Total Skin Electron Therapy Stanford Technique Evolution With Monte Carlo Simulation Toward Personalized Treatments For Cutaneous Lymphoma

Current Total Skin Electron Therapy (TSET) Stanford technique for cutaneous lymphoma, established in the 70's, involves a unique irradiation setup, i.e. patient's position and beam arrangement, for all patients with ensuing great variability in dose distribution and difficult dose optimization. A Geant4-based simulation has been developed to explore the possibility of personalizing the dose to each patient's anatomy. To achieve this optimization of the treatment method, this project enrolls different aspects of the clinical and computational techniques: starting with the knowledge of the experimental parameters involving TSET practice, passing through an innovative approach to model the patient's anatomy, a precise description of the electron beam and a validated configuration of the physics models handling the interactions of the electrons and of secondary particles. The Geant4-based simulation models the patient as a tessellated solid derived from the optical scan of her/his body, realistically reproduces the irradiation environment in detail and calculates the energy deposition corresponding to each facet of the patient's scanned surface. The resulting three-dimensional dose distribution constitutes the basis for the personalization of the medical treatement as appropriate to each patient's specific characteristics.