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
Lencart Joana
Affiliation:
Medical Physics Service, Portuguese Institute of Oncology of Porto, Porto, Portugal Medical Physics, Radiobiology and Radiation Protection Group, IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
Marisa Matos
Affiliation:
Radiation Oncology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal
Joana Gonçalves
Affiliation:
Radiation Oncology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal
*
Author for correspondence: André M. Pires, IPO-Porto – External Radiation Oncology Department, R. Dr. António Bernardino de Almeida nr 865, 4200-072, Porto, Portugal. Tel: +351 225 084 000. E-mail: andre.miranda.pires@ipoporto.min-saude.pt
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Abstract

Introduction:

Total skin electron beam therapy is a treatment option in patients with mycosis fungoides (MF) affecting a significant amount of the body surface. For patients with involvement of soles and interdigital folds, however, this approach is ineffective, requiring alternatives such as localised radiotherapy (RT). Although electron beams are well suited for superficial lesions, on irregular surfaces it provides inadequate tumour coverage and excess dose variance, requiring photon irradiation with tissue compensation.

Methods:

We present the case of a patient with extensive cutaneous MF with skin lesions spread over both lower limbs and treated on these affected areas with photon beam RT. Long sheets of paraffin gauze dressings were used to create a 0·5-cm-thick bolus. The patient received a single fraction of 8 Gy. In vivo dosimetry using Gafchromic films was performed.

Results:

After 3 months, a complete response was achieved. In this case, paraffin gauze bolus proved to be an inexpensive, convenient, effective and flexible method for irregular superficial cancer irradiations.

Conclusion:

Paraffin gauze bolus is a suitable option for irregular contours.

Keywords

bolusin vivo dosimetryparaffin gazeradiotherapysuperficial tumourtreatment planning
Type
Case Study
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e82
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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