Skin dose enhancement from the application of skin-care creams using FF and FFF photon beams in radiotherapy: A Monte Carlo phantom evaluation

Megha Sharma ¹,
James C. L. Chow ^{2,3
,
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1.
Department of Physics, Ryerson University, Toronto, ON, M5B 2K3 Canada
2.
Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, M5G 1X6 Canada
3.
Department of Radiation Oncology, University of Toronto, Toronto, ON, M5T 1P5 Canada

Received: 03 March 2020 Accepted: 21 April 2020 Published: 21 April 2020

Abstract
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Skin-care cream is commonly applied to relieve skin redness in radiotherapy. However, using cream on the patient under the photon field would increase the skin dose in delivery. The aim of this study is to evaluate the dependences of skin dose enhancement on different beam and cream variables using Monte Carlo simulation. Using a solid water phantom with water-equivalent bolus, PMMA layer and cream layer, we irradiated it by 6 MV photon beams. Skin doses were calculated by varying the beam quality (flattening-filter (FF) and flattening-filter-free (FFF)), beam angle (0°–80°), skin-care cream type (water-based and silicon-based) and cream thickness (0–3 mm) using the EGSnrc Monte Carlo code. The densities of the water- and silicon-based cream were 0.92 and 1.14 g/cm³. The dose enhancement factor (DEF) defined as the ratio of the skin dose with skin-care cream to the skin dose without cream was calculated. It is found that the FF photon beam had higher DEF value than the FFF. For the water-based cream of 3 mm, the DEF for the FF beam was about 22.1% higher than that of the FFF. While for the silicon-based cream with the same thickness, the DEF was 24.2% higher. DEF value also increased with the beam angle. The DEF values were from 1.4 to 2.52 (water-based cream) and 1.42 to 2.68 (silicon-based cream) when the beam angle was increased from 20° to 80° using the 6 MV FF beams. Similarly, for the 6 MV FFF beams, the DEF values increased from 1.29 to 2.07 and 1.30 to 2.18 for the water- and silicon-based cream. These simulation results showed that the skin dose enhancement increased with an increase of beam angle, cream thickness, cream density, and the irradiation of FFF photon beams.
- skin-care cream,
- skin redness,
- skin dose,
- flattening-filter-free photon beam,
- Monte Carlo simulation
Citation: Megha Sharma, James C. L. Chow. Skin dose enhancement from the application of skin-care creams using FF and FFF photon beams in radiotherapy: A Monte Carlo phantom evaluation[J]. AIMS Bioengineering, 2020, 7(2): 82-90. doi: 10.3934/bioeng.2020008

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Abstract

Skin-care cream is commonly applied to relieve skin redness in radiotherapy. However, using cream on the patient under the photon field would increase the skin dose in delivery. The aim of this study is to evaluate the dependences of skin dose enhancement on different beam and cream variables using Monte Carlo simulation. Using a solid water phantom with water-equivalent bolus, PMMA layer and cream layer, we irradiated it by 6 MV photon beams. Skin doses were calculated by varying the beam quality (flattening-filter (FF) and flattening-filter-free (FFF)), beam angle (0°–80°), skin-care cream type (water-based and silicon-based) and cream thickness (0–3 mm) using the EGSnrc Monte Carlo code. The densities of the water- and silicon-based cream were 0.92 and 1.14 g/cm³. The dose enhancement factor (DEF) defined as the ratio of the skin dose with skin-care cream to the skin dose without cream was calculated. It is found that the FF photon beam had higher DEF value than the FFF. For the water-based cream of 3 mm, the DEF for the FF beam was about 22.1% higher than that of the FFF. While for the silicon-based cream with the same thickness, the DEF was 24.2% higher. DEF value also increased with the beam angle. The DEF values were from 1.4 to 2.52 (water-based cream) and 1.42 to 2.68 (silicon-based cream) when the beam angle was increased from 20° to 80° using the 6 MV FF beams. Similarly, for the 6 MV FFF beams, the DEF values increased from 1.29 to 2.07 and 1.30 to 2.18 for the water- and silicon-based cream. These simulation results showed that the skin dose enhancement increased with an increase of beam angle, cream thickness, cream density, and the irradiation of FFF photon beams.

Acknowledgment

The authors would like to thank Amir Owrangi of UT Southwestern Medical Centre for assistance in the phase-space files and photon energy spectra of the FF and FFF photon beams used in the Monte Carlo simulations.

Conflict of interest

The authors have no potential conflict of interest on financial or commercial matters associated with this study.

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