Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Home
  • Home
Article
  • Access

Dosimetric impacts on skin toxicity for patients using topical agents and dressings during radiotherapy

  • Karen Tse (a1), Lyndon Morley (a1), Angela Cashell (a1) (a2), Annette Sperduti (a1), Maurene McQuestion (a1) (a3) and James C. L. Chow (a1) (a2)...

Abstract

Background and purpose

Skin care practices for radiotherapy patients are complicated by dosimetric concerns. This study measures the effect on skin dose of various topical agents and dressings.

Materials and methods

Superficial doses were measured under 17 topical agents and dressings and three clinical materials for reference. Dose was measured using a MOSFET detector under a 1 mm polymethyl methacrylate slab, with 6 MV photon beams at 100 cm source to surface distance.

Results

Relative skin dose under reference materials was 128% (thermoplastic mask), 158% (5 mm bolus) and 171% (10 mm bolus). Under a realistic application of topical agent (0·5 mm), relative skin doses were 106–111%. All dry dressings yielded relative dose of ≤111%; two wet dressings yielded higher relative doses (133 and 141%).

Conclusions

Under clinically relevant conditions, no cream, gel or dry dressing increased the skin dose beyond that seen with a thermoplastic mask. Dressings soaked with water produced less skin dose than 5 mm bolus. This may be unacceptable if wet dressings are in place for the majority of the treatment course. Our results suggest that skin care practices should not be limited by dosimetric concerns when using a 6 MV photon beam.

  • View HTML

      • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Dosimetric impacts on skin toxicity for patients using topical agents and dressings during radiotherapy
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Dosimetric impacts on skin toxicity for patients using topical agents and dressings during radiotherapy
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Dosimetric impacts on skin toxicity for patients using topical agents and dressings during radiotherapy
      Available formats
      ×

Copyright

© Cambridge University Press 2016 

Corresponding author

Correspondence to: Lyndon Morley, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, ON M5G 2M9, Canada. Tel: 416-946-4501. Fax: 416-946-2019. E-mail: lyndon.morley@rmp.uhn.on.ca

References

Hide All
1. McQuestion, M. Evidence-based skin care management in radiation therapy: clinical update. Semin Oncol Nurs 2011; 27: e1–e17.
2. Bolderston, A, Lloyd, N S, Wong, R K, Holden, L, Robb-Blenderman, L. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Supp Care Cancer 2006; 14: 802–817.
3. Salvo, N, Barnes, E, van Draanen, J et al. Prophylaxis and management of acute radiation-induced skin reactions: a systematic review of the literature. Curr Oncol 2010; 17: 94–112.
4. D’Haese, S, Van Roy, M, Bate, T, Bijdekerke, P, Vinh-Hung, V. Management of skin reactions during radiotherapy in Flanders (Belgium): a study of nursing practice before and after the introduction of a skin care protocol. Eur J Oncol Nurs 2010; 14: 367–372.
5. Morley, L, Cashell, A, Sperduti, A, McQuestion, M, Chow, J C L. Evaluating the relevance of dosimetric considerations to patient instructions regarding skin care during radiation therapy. J Radiother Pract 2013; 13: 294–301.
6. Bieck, T, Phillips, S. Appraising the evidence for avoiding lotions or topical agents prior to radiation therapy. Clin J Oncol Nurs 2010; 14: 103–105.
7. Aistars, J. The validity of skin care protocols followed by women with breast cancer receiving external radiation. Clin J Oncol Nurs 2006; 10: 487–492.
8. Burch, S E, Parker, S A, Vann, A M, Arazie, J C. Measurement of 6-MV X-ray surface dose when topical agents are applied prior to external beam irradiation. Int J Radiat Oncol Biol Phys 1997; 38: 447–451.
9. Harper, J L, Franklin, L E, Jenrette, J M, Aguero, E G. Skin toxicity during breast irradiation: pathophysiology and management. South Med J 2004; 97: 989–993.
10. Mannix, C M, Bartholomay, M M, Doherty, C S, Lewis, M, Bilodeau, M L. A feasibility study of low-cost, self-administered skin care interventions in patients with head and neck cancer receiving chemoradiation. Clin J Oncol Nurs 2012; 16: 278–285.
11. Fackrell, D, Kirby, D, Sanghera, P, Hartley, A. The effect of silver sulfadiazine and zinc oxide creams on dose distribution during radiotherapy. J Radiother Pract 2015; 14: 111–116.
12. Rietschel, R L. A method to evaluate skin moisturizers in vivo. J Invest Dermatol 1978; 70: 152–155.
13. Thomas, S E, Reimer-Kirkham, S, Kohr, R. Wound dressings during radiotherapy for cancer: a survey of practice. Clin J Oncol Nurs 2015; 19: E87–E91.
14. Thilmann, C, Adamietz, I A, Mose, S, Saran, F, Ramm, U, Bottcher, H D. Increase of surface dose using wound dressings during percutaneous radiotherapy with photons and electrons. Radiother Oncol 1996; 40: 181–184.
15. Takema, Y, Yorimoto, Y, Kawai, M, Imokawa, G. Age-related changes in the elastic properties and thickness of human facial skin. Br J Dermatol 1994; 131: 641–648.
16. Koehler, M J, Vogel, T, Elsner, P, Konig, K, Buckle, R, Kaatz, M. In vivo measurement of the human epidermal thickness in different localizations by multiphoton laser tomography. Skin Res Technol 2010; 16: 259–264.
17. Sandby-Moller, J, Poulsen, T, Wulf, H C. Epidermal thickness at different body sites: relationship to age, gender, pigmentation, blood content, skin type and smoking habits. Acta Derm Venereol 2003; 83: 410–413.
18. Lee, N, Chuang, C, Quivey, J M et al. Skin toxicity due to intensity-modulated radiotherapy for head-and-neck carcinoma. Int J Radiat Oncol Biol Phys 2002; 53: 630–637.
19. Velec, M, Waldron, J N, O’Sullivan, B et al. Cone-beam CT assessment of interfraction and intrafraction setup error of two head-and-neck cancer thermoplastic masks. Int J Radiat Oncol Biol Phys 2010; 76: 949–955.
20. Chow, J C L, Leung, M K K. Monte Carlo simulation of MOSFET dosimeter for electron backscatter using the GEANT4 code. Med Phys 2008; 35: 2383.

Keywords

  • Access

Dosimetric impacts on skin toxicity for patients using topical agents and dressings during radiotherapy

  • Karen Tse (a1), Lyndon Morley (a1), Angela Cashell (a1) (a2), Annette Sperduti (a1), Maurene McQuestion (a1) (a3) and James C. L. Chow (a1) (a2)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed