Verification of nose irradiation using orthovoltage x-ray beams.

Determination of dose distributions from superficial and orthovoltage irradiations of basal cell carcinoma of the nose has been performed using a nose shaped phantom constructed from paraffin wax. EBT type radiochromic film was used for dose measurements. A 2 cm diameter 50 kVp anterior field was used to irradiate the nose phantom, with sheets of film placed at 7 mm, 14 mm and 23 mm physical depth. The percentage depth doses at these points were measured to be 84% +/- 1.6%, 66% +/- 2.7% and 50% +/- 1.2% respectively, compared to the expected percentage depth doses of 72%, 52% and 34%, measured in full scatter conditions. This discrepancy is believed to be due to the steep drop off at the sides of the nose phantom, resulting in reduced attenuation at the edges of the beam, which in turn results in an increase in the scatter contribution to the dose at depth on the central axis. Measured dose profiles from this technique showed a reasonably uniform distribution. A second technique using a 250 kVp tangent-like field to irradiate the tip of the nose was also tested. Radiochromic film was placed against the edges of the phantom for dose measurement. The dose at the surface was measured to be 27% +/- 1.5% less than the expected dose. It is believed that this discrepancy is due to a combination of the lack of backscatter from the phantom, and a small offset between the phantom and the treatment cone. Dose measurements and profiles showed that this technique results in a variation in dose across the treated volume of 7%. However, the difficulty in predicting the delivered dose prohibited it from clinical use.