Customized 3D Bolus Applied to the Oral Cavity and Supraclavicular Area for Head and Neck Cancer

Baek, Seunghyeop; Ahn, Sohyun; Ju, Eunbin; Jung, Nuri

doi:10.21873/invivo.12294

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…In pCT images, the HU range of the EVA material in the paddle blade was between -70 and 140, while the HU range of the tongue was between -20 and 70. Additionally, Baek et al and Yoshizawa et al reported that the customized 3D bolus in the oral cavity resulted in a better dose build-up effect [ 33 , 34 ]. Huang et al found that a 3D printed silicone bite block could reduce the dose to the adjacent normal tissues and improve dosimetric parameters such as dose homogeneity index and conformity index [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Novel tongue-positioning device to reduce tongue motions during radiation therapy for head and neck cancer: Geometric and dosimetric evaluation

Jung,

Kim,

Lee

et al. 2023

PLoS ONE

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This study aimed to assess the performance of a tongue-positioning device in interfractional tongue position reproducibility by cone-beam computed tomography (CBCT). Fifty-two patients treated with radiation therapy (RT) while using a tongue positioning device were included in the study. All patients were treated with 28 or 30 fractions using the volumetric modulated arc therapy technique. CBCT images were acquired at the 1st, 7th, 11th, 15th, 19th, 23th, and 27th fractions. Tongues on planning computed tomography (pCT) and CBCT images were contoured in the treatment planning system. Geometric differences in the tongue between pCT and CBCT were assessed by the Dice similarity coefficient (DSC) and averaged Hausdorff distance (AHD). Two-dimensional in vivo measurements using radiochromic films were performed in 13 patients once a week during sessions. The planned dose distributions were compared with the measured dose distributions using gamma analysis with criteria of 3%/3 mm. In all patients, the mean DSC at the 1st fraction (pCT versus 1st CBCT) was 0.80 while the mean DSC at the 27th fraction (pCT versus 27th CBCT) was 0.77 with statistical significance (p-value = 0.015). There was no statistically significant difference in DSC between the 1st fraction and any other fraction, except for the 27th fraction. There was statistically significant difference in AHD between the 1st fraction and the 19th, 23th, and 27th fractions (p-value < 0.05). In vivo measurements showed an average gamma passing rate of 90.54%. There was no significant difference between measurements at the 1st week and those at other weeks. The tongue geometry during RT was compared between pCT and CBCT. In conclusion, the novel tongue-positioning device was found to minimize interfractional variations in position and shape of the tongue.

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Section: Discussionmentioning

confidence: 99%

Novel tongue-positioning device to reduce tongue motions during radiation therapy for head and neck cancer: Geometric and dosimetric evaluation

Jung,

Kim,

Lee

et al. 2023

PLoS ONE

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“…For example, Baek et al applied 3D boluses during the RT of patients with cancer of the oral cavity and the supraclavicular area. The authors showed that it was possible to reduce the dose delivered to the surrounding normal tissue by 14.4% while maintaining the target coverage [ 14 ]. In addition, Kim et al treated patients with mycosis fungoides using a 3D bolus and accurately delivered doses that were within 0.3–2.1% of the planned treatment dose [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Application of a Customized 3D-Printed Bolus in Radiation Therapy for Distal Extremities

Ahn

Choi

et al. 2023

Life

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In radiation therapy (RT) for skin cancer, tissue-equivalent substances called boluses are widely used to ensure the delivery of an adequate dose to the skin surface and to provide a radioprotective effect for normal tissue. The aim of this study was to develop a new type of three-dimensional (3D) bolus for RT involving body parts with irregular geometries and to evaluate its clinical feasibility. Two 3D-printed boluses were designed for two patients with squamous cell carcinoma (SCC) of their distal extremities based on computed tomography (CT) images and printed with polylactic acid (PLA). The clinical feasibility of the boluses was evaluated by measuring the in vivo skin dose at the tumor site with optically stimulated luminescence detectors (OSLDs) and comparing the results with the prescribed and calculated doses from the Eclipse treatment planning system (TPS). The average measured dose distribution for the two patients was 94.75% of the prescribed dose and 98.8% of the calculated dose. In addition, the average measured dose during repeated treatments was 189.5 ± 3.7 cGy, thus demonstrating the excellent reproducibility of the proposed approach. Overall, the customized 3D-printed boluses for the RT of distal extremities accurately delivered doses to skin tumors with improved reproducibility.

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“…The current National Comprehensive Cancer Network Breast guidelines state: ‘Special consideration should be given to the use of bolus material to ensure that the skin dose is adequate’ ( 15 , 16 ). Worldwide, bolus material has been used frequently in breast cancer treatment to increase the surface dose effect ( 17 ); however, to the best of our knowledge, there have been only two reports of its use in oral cancer ( 18 , 19 ). In these case reports, the indications were limited to tongue cancer and cancer of the palate; however, in our case reports, we used their method at various sites of oral cancer and reported on the clinical courses and adverse effects such as oral mucositis, dysgeusia, and ORN.…”

Section: Introductionmentioning

confidence: 99%

Spacers with boluses applied to various sites of oral squamous cell carcinoma: Technical note and retrospective case series

et al. 2021

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The present report describes a case series in which spacers with boluses were used at various sites in the oral cavity to enhance the therapeutic effect of radiation therapy in oral squamous cell carcinoma. In radiotherapy, the surface dose is reduced due to the build-up region of X-rays. In the present study, a bolus was used to complement the build-up region and increase the surface dose effect. A total of 7 patients with oral cancer from a primary care hospital underwent radiation therapy using spacers and added boluses to improve the surface dose effect. The spacer was made from a plastic splint and the bolus was connected to the splint with a quick self-curing resin. There were no complaints of pain or adverse events from the patients while wearing the intraoral splint. A total of 2 of the 7 patients were subsequently confirmed as having progressed disease, and the remaining 5 are currently being managed following a complete response to treatment. The spacers used at various sites of oral squamous cell carcinoma were safe and effective and did not cause any severe adverse effects.

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Customized 3D Bolus Applied to the Oral Cavity and Supraclavicular Area for Head and Neck Cancer

Cited by 3 publications

References 9 publications

Novel tongue-positioning device to reduce tongue motions during radiation therapy for head and neck cancer: Geometric and dosimetric evaluation

Novel tongue-positioning device to reduce tongue motions during radiation therapy for head and neck cancer: Geometric and dosimetric evaluation

Clinical Application of a Customized 3D-Printed Bolus in Radiation Therapy for Distal Extremities

Spacers with boluses applied to various sites of oral squamous cell carcinoma: Technical note and retrospective case series

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