Case Report
Volume: 7 | Issue: 8 | Published: Dec 18, 2023 | Pages: 158 - 160 | DOI: 10.24911/ejmcr/173-1668678100
Water bolus in photon-beam therapy of irregular skin lesions of extremities: a case report
Authors:
Catarina Novalio Oliveira
, Diana Ferreira Braga
, Nelson Miranda Ferreira
, Claudia Matias Silva
, Ines Henriques de Carvalho Pino
, Filomena Trindade Santos
Article Info
Authors
Catarina Novalio Oliveira
Department of Radiation Oncology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Rua Professor Lima Basto 1099-023, Lisbon, Portugal
Diana Ferreira Braga
Department of Radiation Oncology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Rua Professor Lima Basto 1099-023, Lisbon, Portugal
Nelson Miranda Ferreira
Department of Radiation Oncology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Rua Professor Lima Basto 1099-023, Lisbon, Portugal
Claudia Matias Silva
Department of Radiation Oncology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Rua Professor Lima Basto 1099-023, Lisbon, Portugal
Ines Henriques de Carvalho Pino
Department of Radiation Oncology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Rua Professor Lima Basto 1099-023, Lisbon, Portugal
Filomena Trindade Santos
Department of Radiation Oncology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Rua Professor Lima Basto 1099-023, Lisbon, Portugal.
Publication History
Received: April 17, 2023
Revised: June 27, 2023
Accepted: June 27, 2023
Published: December 18, 2023
Abstract
Background: Mycosis fungoides (MF) represents the most common cutaneous T-cell lymphoma and approximately 4% of non-Hodgkin lymphomas. Treatment of skin lesions includes external beam radiation therapy which often provides adequate local control and symptom relief. Case presentation: A 39-year-old male with the diagnosis of MF presents with infiltrative and pruriginous plaques comprising the plantar, interdigital, lateral and posterior surfaces of the foot. A protocol using a water tank was used to provide uniform coverage to an irregular target volume. By creating a tissue-equivalent and homogenous bolus material a total dose of 8Gy in 2 fractions of photon-beam therapy was prescribed. After one month of treatment there was a partial response with minimal toxicity, achieving complete response in most lesions after six months. Conclusion: Photon-beam therapy for irregular surfaces such as extremities is a valid alternative to conventional electron-beam radiation by attaining uniform coverage while minimizing hotspots. Treatment utilizing a water tank is well-tolerated and has good clinical outcomes even in the presence of extensive skin lesions.
Keywords: Case report, radiation therapy, mycosis fungoides, irregular surface, water tank, tissue compensation, green
