Evaluation of Therapeutic Properties of a Low Energy Electron Beam Plus Spoiler for Local Treatment of Mycosis Fungoides: A Monte Carlo Study

BACKGROUND: When using low-energy electron beams for the treatment of skin lesions, such as Mycosis Fungoides (MF), a beam spoiler is used to decrease electron therapeutic depth (R(90)) while increasing the surface dose. OBJECTIVE: The aim of this study was to evaluate the characteristics of a 5 MeV electron beam when using a spoiler for the local treatment of MF skin lesions by Monte Carlo (MC) simulation. MATERIAL AND METHODS: In this experimental study, a Siemens Primus treatment head and an acrylic spoiler, positioned at the end of applicator, were simulated using BEAMnrc, an EGSnrc user code. The modelled beam was validated by measurement using MP3-M water tank, Roos parallel plate chamber and Semi flex Chamber-31013 (all from PTW, Freiburg, Germany). For different spoiler thicknesses, dose distributions in water were calculated for 2 field sizes and were compared to those for the corresponding open fields. RESULTS: For a 1.3 cm spoiler, therapeutic range changed from 1.5 cm (open field) to 0.5 cm and 0.4 cm for 10 × 10 cm(2) and 20 × 20 cm(2) field sizes, respectively. Maximum increase in penumbra width was 2.8 and 3.8 cm for 10 × 10 cm(2) and 20 × 20 cm(2) field sizes, respectively. Maximum increase in bremsstrahlung contamination was %2 in both field sizes. CONCLUSION: R(90) decreased exponentially with increase in spoiler thickness. The effect of field size on penumbra was much larger for spoiled beam compared to the open beam. The results of this research can be applied to optimize the radiation treatment of MF patients in our hospital.