{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:41:13Z","timestamp":1783438873537,"version":"3.54.6"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Total skin electron therapy (TSET) has proven to be one of the most effective treatments for advanced\u2010stage cutaneous T\u2010cell lymphoma. Two most used techniques are the Stanford six\u2010field and rotational techniques. This study compares patient skin dose distributions as a function of depth between these two techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The EGSnrc system was used to simulate electron beams and calculate patient dose distributions. The calculations assumed the same patient standing on a platform, and the patient's different postures were ignored for the Stanford technique in the comparison of dose distributions. The skin doses were analyzed as a function of skin depth\u2010dose coverage and evaluated using dose\u2010volume\u2010histograms (DVH). The comparisons were performed in three realistic clinical settings in which dual\u2010field were used for patients treated at extended distances of 316 and 500\u00a0cm, and a single field was used at 700 cm. In all cases the realistic patient treatment beam delivery geometry was simulated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Although small dose differences were observed in some local areas, no clinically significant differences were found in the patient 3D dose distributions between the Stanford and rotational techniques. Virtually the same DVH curves between two the techniques were observed for mean dose to skin depth of 0\u20135, 5\u201310, and 10\u201315 mm from the skin surface, respectively. It is found that the skin depth dose coverage is 2 mm shallower for patient treatment at 500\u00a0cm compared to at 316\u00a0cm due to the additional air attenuation. However, very similar dose coverage and uniformity can be achieved at these two different extended treatment distances by adjusting the thickness of acrylic scatter plate. Adequate thickness of a scattering plate improves the skin dose uniformity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both the Stanford and rotational techniques deliver very similar skin dose coverage in DVH plots, and only small differences are seen in local areas. It is worth to emphasize that the DVH is a graphical representation of the distribution of dose within a structure, and it does not contain spatial information. Therefore, comparison of entire skin dose using DVH may mask some variations at different locations of the surface area. In addition, the comparison did not consider different patient postures of the Stanford technique. Including the different patient postures in the calculation may affect the result of doses to the limbs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.15907","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T11:08:55Z","timestamp":1660648135000},"page":"6646-6653","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Skin dose distributions between Stanford and rotational techniques in total skin electron therapy (TSET)"],"prefix":"10.1002","volume":"49","author":[{"given":"George X.","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Vanderbilt University School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe J.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Therapeutic Radiology Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weili","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman Center of Advanced Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy C.","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman Center of Advanced Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.37206\/22"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.595296"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167-8140(92)90374-4"},{"key":"e_1_2_8_5_1","first-page":"2003","volume-title":"Total Skin Electron Irradiation 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