Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi’s sarcoma in the distal extremities

• Published in: Scientific reports Vol. 10; no. 1; p. 9693
• Main Authors: Kim, Sung-woo, Kim, Changhwan, Cho, Min-Seok, Noh, Seonyeong, Lee, Minsik, Jeong, Chiyoung, Kwak, Jungwon, Koh, Minji, Song, Si Yeol, Lee, Sang-wook, Soh, Jeongtae, Cho, Seungryong, Cho, Byungchul
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 16.06.2020; Nature Publishing Group
• Subjects: 692/4028/67/1798; 692/4028/67/1813; Foot; Hand; Humanities and Social Sciences; Humans; Kaposis sarcoma; Mimicry; Monte Carlo Method; multidisciplinary; Phantoms, Imaging; Proton Therapy - methods; Radiation therapy; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Sarcoma; Sarcoma, Kaposi - radiotherapy; Science; Science (multidisciplinary); Skin cancer; Skin diseases; Skin lesions; Skin Neoplasms - radiotherapy
• DOI: 10.1038/s41598-020-66846-5
• ISSN: 2045-2322

A novel wide-field electron arc technique with a scatterer is implemented for widespread Kaposi’s sarcoma (KS) in the distal extremities. Monte Carlo beam modeling for electron arc beams was established to achieve <2% deviation from the measurements, and used for dose calculation. MC-based electron arc plan was performed using CT images of a foot and leg mimicking phantom and compared with in-vivo measurement data. We enrolled one patient with recurrent KS on the lower extremities who had been treated with photon radiation therapy. The 4- and 6-MeV electron arc plans were created, and then compared to two photon plans: two opposite photon beam and volumetric modulated arc with bolus. Compared to the two photon techniques, the electron arc plans resulted in superior dose saving to normal organs beneath the skin region, although it shows inferior coverage and homogeneity for PTV. The electron arc treatment technique with scatterer was successfully implemented for the treatment of widespread KS in the distal extremities with lower radiation exposure to the normal organs beyond the skin lesions, which could be a treatment option for recurrent skin cancer in the extremities.