A feasibility study of two millimeter bolus for post-mastectomy radiation therapy

Publication date: Available online 24 October 2016
Source:Practical Radiation Oncology
Author(s): Lauren C. Das, Daniel W. Golden, Eugenia Perevalova DMP, Anthony C. Wong, Kimberly De Nardo, Christopher Stepaniak, Daniel S. Joyce, Bradley P. McCabe, Yasmin Hasan, Steven J. Chmura, Anne McCall
PurposeTo prospectively evaluate the use of daily 2mm bolus in patients undergoing post-mastectomy radiation without reconstruction using optically stimulated luminescence dosimetry (OSLD) and weekly assessment of skin toxicity.Methods and MaterialsWe prospectively collected data from the first 49 women treated with a daily 2mm Superflab™ (Mick Radio-Nuclear Instruments, Mount Vernon, NY) bolus during their post-mastectomy radiation therapy from 2013–2016 at XXXX. Within the first three days of starting radiation therapy, we measured the surface dose in vivo at five anatomical locations under the 2mm bolus on the chest wall. We assessed the acute skin toxicity during radiation weekly using the National Cancer Institute Common Toxicity Criteria (NCI CTC). Patients with reconstruction prior to radiation therapy were excluded.ResultsForty-nine women with a mean age of 54.3years were treated with daily 2mm bolus to the chest wall following mastectomy. Median follow-up was 32.7weeks. The mean percentage of prescribed dose (standard deviation) for the median, central, lateral, superior, and inferior OSLDs were 100.1% (5.6%), 108.1% (6.7%), 98.1% (6.5%), 102.6% (8.9%), and 106.3% (6.6%) respectively. The majority (71.4%) of women experienced a maximum acute NCI CTC skin toxicity score of 2 with only 12.2% experiencing a score of 3. There were no grade 4 toxicities. There were no local recurrences during our follow-up period.ConclusionsDaily 2mm bolus is a feasible regimen for chest wall bolus during post-mastectomy radiation therapy with acceptable dose build-up and skin toxicity.



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