• 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.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.337-345
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• 1998

Purpose : To obtain the uniform dose at limited depth to entire surface of the body, the dose characteristics of degraded electron beam of the large target-skin distance and the dose distribution of the six-dual electron fields were investigated Materials and Method : The experimental dose distributions included the depth dose curve, spatial dose and attenuated electron beam were determined with 300 cm of target-skin distance (TSD) and full collimator size (35*35 $cm^2$ on TSD 100 cm) in 4 MeV electron beam energy. Actual collimated field size of 105 cm * 105 cm at the distance of 300 cm could include entire hemibody. A patient was standing on step board with hands up and holding the pole to stabilize his/her positions for the six-dual fields technique. As a scatter-degrader, 0.5 cm of acrylic plate was inserted at 20 cm from the body surface on the electron beam path to induce ray scattering and to increase the skin dose. Results : The full width at half maximum(FWHM) of dose profile was 130 cm in large field of 105*105 $cm^2$ The width of $100\pm10\%$ of the resultant dose from two adjacent fields which were separated at 25 cm from field edge for obtaining the dose unifomity was extended to 186 cm. The depth of maximum dose lies at 5 mm and the 80$\%$ depth dose lies between 7 and 8 mm for the degraded electron beam by using the 0.5 cm thickness of acrylic absorber. Total skin electron beam irradiation (TSEBI) was carried out using the six dual fields has been developed at Stanford University. The dose distribution in TSEBI showed relatively uniform around the flat region of skin except the protruding and deeply curvatured portion of the body, which showed excess of dose at the former and less dose at the latter. Conclusion : The percent depth dose, profile curves and superimposed dose distribution were investigated using the degraded electron beam through the beam absorber. The dose distribution obtained by experiments of TSEBI showed within$\pm10\%$ difference except the protruding area of skin which needs a shield and deeply curvatured region of skin which needs boosting dose.

• 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.

• 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.

• Journal of radiological science and technology
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• v.41 no.2
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• pp.141-148
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• 2018

This study examined the properties of photons and the dose distribution in a human body via a simulation where the total body irradiation(TBI) is performed on a pediatric anthropomorphic phantom and a child size water phantom. Based on this, we tried to find the optimal photon beam energy and material for beam spoiler. In this study, MCNPX (Ver. 2.5.0), a simulation program based on the Monte Carlo method, was used for the photon beam analysis and TBI simulation. Several different beam spoiler materials (plexiglass, copper, lead, aluminium) were used, and three different electron beam energies were used in the simulated accelerator to produce photon beams (6, 10, and 15 MeV). Moreover, both a water phantom for calculating the depth-dependent dosage and a pediatric anthropomorphic phantom for calculating the organ dosage were used. The homogeneity of photon beam was examined in different depths for the water phantom, which shows the 20%-40% difference for each material. Next, the org an doses on pediatric anthropomorphic phantom were examined, and the results showed that the average dose for each part of the body was skin 17.7 Gy, sexual gland 15.2 Gy, digestion 13.8 Gy, liver 11.8 Gy, kidney 9.2 Gy, lungs 6.2 Gy, and brain 4.6 Gy. Moreover, as for the organ doses according to materials, the highest dose was observed in lead while the lowest was observed in plexiglass. Plexiglass in current use is considered the most suitable material, and a 6 or 10 MV photon energy plan tailored to the patient condition is considered more suitable than a higher energy plan.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.261-266
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• 1992

We analyzed retrospectively the patients of granulocytic sarcoma treated with radiotherapy at the Department of Radiation Oncology, Yonsei University College of Medicine from Mar 1987 to Mar.1992 in an attempt to review our experience with irradiation of granulocytic sarcoma and to evaluate the treatment results for the radiation dose response. Fourteen lesions of granulocytic sarcoma in 9 patients were developed in variable clinical settings such as AML, CML and without leukemia. The involved lesions were bone, lymph node, soft tissue and skin in descending order of occurrence. All of the lesions in 9 patients were treated with external beam radiotherapy (Co-60 or electron beam). Both age distribution and clinical settings did not show any correlation with the response to treatment. The response to treatment seemed to be better for lesions in the bone than in other involved lesions. The majority received local irradiation of a total dose of more than 2000 cGy. Radiation dose of more than 2000 cGy showed excellent local control of $100\%$, (11/11), while local control decreased to $33\%$(1/3) with total dose less than 2000 cGy. In conclusion, local radiotherapy seems to be very effective for palliative or curative aim of granulocytic sarcoma, and a radiation dose more than 2000 cGy is highly recommended.