TOTAL SKIN ELECTRON BEAM THERAPY (TSET)

INTRODUCTION:

Total Skin Electron Beam Therapy (TSET) is a radiation technique which is used to treat patient’s entire/total skin surface using electron beams .

TEST is used to treat Skin Lymphoma and/or Mycosis Fungoides. Patients present with red and scaling skin patches which are generally annular or arc shaped. These later on progress to form infiltrative scaling plaques, nodules and sometimes have superficial ulcerations.

Figure 1 – Clinical Pics of patients with MF

Aim while treating such type of skin lymphomas is to deliver radiation dose to skin of the body to a shallow depth by sparing the deep seated tissues and organs.

Technically TSET is a complex treatment and requires experienced team of Radiation Oncologists, Medical Physicists and Technologists to carry it out well. TSET requires complex dosimetry and quality assurance processes before and during treatment.

At Max Hospital, Shalimar Bagh we have been treating patients of mycosis fungoides/cutaneous lymphomas with TSET regularly and with very rewarding results.

For each treatment, patients are  asked to stand in  different positions, alternating daily (total 6 positions) in front of Linear Accerlator. Each position exposes entire  patient’s skin to the radiation beam of  low energy electrons. (Figure 2-3)

Everyday Patients nail bed and eyes are shielded before treatment using special applicators and lead goggles. (Fig 4)

Figure 2 – Patient positioned in front of Linear Accelerator

Figure 3- Clinical sketch of six treatment positions used for delivering TSET

Figure 4- Nail bed shielding and lead goggles

POSSIBLE SIDE EFFECTS OF TSET AND PREVENTIVE MEASURES:

Itchy skin -  keep skin moisturized, wear cotton cloths
Dry cracking skin - apply moisturizer
Sun sensitivity- wear sunglass , cap and full gown
Fatigue – take rest and eat healthy food
Temperature  regulation- Avoid humid hot weather and drink plenty of water
Partial temporary hair loss

Treatment Outcomes

 TSET is the most effective treatment modality for MF.  It is a technically challenging and   demanding treatment modality and requires stringent quality assurance and team work.

#Mycosis Fungoides #Skin Lymphoma # Cutaneous Lymphoma # Electron Therapy #TSET #Total Skin Electron Therapy