Evaluation of dosimetric properties of handmade bolus for megavoltage electron and photon radiation therapy

Background: The use of boluses for radiation therapy is very necessary to overcome the problem of sending inhomogeneous doses in the target volume due to ir-regularities on the surface of the skin. The bolus materials for radiation therapy need to be evaluated. Objective: The present study aims to evaluate some handmade boluses for mega-voltage electron and photon radiation therapy. Several dosimetric properties of the synthesized boluses, including relative electron density (RED), transmission factor, mass attenuation coefficient, percentage depth dose (PDD), and percentage surface dose (PSD) were investigated. Material and Methods: In this experimental study, we evaluated natural rubber, silicone rubber mixed either with aluminum or bismuth, paraffin wax, red plasticine, and play-doh as soft tissue equivalent. CT-simulator, in combination with ECLIPSE software, was used to determine bolus density. Meanwhile, Linear Accelerator (Linac) Clinac iX (Varian Medical Systems, Palo Alto), solid water phantom, and Farmer ionization chamber were used to measure and analyze of dosimetric properties. Results: The RED result analysis has proven that all synthesized boluses are equivalent to the density of soft tissue such as fat, breast, lung, and liver. The dosimetric evaluation also shows that all synthesized boluses have a density similar to the density of water and can increase the surface dose with a value ranging from 6-20% for electron energy and 30-50% for photon energy. Conclusion: In general, all synthesized boluses have an excellent opportunity to be used as an alternative tissue substitute in the surface area of the body when using megavoltage electron and photon energy.