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Services & Therapies
Total Skin Electron Therapy (TSET)

Certain superficial lesions, such as; mycosis fungoides (a cutaneous T-cell lymphoma), are best treated with total skin electron therapy. To achieve optimum results, the use of proper treatment technique is crucial in TSET. A low energy electron beam (6 MeV or less) is often used to provide maximum dose at or close to the skin surface. The patient is treated at extended distance (usually 3 to 4 m from radiation source) using large electron fields. Other main goals of treatment are to minimize contaminant x-ray (bremsstrahlung) to prevent dose to deep body tissues and to maintain dose uniformity (± 10%) over entire treatment area. Historically, a number of irradiation techniques have been used at different institutions, the most common being the Stanford technique using six-dual area fields. In our department, a rotational treatment scheme is used. The patient is seated in a chair placed on a platform capable of rotating at about one revolution per minute. The gantry is angled such that the beam is pointed on top of the patient’s head to minimize X-ray dose. The main advantage of rotational therapy is that a uniform dose to the patient is given and chances of any hot spots caused by field junctions are eliminated.

A 6MeV electron beam is used to deliver approximately 20-30 Gy skin dose in 1 to 2 Gy daily fractions. The patient is treated 4 days a week, with no treatment given on Wednesdays. Treatment duration is usually about 20-30 minutes. There will be a planning session prior to start of treatment course, during necessary measurements will be made in order to custom design treatments. During TSET, careful positioning of arms and legs is required to ensure dose uniformity over entire body. Your treatment may require certain untreated or partially treated body parts (scalp, sole of feet) to receive extra (boost) radiation dose. These focused radiation treatments are custom designed and are given using small treatment cones. During your treatments, certain sensitive tissues, such as, eyes, finger/toe nails will be shielded using custom metal shields.

Some of the short term side effects of this treatment may include, fatigue, dry-skin, hair-loss etc.