3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer
PurposeTo investigate the values of a 3D-printed bolus ensuring the precise postmastectomy chest wall radiation therapy for breast cancer.Methods and materialsIn the preclinical study on the anthropomorphic phantom, the 3D-printed bolus was used for dosimetry and fitness evaluation. The dosimetric p...
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Frontiers Media S.A.
2022-09-01
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Series: | Frontiers in Oncology |
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Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.964455/full |
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author | Xiran Wang Jianling Zhao Zhongzheng Xiang Xuetao Wang Yuanyuan Zeng Ting Luo Ting Luo Xi Yan Xi Yan Zhuang Zhang Feng Wang Feng Wang Lei Liu Lei Liu |
author_facet | Xiran Wang Jianling Zhao Zhongzheng Xiang Xuetao Wang Yuanyuan Zeng Ting Luo Ting Luo Xi Yan Xi Yan Zhuang Zhang Feng Wang Feng Wang Lei Liu Lei Liu |
author_sort | Xiran Wang |
collection | DOAJ |
description | PurposeTo investigate the values of a 3D-printed bolus ensuring the precise postmastectomy chest wall radiation therapy for breast cancer.Methods and materialsIn the preclinical study on the anthropomorphic phantom, the 3D-printed bolus was used for dosimetry and fitness evaluation. The dosimetric parameters of planning target volume (PTV) were assessed, including Dmin, Dmax, Dmean, D95%, homogeneity index (HI), conformity index (CI), and organs at risk (OARs). The absolute percentage differences (|%diff|) between the theory and fact skin dose were also estimated, and the follow-up was conducted for potential skin side effects.ResultsIn preclinical studies, a 3D-printed bolus can better ensure the radiation coverage of PTV (HI 0.05, CI 99.91%), the dose accuracy (|%diff| 0.99%), and skin fitness (mean air gap 1.01 mm). Of the 27 eligible patients, we evaluated the radiation dose parameter (median(min–max): Dmin 4967(4789–5099) cGy, Dmax 5447(5369–5589) cGy, Dmean 5236(5171–5323) cGy, D95% 5053(4936–5156) cGy, HI 0.07 (0.06–0.17), and CI 99.94% (97.41%–100%)) and assessed the dose of OARs (ipsilateral lung: Dmean 1341(1208–1385) cGy, V5 48.06%(39.75%–48.97%), V20 24.55%(21.58%–26.93%), V30 18.40%(15.96%–19.16%); heart: Dmean 339(138–640) cGy, V30 1.10%(0%–6.14%), V40 0.38%(0%–4.39%); spinal cord PRV: Dmax 639(389–898) cGy). The skin doses in vivo were Dtheory 208.85(203.16–212.53) cGy, Dfact 209.53(204.14–214.42) cGy, and |%diff| 1.77% (0.89–2.94%). Of the 360 patients enrolled in the skin side effect follow-up study (including the above 27 patients), grade 1 was the most common toxicity (321, 89.2%), some of which progressing to grade 2 or grade 3 (32, 8.9% or 7, 1.9%); the radiotherapy interruption rate was 1.1%.ConclusionA 3D-printed bolus can guarantee the precise radiation dose on skin surface, good fitness to skin, and controllable acute skin toxicity, which possesses a great clinical application value in postmastectomy chest call radiation therapy for breast cancer. |
first_indexed | 2024-04-11T14:09:14Z |
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id | doaj.art-61dc40acb7d24f939cf8e4af708ff0b8 |
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last_indexed | 2024-04-11T14:09:14Z |
publishDate | 2022-09-01 |
publisher | Frontiers Media S.A. |
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spelling | doaj.art-61dc40acb7d24f939cf8e4af708ff0b82022-12-22T04:19:47ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.9644559644553D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancerXiran Wang0Jianling Zhao1Zhongzheng Xiang2Xuetao Wang3Yuanyuan Zeng4Ting Luo5Ting Luo6Xi Yan7Xi Yan8Zhuang Zhang9Feng Wang10Feng Wang11Lei Liu12Lei Liu13Department of Head and Neck and Mammary Oncology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Radiotherapy, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Head and Neck and Mammary Oncology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Radiotherapy, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Head and Neck and Mammary Oncology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Head and Neck and Mammary Oncology, West China Hospital, Sichuan University, Chengdu, ChinaClinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Head and Neck and Mammary Oncology, West China Hospital, Sichuan University, Chengdu, ChinaClinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, ChinaState Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, ChinaDepartment of Head and Neck and Mammary Oncology, West China Hospital, Sichuan University, Chengdu, ChinaClinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Head and Neck and Mammary Oncology, West China Hospital, Sichuan University, Chengdu, ChinaClinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, ChinaPurposeTo investigate the values of a 3D-printed bolus ensuring the precise postmastectomy chest wall radiation therapy for breast cancer.Methods and materialsIn the preclinical study on the anthropomorphic phantom, the 3D-printed bolus was used for dosimetry and fitness evaluation. The dosimetric parameters of planning target volume (PTV) were assessed, including Dmin, Dmax, Dmean, D95%, homogeneity index (HI), conformity index (CI), and organs at risk (OARs). The absolute percentage differences (|%diff|) between the theory and fact skin dose were also estimated, and the follow-up was conducted for potential skin side effects.ResultsIn preclinical studies, a 3D-printed bolus can better ensure the radiation coverage of PTV (HI 0.05, CI 99.91%), the dose accuracy (|%diff| 0.99%), and skin fitness (mean air gap 1.01 mm). Of the 27 eligible patients, we evaluated the radiation dose parameter (median(min–max): Dmin 4967(4789–5099) cGy, Dmax 5447(5369–5589) cGy, Dmean 5236(5171–5323) cGy, D95% 5053(4936–5156) cGy, HI 0.07 (0.06–0.17), and CI 99.94% (97.41%–100%)) and assessed the dose of OARs (ipsilateral lung: Dmean 1341(1208–1385) cGy, V5 48.06%(39.75%–48.97%), V20 24.55%(21.58%–26.93%), V30 18.40%(15.96%–19.16%); heart: Dmean 339(138–640) cGy, V30 1.10%(0%–6.14%), V40 0.38%(0%–4.39%); spinal cord PRV: Dmax 639(389–898) cGy). The skin doses in vivo were Dtheory 208.85(203.16–212.53) cGy, Dfact 209.53(204.14–214.42) cGy, and |%diff| 1.77% (0.89–2.94%). Of the 360 patients enrolled in the skin side effect follow-up study (including the above 27 patients), grade 1 was the most common toxicity (321, 89.2%), some of which progressing to grade 2 or grade 3 (32, 8.9% or 7, 1.9%); the radiotherapy interruption rate was 1.1%.ConclusionA 3D-printed bolus can guarantee the precise radiation dose on skin surface, good fitness to skin, and controllable acute skin toxicity, which possesses a great clinical application value in postmastectomy chest call radiation therapy for breast cancer.https://www.frontiersin.org/articles/10.3389/fonc.2022.964455/full3D-printed bolusbreast cancerPMRTdosimetryradiation dermatitis |
spellingShingle | Xiran Wang Jianling Zhao Zhongzheng Xiang Xuetao Wang Yuanyuan Zeng Ting Luo Ting Luo Xi Yan Xi Yan Zhuang Zhang Feng Wang Feng Wang Lei Liu Lei Liu 3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer Frontiers in Oncology 3D-printed bolus breast cancer PMRT dosimetry radiation dermatitis |
title | 3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer |
title_full | 3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer |
title_fullStr | 3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer |
title_full_unstemmed | 3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer |
title_short | 3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer |
title_sort | 3d printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer |
topic | 3D-printed bolus breast cancer PMRT dosimetry radiation dermatitis |
url | https://www.frontiersin.org/articles/10.3389/fonc.2022.964455/full |
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