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Biomed Mater Eng. 2015;26 Suppl 1:S1677-83. doi: 10.3233/BME-151467.

In vivo evaluating skin doses for lung cancer patients undergoing volumetric modulated arc therapy treatment.

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Department of Radiation Oncology, Chung Shan Medical University Hospital, Taiwan, Republic of China.
School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan, Republic of China.
Graduate Institute of Radiological Science, Central Taiwan University of Science and Technology, Takun, Taichung 40609, Taiwan, Republic of China.
School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung 40201, Taiwan, Republic of China.
Department of Radiation Oncology, Kaohsiung Veterans Geeral Hospital, Kaohsiung 81362, Taiwan, Republic of China.
Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, 11221 Taiwan, Republic of China.


This study is the first to use 10- to 90-kg tissue-equivalent phantoms as patient surrogates to measure peripheral skin doses (Dskin) in lung cancer treatment through Volumetric Modulated Arc Therapy of the Axesse linac. Five tissue-equivalent and Rando phantoms were used to simulate lung cancer patients using the thermoluminescent dosimetry (TLD-100H) approach. TLD-100H was calibrated using 6 MV photons coming from the Axesse linac. Then it was inserted into phantom positions that closely corresponded with the position of the represented organs and tissues. TLDs were measured using the Harshaw 3500 TLD reader. The ICRP 60 evaluated the mean Dskin to the lung cancer for 1 fraction (7 Gy) undergoing VMAT. The Dskin of these phantoms ranged from 0.51±0.08 (10-kg) to 0.22±0.03 (90-kg) mSv/Gy. Each experiment examined the relationship between the Dskin and the distance from the treatment field. These revealed strong variations in positions close to the tumor center. The correlation between Dskin and body weight was Dskin (mSv) = -0.0034x + 0.5296, where x was phantom's weight in kg. R2 is equal to 0.9788. This equation can be used to derive an equation for lung cancer in males. Finally, the results are compared to other published research. These findings are pertinent to patients, physicians, radiologists, and the public.


Axesse linac; ICRP 60; TLD; skin dose; tissue-equivalent phantom

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