Patrick Melby

Leipzig Cone Applicator

Skin cancers can be difficult types of cancers to control using radiation. Particularly,
small lesions provide a challenge to treat the area without treating an excess of healthy tissue.
Because of their effectiveness close to the skin surface many times electrons are used to treat
skin cancers. Difficulties arise when field sizes are smaller than the practical range of the
electrons. In these fields the percentage depth dose changes creating the need for additional
measurement to confirm the correct dose is being placed.1 Other than orthovoltage machines
which are rarely available, the Leipzig cone applicator can provide adequate coverage of small
superficial lesions.
The Leipzig cone applicator consists of a Tungsten-allow cone that shields an Iridium192 form the rest of the room. Figure 1 displays the how it looks along with how it is place on
the skin. There are two types of applicators, a vertical and a horizontal applicator. Both provide
similar shielding, but the dose rate to depth differs depending on the orientation of the source
coming into the cone.2 The two different dose rates are shown in figure 2. These applicators are
used for lesions less than 4 mm deep. After 3mm the dose rapidly begins to fall off because of
the low energy of the photons. The Leipzig Cone has no flattening filter, so the isodose lines
bow out.3 Because of this, a 3cm cone can give adequate coverage to a lesion smaller than 2cm.
Another skin applicator similar to the Leipzig is the Valencia. The Valencia has a flattening
filter, which slows down the dose rate, but helps to smooth out the isodose lines. These
applicators work best on smooth, irregular surfaces. Irregular surfaces cause a skin gaps which
can affect the isodose distribution.
Other areas in which the Leipzig cone applicator has been used include oral cavities and
the vaginal cuff.1 Treatments using a Leipzig Cone applicator with an Iridium-192 source has
been proven to effectively treat surface lesions.3

References:
1. Prez-Calatayud J, Granero D, Ballester F et al. A dosimetric study of Leipzig applicators.
International Journal of Radiation Oncology*Biology*Physics. 2005;62(2):579-584.
doi:10.1016/j.ijrobp.2005.02.028.

2. Sarudis, S. Dose distribution beneath the Leipzig skin applicator set.

http://ki.se/sites/default/files/sebastian_sarudis_exjobb.pdf. Stockholm: Thesis University of
Stockholm, 2006. Accessed April 21, 2016.
3. 2. Miller RJ. Skin HDR applicators. Aboutcancercom. Available at:
http://aboutcancer.com/skin_hdr_applicators.htm. Accessed April 21, 2016.

Figure 1. The source placement within a horizontal and vertical applicators.

Figure 2. The dose rate of the horizontal and vertical applicators.