Using a thermoluminescent dosimeter to evaluate the location reliability of the highest-skin dose area detected by treatment planning in radiotherapy for breast cancer

Acute skin reaction during adjuvant radiotherapy for breast cancer is an inevitable process, and its severity is related to the skin dose. A high-skin dose area can be speculated based on the isodose distribution shown on a treatment planning. To determine whether treatment planning can reflect high-skin dose location, 80 patients were collected and their skin doses in different areas were measured using a thermoluminescent dosimeter to locate the highest-skin dose area in each patient. We determined whether the skin dose is consistent with the highest-dose area estimated by the treatment planning of the same patient. The χ2 and Fisher exact tests revealed that these 2 methods yielded more consistent results when the highest-dose spots were located in the axillary and breast areas but not in the inframammary area. We suggest that skin doses shown on the treatment planning might be a reliable and simple alternative method for estimating the highest skin doses in some areas.