(Sunday, 7/14/2019)
Room: ePoster Forums
Purpose: To investigate the feasibility of adopting a custom made superflab bolus for the treatment of Kaposi’s sarcoma developed on the skin of the foot and to demonstrate its potential for improved accuracy in patient positioning and comfort.
Methods: The common approach to achieve a homogeneous dose has been to immerse patient’s extremity in a water bath. The new custom bolus has the advantage of an easy and reproducible patient setup. To mimic the patient’s foot, we used a rubber foot. A mold was taken of the foot using a skin safe alginate that cures quickly. If needed, the foot can be covered with a thin layer of plastic wrap to avoid skin contact with the mold or bolus.To improve homogeneity and separate the toes, small boluses made of Adapt-it thermoplastic pellets were placed between the toes before the mold was taken. Next a plaster was cast into the mold. In a well ventilated room, the superflab was heated and poured over the plaster that was placed in a rectangular box, creating a boot like bolus. The bolus was left to cool for several hours. The foot with the superflab bolus was scanned feet first supine. The rubber foot was also scanned immersed in the water bath.
Results: Only minimal air gaps were noted between the foot and the bolus during the CT scan because the bolus was custom made. The dosimetric results of treatment plan using the water bath were compared with the custom bolus, and similar results were noticed.
Conclusion: While maintaining the homogeneous distribution of the dose to the skin, this procedure allows easy positioning of the patient, offering more comfort to the patients with poor mobility. The tissue equivalent custom bolus is soft, malleable and involves minimal contamination, making it suitable for patients with open wounds.
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