The Carl Zeiss INTRABEAM system is a mobile compact miniature x-rays device which delivers treatment by various techniques; including intraoperative, interstitial, intra-cavity, and surface treatments. The main purpose of the study was to observe dose homogeneity in surface applicator overlapping and non-overlapping region using 3D printed bolus in INTRABEAM System for skin cancer treatment. Dose uniformity plays a crucial role between overlapping and non-overlapping region of applicator during dose delivery in skin cancer. The different thickness, shape (concave, convex) and filament densities of ABS (Acrylonitrile Butadiene Styrene) were made to form main body parts of bolus for surface applicator of diameter 4 cm in Carl Zeiss INTRABEAM system with the help of German RepRap 3D printer. Concave and Convex part refer to the structures similar to the cross section of concave and convex lens respectively. GafChromic eBT films which were irradiated with 50 kV x-ray with surface applicator in presence of bolus. After that films were scanned with an EPSON® Expression 10000 XL/Pro flatbed scanner and dose profile were plotted with ImageJ Software, from which dose homogeneity was determined. The dose profiles were plotted for the different combination (filament density) of concave and convex parts of bolus (printed from 3D printer) with thickness 5 mm, 6 mm, 7 mm, 8 mm, 9 mm and 10 mm. From the plotted profiles, the maximum flat profile was seen in the bolus with thickness 10 mm and combination of concave filament density 45% and convex filament density 100%.The dose homogeneity is better achieved for the INTRABEAM system Surface applicator at overlapping and non-overlapping region by using homemade bolus with appropriate combination (filament density) of concave and convex parts of bolus comparative to the other methods. The aim of the research is to provide a better method for the treatment of the localized skin cancer of the size >4 cm. According to World Health Organization (WHO) skin cancer incidence is increasing in past decades and estimates about 2-3 million Non-Melanoma Skin Cancers (NMSC) occur worldwide each year with one in every three cancers diagnosed being a skin cancer. The incidence rates in Europe varied between 40-130/100,000 person years for Basal Cell Carcinoma (BCC) and 8-30/100,000 person years for Squamous Cell Carcinoma (SCC) respectively. It is expected that NMSC may soon start to represent a major public health problem and pose a significant burden to any health care system [1]. Hence skin cancer became ideal topic of choice for many researchers. Various radiotherapy techniques have been developed to treat skin cancer: Superficial and orthovoltage X-rays, electron and megavoltage photon treatment and brachytherapy (Radionuclide and Electronic). The treatment choice is usually based on institutional resources and specialist experience and should consider local control, cosmesis, toxicity and convenience/expected compliance of the treatment. Electronic Brachytherapy (eBT) is an appropriate and effective treatment option for selected skin cancers, mainly NMSC that are not better served by surgical removal

With Regards,
Sara Giselle
Associate Managing Editor
 Journal of Medical Physics and Applied Sciences