A Novel Approach To Accurate Placement of Skin HDR Applicators Using Swimmers Cap
G Cifter*, H Aghdam, Y Rao, M Sarfaraz, George Washington University Hospital, Washington, DC
Presentations
PO-BPC-Virtual-14 (Saturday, 4/17/2021) [Eastern Time (GMT-4)]
Purpose: Total or partial scalp irradiation is used to treat variety of scalp lesions including squamous cell carcinoma. The close proximity of brain and other critical structures make electron therapy and high dose rate brachytherapy (HDR) desirable methods. The delivery of these methods remain challenging due to the complex shape and curvature of the scalp. The attachment of HDR skin applicator is of particular importance due to need for homogenous dose distribution throughout the target area. Clinically common techniques are often unreliable and can result in partial misdelivery of treatment. Here, we propose to use swimmers cap to help ensure accurate contact of applicator to skin and homogenous treatment delivery.
Methods: Freiburg flap was used as the skin applicator and cut to size to match the target. Adhesive tape was used to place the flap onto the scalp. Later the swimmer’s cap was placed covering all of patient’s scalp. It was apparent that the flap was in contact with the skin tightly.
Results: Patient’s CT scan revealed that the placement of the flap was impeccable and all of the edges were in contact with patient’s skin. An HDR plan was generated later and homogenous dose distribution was obtained throughout the target. 100% of the target area was getting 100% of prescribed dose while %50 isodose line was about a maximum of 2.3 cm away from the surface. We found the placement of the flap much easier and reproducible than existing methods.
Conclusion: Accurate placement of the flap is crucially important in terms of accurate treatment delivery. The use of swimmers cap was easy to place and reproducibility was reliable. The patient had minimal to no discomfort. Swimmers cap is proven to be an easy and beneficial method to be used during skin HDR on scalp.
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