Evaluation of dose variation during total skin electron irradiation using thermoluminescent dosimeters

Purpose: To determine acceptable dose variation using thermoluminescent dosimeters (TLD) in the treatment of Mycosis Fungiodes with total electron beam (TSEB) irradiation. Methods and Materials: From 1983 to 1993, 22 patients were treated with total skin electron beam therapy in the standing position. A six-field technique was used to deliver 2 Gy in two days, treating 4 days per week, to a total dose of 35 of 40 Gy using a degraded 9 MeV electron beam. Thermoluminescent dosimeters were placed on several locations of the body and the results recorded. The variations in these readings were analyzed to determine normal dose variation for various body locations during TSEB. Results: The dose to flat surfaces of the body was essentially the same as the dose to the prescription point. The dose to tangential surfaces was within ± 10% of the prescription dose, but the readings showed much more variation (up to 24%). Thin areas of the body showed large deviations from the prescriptions dose along with a large amount of variation in the readings (up to 22%). Special areas of the body, such as the perineum and eyelid, showed large deviations from the prescription dose with very large (up to 40%) variations in the readings. Discussion: The TLD results of this study will be used as a quality assurance check for all new patients treated with TSEB. The results of the TLDs will be compared with this baseline study to determine if the delivered dose is within acceptable ranges. If the TLD results fall outside acceptable limits establised above, then the patient position can be modified or the technique itself evaluated.