# Initial Clinical Experience of a Novel Shapeable Bolus for Radiotherapy in a Patient With a Facial Cutaneous Squamous Cell Carcinoma: A Case Report

## TL;DR

A new shapeable bolus improves radiation therapy for facial skin cancer by providing a more uniform dose and better adherence to the skin.

## Contribution

The first clinical use of a novel shapeable bolus for radiotherapy in facial skin cancer is reported.

## Key findings

- The HM bolus provided a more uniform dose to the target compared to a plan without it.
- The bolus adhered stably to the patient's skin without clinical issues.

## Abstract

Radiation therapy with X-rays for skin cancer uses a bolus to increase the surface dose. Commercial gel sheet boluses adhere poorly to the patient’s body because of surface irregularities. This causes an air gap and reduces the surface dose. We have developed a novel shapeable bolus (HM bolus; Hayakawa Rubber Co., Ltd., Hiroshima, Japan), and we describe the first clinical application of this bolus here. The case was an 82-year-old male with a facial cutaneous squamous cell carcinoma. The postoperative radiotherapy plan using the HM bolus provided a more uniform dose to the target compared with a plan without the HM bolus. The HM bolus adhered stably to the patient’s skin, and there were no issues with its clinical use.