Scalp and Cranium Radiation Therapy Using Modulation (SCRUM) and Bolus

PURPOSE: A bolus is usually required to ensure radiation dose coverage of extensive superficial tumors of the scalp or skull. Oftentimes, these boluses are challenging to make and are nonreproducible, so an easier method was sought. METHODS AND MATERIALS: Thermoplastic sheets are widely available in radiation oncology clinics and can serve as bolus. Two template cutouts were designed for anterior and posterior halves to encompass the cranium of children and adults. RESULTS: The created bolus was imaged using computed tomography, which demonstrated good conformity and minimal air gaps. CONCLUSIONS: Although making a bolus for treating superficial tumors of the scalp or head and neck is challenging, the presented technique enables thermoplastic to be used as a bolus and is quick, easy, and reproducible.