Improved external beam radiotherapy for the treatment of retinoblastoma

Abstract

An applicator attached to a 6 MV linear accelerator has been adapted to produce a well defined beam for the treatment of retinoblastoma. By using a contact lens as the reference point on the patient''s cornea, the beam edge is aligned to just behind the posterior margin of the crystalline lens, thus sparing the anterior chamber and lens from the radiation field. In addition to basic dosimetric measurements made using an ionisation chamber and film densitometry to quantify the output and dose distribution from the applicator, extensive use was made of thermoluminescent dosimeters and a tissue-equivalent anthropomorphic head phantom. This was designed for detailed dosimetry on the eye and was used to confirm the correct positioning and reproducibility of the clinical set-up. We present data that corroborate and extend the dosimetric analyses documented in an earlier Dutch publication. In addition to the improved dosimetric analysis, other advantages include patient immobilisation, anaesthetic procedure and finer couch control as well as a recommendation on the dose prescription.