Analisis Penggunaan Bolus Lunak terhadap Distribusi Dosis pada Penyinaran Karsinoma Sel Skuamosa Facial dengan Teknik IMRT di Departemen Radioterapi MRCCC Siloam Hospital Semanggi

Abstract

Background: Diagnostically, Facial Squamous Cell Carcinoma develops in the areas of the face that are

uneven in nature on the surface of the skin. For that reason, irradiation in this area can cause any

inhomogeneous dose distribution and increase the potential for the emergence of new cancer due to

radiation exposure to the surrounding healthy tissue; therefore, it is necessary to use a soft bolus which is

combined with IMRT radiation technique to make the dose distribution more optimal.

Methods: This research applies descriptive qualitative method with one sample taken from secondary data

of the patients with Facial Squamous Cell Carcinoma cases using a soft bolus with IMRT technique. As for

the research methods, they include among the other things literature study, observation, interviews, and

documentation. Meanwhile, this research was conducted starting from February up to May 2024 executed

at Radiotherapy Department of MRCCC Siloam Hospital Semanggi.

Results: IMRT technique is used with the use of MLC and irradiation from several angles combined with

the use of a soft bolus made from plasticine to increase the surface dose and optimize the dose distribution.

Apparently, the planning result suggests that the distribution of doses in the organ at risk against the

tolerated dose shows that the right eye is above tolerance; however, the other organs at risk such as

brainstem, chiasm, eye left, lens left, lens right, optic nerve left, and optic nerve right are below the

tolerance.

Conclusions: The planning results highlight that the use of IMRT technique combined with a soft bolus

increases surface dose and optimizes dose distribution in Facial Squamous Cell Carcinoma irradiation,

while ensuring most organs at risk remain within tolerance levels except for the right eye.