Purpose: Minimizing radiation-induced skin toxicity while ensuring optimal tumor coverage is a critical challenge in cervical cancer radiotherapy. This study compares Entrance Skin Dose (ESD) and target coverage for Intensity-Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT), highlighting their implications for radiation protection. Materials and methods: Eight Optically Stimulated Luminescence (OSL) dosimeters, providing precise point measurements of ESD with high spatial resolution, were placed at clinically relevant anatomical sites on a female anthropomorphic phantom. The phantom underwent a planning CT scan, and IMRT and VMAT plans were simulated in Eclipse using 6 MV photon beams on a Varian TrueBeam linear accelerator. Results: IMRT delivered slightly higher skin doses (0.589 Gy measured vs. 0.566 Gy calculated) compared to VMAT (0.494 Gy measured vs. 0.477 Gy calculated), with an average relative increase of ~0.5%. Conclusion: VMAT demonstrates lower skin exposure and may be preferable for patients at higher risk of radiation-induced skin toxicity. OSL dosimetry allowed accurate ESD assessment, supporting radiation protection by confirming doses remain within safe limits and showing strong agreement with ICRU Reports 50 and 83.
Ahlam et al. (Mon,) studied this question.