Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey
Objective: To investigate the dosimetric effects of using individualized silicone rubber (SR) bolus on the target area and organs at risk (OARs) during postmastectomy radiotherapy (PMRT), as well as evaluate skin acute radiation dermatitis (ARD). Methods: A retrospective study was performed on 30 pa...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2024-01-01
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| Series: | Technology in Cancer Research & Treatment |
| Online Access: | https://doi.org/10.1177/15330338241229367 |
| _version_ | 1797336240989667328 |
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| author | Xue-mei Chen MS Chen-di Xu MS Li-ping Zeng BS Xiao-tong Huang BS Ao-qiang Chen BS Lu Liu MS Liu-wen Lin BS Le-cheng Jia PhD Hua Li PhD Xiao-bo Jiang BS |
| author_facet | Xue-mei Chen MS Chen-di Xu MS Li-ping Zeng BS Xiao-tong Huang BS Ao-qiang Chen BS Lu Liu MS Liu-wen Lin BS Le-cheng Jia PhD Hua Li PhD Xiao-bo Jiang BS |
| author_sort | Xue-mei Chen MS |
| collection | DOAJ |
| description | Objective: To investigate the dosimetric effects of using individualized silicone rubber (SR) bolus on the target area and organs at risk (OARs) during postmastectomy radiotherapy (PMRT), as well as evaluate skin acute radiation dermatitis (ARD). Methods: A retrospective study was performed on 30 patients with breast cancer. Each patient was prepared with an individualized SR bolus of 3 mm thickness. Fan-beam computed tomography (FBCT) was performed at the first and second fractions, and then once a week for a total of 5 times. Dosimetric metrics such as homogeneity index (HI), conformity index (CI), skin dose (SD), and OARs including the heart, lungs, and spinal cord were compared between the original plan and the FBCTs. The acute side effects were recorded. Results: In targets' dosimetric metrics, there were no significant differences in D mean and V 105% between planning computed tomography (CT) and actual treatments ( P > .05), while the differences in D 95% , V 95% , HI, and CI were statistically significant ( P < .05). In OARs, there were no significant differences between the D mean , V 5 , and V 20 of the affected lung, V 5 of the heart and D max of the spinal cord ( P > .05) except the V 30 of affected lung, which was slightly lower than the planning CT ( P < .05). In SD, both D max and D mean in actual treatments were increased than plan A, and the difference was statistically significant ( P < .05), while the skin-V 20 and skin-V 30 has no difference. Among the 30 patients, only one patient had no skin ARD, and 5 patients developed ARD of grade 2, while the remaining 24 patients were grade 1. Conclusion: The OR bolus showed good anastomoses and high interfraction reproducibility with the chest wall, and did not cause deformation during irradiation. It ensured accurate dose delivery of the target and OARs during the treatment, which may increase SD by over 101%. In this study, no cases of grade 3 skin ARD were observed. However, the potential of using OR bolus to reduce grade 1 and 2 skin ARD warrants further investigation with a larger sample size. |
| first_indexed | 2024-03-08T08:50:27Z |
| format | Article |
| id | doaj.art-87661bd92ea94b87bda88d7508bbeccd |
| institution | Directory Open Access Journal |
| issn | 1533-0338 |
| language | English |
| last_indexed | 2024-03-08T08:50:27Z |
| publishDate | 2024-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Technology in Cancer Research & Treatment |
| spelling | doaj.art-87661bd92ea94b87bda88d7508bbeccd2024-02-01T11:04:12ZengSAGE PublishingTechnology in Cancer Research & Treatment1533-03382024-01-012310.1177/15330338241229367Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis SurveyXue-mei Chen MS0Chen-di Xu MS1Li-ping Zeng BS2Xiao-tong Huang BS3Ao-qiang Chen BS4Lu Liu MS5Liu-wen Lin BS6Le-cheng Jia PhD7Hua Li PhD8Xiao-bo Jiang BS9 State Key Laboratory of Oncology in South China, , Guangzhou, P.R. China State Key Laboratory of Oncology in South China, , Guangzhou, P.R. China Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong Province, P.R. China State Key Laboratory of Oncology in South China, , Guangzhou, P.R. China State Key Laboratory of Oncology in South China, , Guangzhou, P.R. China State Key Laboratory of Oncology in South China, , Guangzhou, P.R. China State Key Laboratory of Oncology in South China, , Guangzhou, P.R. China Shenzhen United Imaging Research Institute of Innovative Medical Equipment, Shenzhen, Guangdong Province, P.R. China Shenzhen United Imaging Research Institute of Innovative Medical Equipment, Shenzhen, Guangdong Province, P.R. China State Key Laboratory of Oncology in South China, , Guangzhou, P.R. ChinaObjective: To investigate the dosimetric effects of using individualized silicone rubber (SR) bolus on the target area and organs at risk (OARs) during postmastectomy radiotherapy (PMRT), as well as evaluate skin acute radiation dermatitis (ARD). Methods: A retrospective study was performed on 30 patients with breast cancer. Each patient was prepared with an individualized SR bolus of 3 mm thickness. Fan-beam computed tomography (FBCT) was performed at the first and second fractions, and then once a week for a total of 5 times. Dosimetric metrics such as homogeneity index (HI), conformity index (CI), skin dose (SD), and OARs including the heart, lungs, and spinal cord were compared between the original plan and the FBCTs. The acute side effects were recorded. Results: In targets' dosimetric metrics, there were no significant differences in D mean and V 105% between planning computed tomography (CT) and actual treatments ( P > .05), while the differences in D 95% , V 95% , HI, and CI were statistically significant ( P < .05). In OARs, there were no significant differences between the D mean , V 5 , and V 20 of the affected lung, V 5 of the heart and D max of the spinal cord ( P > .05) except the V 30 of affected lung, which was slightly lower than the planning CT ( P < .05). In SD, both D max and D mean in actual treatments were increased than plan A, and the difference was statistically significant ( P < .05), while the skin-V 20 and skin-V 30 has no difference. Among the 30 patients, only one patient had no skin ARD, and 5 patients developed ARD of grade 2, while the remaining 24 patients were grade 1. Conclusion: The OR bolus showed good anastomoses and high interfraction reproducibility with the chest wall, and did not cause deformation during irradiation. It ensured accurate dose delivery of the target and OARs during the treatment, which may increase SD by over 101%. In this study, no cases of grade 3 skin ARD were observed. However, the potential of using OR bolus to reduce grade 1 and 2 skin ARD warrants further investigation with a larger sample size.https://doi.org/10.1177/15330338241229367 |
| spellingShingle | Xue-mei Chen MS Chen-di Xu MS Li-ping Zeng BS Xiao-tong Huang BS Ao-qiang Chen BS Lu Liu MS Liu-wen Lin BS Le-cheng Jia PhD Hua Li PhD Xiao-bo Jiang BS Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey Technology in Cancer Research & Treatment |
| title | Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey |
| title_full | Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey |
| title_fullStr | Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey |
| title_full_unstemmed | Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey |
| title_short | Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey |
| title_sort | analysis of individualized silicone rubber bolus using fan beam computed tomography in postmastectomy radiotherapy a dosimetric evaluation and skin acute radiation dermatitis survey |
| url | https://doi.org/10.1177/15330338241229367 |
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