• Radiation Oncology Journal
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• v.10 no.1
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• pp.107-113
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• 1992

Increasing frequency of skin cancer, mycosis fungoides, Kaposi's sarcoma etc, it need to treatment dose planning for total skin electron beam (TSEB) therapy. Appropriate treatment planning for TSEB therapy is needed to give homogeneous dose distribution throughout the entire skin surface. The energy of 6 MeV electron from the 18 MeV medical linear accelerator was adapted for superficial total skin electron beam therapy. The energy of the electron beam was reduced to 4.2 MeV by a $0.5\;cm\times90\;cm{\times}180\;cm$ acryl screen placed in a feet front of the patient. Six dual field beam was adapted for total skin irradiation to encompass the entire body surface from head to toe simultaneously. The patients were treated behind the acryl screen plate acted as a beam scatterer and contained a parallel-plate shallow ion chamber for dosimetry and beam monitoring. During treatment, the patient was placed in six different positions due to be homogeneous dose distribution for whole skin around the body. One treatment session delivered 400 cGy to the entire skin surface and patients were treated twice a week for eight consecutive weeks, which is equivalent to TDF value 57. instrumentation and techniques developed in determining the depth dose, dose distribution and bremsstrahlung dose are discussed.

• The Journal of Korean Society for Radiation Therapy
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• v.11 no.1
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• pp.79-83
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• 1999

• Progress in Medical Physics
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• v.21 no.1
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• pp.60-69
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• 2010

For treatment of Total Skin Electron beam Therapy (TSET), measurement of dose at various conditions is need on the contrary to usual radiotherapy. When treating TSET with modified Stanford technique based on linear accelerator, the energy of treatment electron beam, the spatial dose distribution and the actual doses deposited on the surface of the patient were measured by using EBT2. The measured energy of the electron beam was agreed with the value that measured by ionization chamber, and the spatial dose distribution at the patient position and the doses at several point on the patient's skin could be easily measured by EBT2 film. The dose on the patient that was measured by EBT2 film showed good agreement with the data measured simultaneously by TLD. With the results of this study, it was proven that the EBT2 film can be one of the useful dosimeter for TSET.

• Progress in Medical Physics
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• v.20 no.3
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• pp.152-158
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• 2009

Total Skin Electron Beam Therapy (TSEBT) of linear accelerator has become use so as to be useful, 2~9 MeV of energy territories came to be used with mycosis fungoides and cutaneous lymphomas in the superficial lesion treatment which covers the major portion of the body. I treat a patient to Stanford technique in this study, and it is $60^{\circ}$ around the patients whom Stanford technique irradiated electronic beam to a linear accelerator in horizontal directions and there is a way a standard of TSEBT treat it to six located field (anterior, posterior, and four obliques) becoming. An each field does horizontally it and consist to beam of the two component which fitted the center to a suitable angle. a patient treats it to three dual field a day in order to make short treatment time. when a first day, we treat one dual field at anterior position and two dual field at posterior position. when the second day, treat one dual field at posterior position and two dual field at anterior position. Therefore, six dual field is finished in perfect periodic two days. we made cylindrical acrylic phantom, and I inserted a dosimeter film between phantom. in order to measure a dose distribution calculation before treat a patient, and a patient checked it in six field directions that got from a treatment. It is after that thermoluminescent dosimetry (TLD) as it uses Rando phantom and then measurement dose distribution in six field directions after attaching at chest, the right and left flank, a back after irradiation.

• Progress in Medical Physics
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• v.7 no.2
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• pp.57-65
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• 1996

Total Skin Electron Beam Therapy (TSEBT) is one of the most effective treatment methods for superficially disseminated skin cancer or cutaneous T-cell lymphoma. We have treated a patient with cutaneous T-cell lymphoma. We have used Stanford technique using six dual field. The nominal energy of electron beam was 4MeV. SSD was 390cm and the gantry angles of dual fields were 76$^{\circ}$ and 104$^{\circ}$. The dose profiles of single field and dual fields were measured with films and a Farmer type ion chamber. The field uniformity was 10％ over the patient's surface. During treatment, the patient was placed in six different positions for homogenous dose distribution over the body surface. The areas not directly exposed to the path of the electron beam (soles of feet, perineum and vertex of scalp) were boosted with 7MeV electron beam. During the treatment, lens, fingernails and toenails were shielded.

• The Journal of Korean Society for Radiation Therapy
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• v.12 no.1
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• pp.112-116
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• 2000

Purpose : The vertex scalp is always tangentially irradiated during total skin electron beam(TSEB) This study was discuss to the dose distribution at the vertex scalp and to evaluate the use of an electron reflector. positioned above the head as a means of improving the dose uniformity. Methods and Materials Vetex dosimetry was performed using ion-chamber and TLD. Measurements were 6 MeV electron beam obtained by placing an acrylic beam speller in the beam line. Studies were performed to investigate the effect of electron scattering on vertex dose when a lead reflector $40{\times}40cm$ in area, was positioned above the phantom. Results : The surface dose at the vertex, in the without of the reflector was found to be less than $37.8\%$ of the skin dose. Use of the lead reflector increased this value to $62.2\%$ for the 6 MeV beam. Conclusion : The vertex may be significantly under-dosed using standard techniques for total skin electron beam. Use of an electron reflector improves the dose uniformity at the vertex and may reduce or eliminate the need for supplemental irradiation.

• Radiation Oncology Journal
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• v.36 no.2
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• pp.153-162
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• 2018

Purpose: We aimed to evaluate clinical outcomes including progression-free survival (PFS), overall survival (OS), partial response, and complete response in patients who underwent radiation therapy (RT) for mycosis fungoides (MF). Also, we sought to find prognostic factors for clinical outcomes. Materials and Methods: Total 19 patients confirmed with MF between 1999-2015 were retrospectively reviewed. Clinical and treatment characteristics, clinical outcomes, and and toxicities were analyzed. Results: Eleven patients were treated with total skin electron beam radiotherapy (TSEBT) and 8 patients with involved field radiation therapy (IFRT) with median dose of 30 Gy, respectively. The median time interval from diagnosis to RT was 2.6 months (range, 0.4 to 87.3 months). The overall response rate was 100%; 11 patients (57.9%) had a complete response and 8 patients (42.1%) a partial response. The presence of positive lymph node at the time of consultation of RT was associated with lower OS (p = 0.043). In multivariate analysis, PFS was significantly lower for patients with increased previous therapies experienced following RT (p = 0.019) and for patients showing PR during RT (p = 0.044). There were no reported grade 3 or more skin toxicities related with RT. Conclusion: Both IFRT and TSEBT are effective treatment for MF patients. Patients with short disease course before RT or complete response during RT are expected to have longer PFS. Positive lymph node status at the initiation of RT was associated woth poor OS, suggesting other treatment modalities such as low-dose RT for patients with low life-expectancy.

• Radiation Oncology Journal
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• v.26 no.2
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• pp.113-117
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• 2008

Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.1
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• pp.57-71
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• 2005

Purpose : To evaluate radiation dose and accuracy with TLD and diode detector when treat total skin with electron beam. Materials and Methods : Using Stanford Technique, we treated patient with Mycosis Fungoides. 6 MeV electron beam of LINAC was used and the SSD was 300 cm. Also, acrylic speller(0.8 cm) was used. The patient position was 6 types and the gantry angle was 64, 90 and $116^{\circ}$. The patient's skin dose and the output were detected 5 to 6 times with TLD and diode. Result : The deviations of dose detected with TLD from tumor dose were CA $+\;6\%$, thigh $+\;8\%$, umbilicus $+\;4\%$, calf $-\;8\%$, vertex $-\;74.4\%$, deep axillae $-\;10.2\%$, anus and testis $-\;87\%$, sole $-\;86\%$ and nails shielded with 4mm lead $+4\%$. The deviations of dose detected with diode were $-4.5\%{\sim}+5\%$ at the patient center and $-1.1\%{\sim}+1\%$ at the speller. Conclusion : The deviation of total skin dose was $+\;8\%{\sim}-\;8\%$ and that deviation was within the acceptable range(${\pm}\;10\%$). The boost dose was irradiated for the low dose areas(vertex, anus, sole). The electron beam output detected at the sootier was stable. It is thought that the deviation of dose at patient center detected with diode was induced by detection point and patient position.