Metal-polysiloxane shields for radiation therapy of maxillo-facial tumors.

In the treatment of some head and neck lesions with high-intensity radiation (teletherapy), an essential procedure is the application of an individually customized shielding appliance, which is designed, modeled, and formed into a working extra- or intraoral stent for the purpose of sparing healthy tissues. The present state of the art is slow and technique intensive, which can add to patient discomfort and inconvenience during molding and fabrication. A new formulation is described, which offers speed and ease of forming a moldable composite stent especially for intraoral use. Interleaved stacks of calibrated thin radiochromic film strips and soft-tissue-simulating plastic (polystyrene) layers gave a means of mapping one- or two-dimensional profiles of dose distributions adjacent to the high-density shielding materials using a spectrophotometer equipped with a gel scanner or a scanning laser-beam microdensitometer. Tests using collimated gamma-ray beams from a 60Co teletherapy unit were made in order to measure the dose distribution near interfaces of tissue-simulating polymer and the composite stent material with and without mixtures of metals (Ag-Cu and Sn-Sb). These results show that quickly formed composites made of a flexible resin with high concentrations of powdered spherical metal alloys provide effective custom-designed shielding, and, with a thin overlayer of the resin without metal, a diminished back-scattered radiation dose to normal tissues. An example of a successful formulation is a mixture of 90% by weight Ag-Cu alloy powder in a vinyl polysiloxane resin. This material is a moldable putty which, upon polymerization, forms a rigid elastomeric material, providing a half-value layer of approximately 2.5 to 2.8 cm for a gamma-ray beam from a 60Co source.