Thilmann C, Adamietz I A, Ramm U, Mose S, Saran F, Böttcher H D
Abteilung für Strahlentherapie, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt a. M.
Strahlenther Onkol. 1996 May;172(5):270-4.
Silicone-coated polyamide wound dressing is frequently used for the supportive treatment in patients with radiation induced skin lesions. The use of this kind of dressing during radiotherapy with high energy beams shifts the dose built-up effect towards the skin surface. Thus the dose delivered to the skin increases. The present work quantifies changes of the skin dose by a commercial silicon-coated polyamide wound dressing. The dependence on the beam quality and on different treatment techniques is investigated.
Measurements were performed with photon (60Co, 6 MV, 42 MV) and electron (7 MeV, 20 MeV, 40 MeV) beams using thin LiF thermoluminescence dosimeters (TLD) in a perspex phantom. The beams were directed perpendicularly to the phantom surface. For 60Co and 6 MV photon beams the skin dose was evaluated in vivo at different beam arrangements and at a given reference dose.
For 60Co, 6 MV and 42 MV photon beams wound dressing caused a dose increase on the surface of the perspex phantom by a factor of 1.65, 1.39 and 1.33 respectively. Using oblique or rotational techniques for 60Co and 6 MV photon irradiation the wound dressing increased the skin dose but less compared to perpendicular beam direction. For electron beams the skin dose is relatively high (from 84% to 92%) and an increase by a dressing has no clinical relevance (factor 1.03 to 1.05).
The silicone-coated polyamide wound dressing causes no relevant skin dose increase during radiation treatment with electron beams and can be left on the skin during irradiation. During radiation treatment with photon beams like 60Co and 6 MV the protective procedure should be adapted to skin changes, in case of strong skin reactions a removal during the time of irradiation should be considered.
硅胶涂层聚酰胺伤口敷料常用于放射性皮肤损伤患者的支持性治疗。在高能束放疗期间使用这种敷料会使剂量积累效应向皮肤表面转移。因此,传递到皮肤的剂量增加。本研究量化了商用硅胶涂层聚酰胺伤口敷料引起的皮肤剂量变化。研究了其对束流质量和不同治疗技术的依赖性。
使用薄型LiF热释光剂量计(TLD)在有机玻璃模型中,用光子束(60Co、6MV、42MV)和电子束(7MeV、20MeV、40MeV)进行测量。束流垂直指向模型表面。对于60Co和6MV光子束,在不同束流配置和给定参考剂量下,在体内评估皮肤剂量。
对于60Co、6MV和42MV光子束,伤口敷料分别使有机玻璃模型表面的剂量增加了1.65倍、1.39倍和1.33倍。对于60Co和6MV光子照射,使用倾斜或旋转技术时,伤口敷料增加了皮肤剂量,但与垂直束流方向相比增加较少。对于电子束,皮肤剂量相对较高(84%至92%),敷料引起的剂量增加没有临床意义(1.03至1.05倍)。
硅胶涂层聚酰胺伤口敷料在电子束放疗期间不会引起相关的皮肤剂量增加,照射期间可留在皮肤上。在使用60Co和6MV等光子束放疗期间,应根据皮肤变化调整保护措施,如皮肤反应强烈,应考虑在照射期间去除敷料。