Clinical application of 3D-printed-step-bolus in post-total-mastectomy electron conformal therapy

Abstract

The 3D-printed boluses were used during the radiation therapy of the chest wall in six patients with breast cancer after modified radical mastectomy (MRM). We measured the in-vivo skin doses while both conventional and 3D-printed boluses were placed on the chest wall and compared the mean doses delivered to the ipsilateral lung and the heart. The homogeneity and conformity of the dose distribution in the chest wall for both types of boluses were also evaluated. The uniformity index on the chest skin was improved when the 3D-printed boluses were used, with the overall average skin dose being closer to the prescribed one in the former case (-0.47% versus -4.43%). On comparing the dose-volume histogram (DVH), it was found that the 3D-printed boluses resulted in a reduction in the mean dose to the ipsilateral lung by up to 20%. The precision of dose delivery was improved by 3% with the 3D-printed boluses; in contrast, the conventional step bolus resulted in a precision level of 5%. In conclusion, the use of the 3D-printed boluses resulted in better dose homogeneity and conformity to the chest wall as well as the sparing of the normal organs, especially the lung. This suggested that their routine use on the chest wall as a therapeutic approach during post-mastectomy radiation therapy offers numerous advantages over conventional step boluses.

Three-dimensional printer-generated patient-specific phantom for artificial in vivo dosimetry in radiotherapy quality assurance

“…Several previous works had employed ABS filament because its physical properties closely resemble those of water [17,25,26]. However, ABS filament can undergo considerable deformation during cooling [16,18,19]; thus, we employed PLA filament. The results of this study demonstrate slight geometric errors between the CT scanned image of the anthropomorphic head phantom and the 3D-printed phantom, mostly in the bottom region.…”

“…Ju et al suggested a new system for manufacturing a range compensator in proton therapy, using an industrial 3D printer with ultraviolet curable acrylic plastic [15]. Park et al fabricated a patientspecific customized bolus, using a low-cost personal 3D printer with a polylactic acid (PLA) filament, and evaluated its feasibility for posttotal-mastectomy electron conformal therapy [16]. Further, Ehler et al demonstrated the construction of a patient-specific phantom, using a 3D printer with an acrylonitrile butadiene styrene (ABS) filament for dosimetry [17].…”

“…PLA filaments are generally more robust to warping during cooling than ABS filaments [16,18,19]. The aim of this study is to construct a system for the fabrication of patient-specific phantoms, using a 3D printer with a PLA filament and to evaluate the feasibility of this 3Dprinted phantom for artificial in vivo dosimetry in radiotherapy QA.…”

Intraoperative use of dexmedetomidine promotes postoperative sleep and recovery following radical mastectomy under general anesthesia

“…Radical mastectomy under general anesthesia is a widely-used therapy in patients with breast cancer [ 13 - 15 ]. It has been known that breast cancer patients undergoing radical mastectomy experience severe sleep disturbance and fatigue [ 16 , 17 ], which might lead to prolonged convalescence and additional hospital costs.…”

Quality assurance for a six degrees‐of‐freedom table using a 3D printed phantom

“…Moreover, the emergence of 3D printing technology in various arenas in medicine has garnered similar interest in radiation oncology. A significant amount of effort into 3D printing has been utilized for patient‐specific devices, which include: bolus for electron treatments, compensators for photon treatments, and patient immobilization . 3D printing in brachytherapy applicators has also been investigated.…”