Study on the impact of different wound dressings on surface dose and deep dose analysis in head and neck radiation therapy

IF 2.8 3区物理与天体物理 Q3 CHEMISTRY, PHYSICAL

Radiation Physics and Chemistry Pub Date : 2025-06-24 DOI:10.1016/j.radphyschem.2025.113071

Hsiao-Ju Fu, Chih-Chia Chang, Yuk-Wah Tsang, De-Shin Liu

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引用次数: 0

Abstract

Wound dressings are essential for managing skin reactions in patients who have undergone treatments lasting over three to four weeks preventing the progression to more severe wounds, particularly when frequent dressing changes are necessary. However, the use of wound dressings can influence surface radiation doses in the treatment area. This study aimed to evaluate the dosimetric impact of two commonly used hydrocolloid dressings—Aquacel® Ag+ Extra™ (Aquacel-Ag) and DuoDERM® CGF® (DuoDERM)—on surface and near-surface doses in head and neck radiotherapy using IMRT and VMAT techniques. Surface dose measurements were performed using a Markus parallel plate ionization chamber and EBT3 film on both polystyrene slabs and a head-and-neck (HN) IMRT verification phantom. Field sizes of 5×5, 10×10, and 15×15 cm2 were investigated. Dressing thicknesses were 0.47 mm (Aquacel-Ag) and 2 mm (DuoDERM). Paired sample t-tests were conducted to evaluate dose differences between no dressing, Aquacel-Ag, and DuoDERM, including analysis of Ds/D1cm ratios. The calibration of the dosimeters demonstrated standard deviations within 1% for both the Markus ion chamber and EBT3 film, indicating high precision with coefficients of variation (R2 = 0.9999 and 0.9916, respectively). Both dressings increased surface dose significantly (p ≤ 0.05), with DuoDERM causing a maximum increase of 31.67% under a 5×5 cm2 field. Aquacel-Ag showed modest increases (<6%) across all field sizes. In the HN phantom, DuoDERM significantly elevated surface dose and Ds/D1cm ratio under IMRT (p = 0.006), whereas Aquacel-Ag had no statistically significant impact. VMAT plans showed less dose enhancement due to the technique’s distributed angular weighting. All measured Ds/D1cm values remained within the clinically acceptable range (below 95% of the prescription dose), per ICRU Report 83. This study highlights the significant impact of hydrocolloid dressings on surface radiation doses during treatments lasting over three to four weeks. These findings emphasize the importance of considering dressing materials when planning radiation treatments to ensure accurate dose and patient safety.

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不同伤口敷料对头颈部放射治疗表面剂量和深部剂量分析影响的研究

伤口敷料对于治疗持续超过三到四周的患者的皮肤反应是必不可少的，可以防止进展到更严重的伤口，特别是在需要频繁更换敷料的情况下。然而，伤口敷料的使用会影响治疗区域的表面辐射剂量。本研究旨在评估两种常用的水胶体敷料- aquacel®Ag+ Extra™（Aquacel-Ag）和DuoDERM®CGF®(DuoDERM) -在使用IMRT和VMAT技术的头颈部放疗中对表面和近表面剂量的剂量学影响。表面剂量测量使用Markus平行板电离室和EBT3膜在聚苯乙烯板和头颈部（HN） IMRT验证幻影上进行。考察了5×5、10×10和15×15 cm2的田间面积。饲喂厚度分别为0.47 mm （Aquacel-Ag）和2 mm （DuoDERM）。采用配对样本t检验评估无敷料、Aquacel-Ag和DuoDERM之间的剂量差异，包括Ds/D1cm比值分析。Markus离子室和EBT3膜的剂量计校准精度均在1%以内，变异系数R2分别为0.9999和0.9916，精度较高。两种敷料均显著增加表面剂量（p≤0.05），在5×5 cm2场下，DuoDERM最大增加31.67%。水产养殖农业在所有规模的农田中都有适度的增长（6%）。在HN幻相中，十二指肠黏膜可显著提高IMRT下的表面剂量和Ds/D1cm比值（p = 0.006），而Aquacel-Ag则无统计学意义。由于该技术的分布角加权，VMAT方案显示较少的剂量增强。根据ICRU报告83，所有测量的Ds/D1cm值保持在临床可接受范围内（低于处方剂量的95%）。这项研究强调了水胶体敷料在持续三到四周的治疗期间对表面辐射剂量的显著影响。这些发现强调了在计划放射治疗时考虑敷料的重要性，以确保准确的剂量和患者安全。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiation Physics and Chemistry 化学-核科学技术

CiteScore

5.60

自引率

17.20%

发文量

574

审稿时长

12 weeks

期刊介绍： Radiation Physics and Chemistry is a multidisciplinary journal that provides a medium for publication of substantial and original papers, reviews, and short communications which focus on research and developments involving ionizing radiation in radiation physics, radiation chemistry and radiation processing. The journal aims to publish papers with significance to an international audience, containing substantial novelty and scientific impact. The Editors reserve the rights to reject, with or without external review, papers that do not meet these criteria. This could include papers that are very similar to previous publications, only with changed target substrates, employed materials, analyzed sites and experimental methods, report results without presenting new insights and/or hypothesis testing, or do not focus on the radiation effects.