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Evaluating the relevance of dosimetric considerations to patient instructions regarding skin care during radiation therapy

Published online by Cambridge University Press:  11 June 2013

Lyndon Morley ,
Angela Cashell ,
Annette Sperduti ,
Maurene McQuestion  and
James C. L. Chow
Lyndon Morley*
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
Angela Cashell
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Annette Sperduti
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
Maurene McQuestion
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
James C. L. Chow
Affiliation:
Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada Department of Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
*
Correspondence to: Lyndon Morley, Department of Radiation Therapy, Princess Margaret Cancer Centre, 610 University Avenue, Room 2B-615, Toronto, Ontario, Canada M5G 2M9. Tel: 416-946-4501, ext. 4889. Fax: 416-946-2019. E-mail: lyndon.morley@rmp.uhn.on.ca
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Abstract

Introduction

Patient teaching in radiation therapy may include restrictions on applying skin products owing to concerns that the presence of such materials may increase skin dose. These restrictions may create unnecessarily complicated and conflicting self-care instructions.

Purpose

To determine what thickness of skin product is necessary to produce a clinically meaningful dose increase to the skin, and provide recommendations for evidence-based patient instructions.

Methods

Dosimetric measurements and Monte Carlo simulations were used to calculate skin dose under 0–1·5 mm thicknesses of two common classes of skin product for a variety of treatment geometries. The thickness of product required to produce a clinically significant dose increase to the skin was determined.

Results

The thickness of product required to create a clinically meaningful dose increase was >0·7 mm for 10 × 10 cm2 fields and >1·5 mm for 1 × 1 cm2 fields. A typical application of product would be only 0·3 mm.

Conclusion

It seems unrealistic to anticipate patients using sufficiently large quantities of skin product to be of clinical concern. We therefore recommend that there are no dosimetric reasons to restrict the use of these types of skin products during radiation therapy for common treatment scenarios.

Keywords

medical dosimetrypatient educationpatient teachingradiation therapyradiation skin doseself-care instructionsside-effect managementskin care during radiation therapy
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 13 , Issue 3 , September 2014 , pp. 294 - 301
Copyright
Copyright © Cambridge University Press 2013 

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