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Correspondence to Author: Sakshi Rana¹, Ashu Abhishek¹, Anita Priyadarshini¹, Shaleen Agrawal¹, Amal Roy Chaudhoory¹,Radhakrishnan Balan Nair¹Anil Kumar Anand¹. 

Department of Radiation Oncology ,Fortis Memorial Research Institute ,Gurugram , Haryana.

DOI: 10.52338/tjoro.2025.4741

Abstract:

Total scalp irradiation is used to treat melanoma, lymphoma, angiosarcoma, mycosis fungoides, basal, and squamous cell carcinoma. Treatment of the total scalp is typically reserved for diffuse disease presentations, recurrences and its intent is mostly palliative1-5. Planning and delivering radiation treatment to whole of the scalp is technically challenging due to the geometry of the head and the close relation of the scalp to the brain, optical structures, and other nearby healthy organs at risk. The main challenge of scalp irradiation is to deliver a homogenous dose while sparing the normal brain and other healthy structures. The thickness of scalp is only 4–6 mm, so traditionally electrons have been the modality of choice because of its high surface dose, rapid dose falloff and its finite range, with acceptable dose received by the brain resulting in only minimal treatment-related toxicity. Nonetheless, electron treatments have its own difficulties in terms of the scattering of electrons at oblique surfaces which can create unusual dose distributions6. Many techniques using photons and mega voltage electron beams have been described in the literature. Most of the techniques have used photons obtaining a good conformation of dose to target and protection of surrounding normal tissue as well7-11. Techniques such as static electron fields, electron arc therapy, intensity modulated electron radiation therapy, helmet mold-based surface brachytherapy, volumetric arc therapy and helical tomotherapy have been used worldwide. In this report, we describe a combination of volumetric arc therapy technique and electron therapy for boost for a patient with recurrent tumours in scalp.

Citation:

Dr. Sakshi Rana, Total Scalp Irradiation : Benefits From Optimisation Of Customised Bolus With Volumetric Arc And Electron Combination Therapy. The Journal of Radiation Oncology 2025.