Comparison of Super Stuff and paraffin wax bolus in radiation therapy of irregular surfaces.

Irregular facial contours can make radiation therapy of head and neck tumors difficult. Isodose lines become skewed, making treatment planning complex. A traditional solution to this problem is the paraffin wax box bolus. Such a bolus is made to fit the irregular surface compensating for the topology and creating an even surface. The fabrication of a wax bolus can be a difficult and time-consuming process. A method that is simple and efficient has been devised. Super Stuff bolus can be easily molded and has approximately the same effect as a similar paraffin wax bolus. This was verified by irradiating a Rando head phantom with both a paraffin wax bolus and a Super Stuff bolus. Doses to various points of interest were measured with thermoluminescent dosimetry (TLD) chips (LiF). The particular case addressed is malignant melanoma of the nasal septum, but the technique described can be useful in the treatment of other sites as well.