But so is Gleason 6 prostate and DCIS… they say
I've never known AK to be in the basket of things we treat, but @taserlaser provided that interesting link
Where is it? I'd be more on board if arn electron. This sounds like arcs and a complicated bolus setup. This is not to say I'm not interested in doing this in the right situation.
Haha. No, that seems crazy. I just like flat bolus. I'm simple. A swim cap with bolus or wet rags etc is above my pay grade. I'll do it, it's just getting late in the year and I was hoping to coast into January.
i think he means a dyi freiburg flap. believe it or not; i’ve done all of the options for similar cases (e- match, photon arc, freiburg). i think they are all pains in the ass and all have pros/cons. for this, a freiburg might be my pref but dealers choice; i think tangential photons can be executed well given most departments relative expertise
Unless you have a commercial freiberg flap, this process seems incredibly more intense than arcs w/ a mask (include potential couch kick as feasible), +/- aquaplast bolus. Honestly, with the incident angles seen w/ VMAT, benefit of anything more than 3mm bolus is likely minimal if you're doing "whole scalp"
One of the physicists I used to work with did some work figuring out the ‘minimum’ amount of bolus needed for arcs, and yeah, I think it was about 3mm. We just use a cm of beeswax since it’s easier to keep standard across shells and extra bolus here has never hurt. Edit: I should also add it’s nice as ‘flash’ in case there’s something lumpy and growing.
Also this. There is some (weak) evidence to show I creased amount of new primaries in skin irradiated fields I believe though. Some of it was perhaps moreso in electron beam with wider penumbras, but would have to dig up and look.
As you know, dermatologists treat more skin cancer with radiation than rad oncs.
