In vivo monitoring of total skin electron dose using optically stimulated luminescence dosimeters.

AIM: This study retrospectively analysed the results of using optically stimulated radiation dosimeters (OSLDs) for in vivo dose measurements during total skin electron therapy (TSET, also known as TSEI, TSEB, TSEBT, TSI or TBE) treatments of patients with mycosis fungoides. BACKGROUND: TSET treatments are generally delivered to standing patients, using treatment plans that are devised using manual dose calculations that require verification via in vivo dosimetry. Despite the increasing use of OSLDs for radiation dosimetry, there is minimal published guidance on the use of OSLDs for TSET verification. MATERIALS AND METHODS: This study retrospectively reviewed in vivo dose measurements made during treatments of nine consecutive TSET patients, treated between 2013 and 2018. Landauer nanoDot OSLDs were used to measure the skin dose at reference locations on each patient, as well as at locations of clinical interest such as the head, hands, feet, axilla and groin. RESULTS: 1301 OSLD measurements were aggregated and analysed, producing results that were in broad agreement with previous TLD studies, while providing additional information about the variation of dose across concave surfaces and potentially guiding future refinement of treatment setup. In many cases these in vivo measurements were used to identify deviations from the planned dose in reference locations and to identify anatomical regions where additional shielding or boost treatments were required. CONCLUSIONS: OSLDs can be used to obtain measurements of TSET dose that can inform monitor unit adjustments and identify regions of under and over dosage, while potentially informing continuous quality improvement in TSET treatment delivery.