Dosimetric assessment of bolus for postmastectomy radiotherapy

Kawamoto, Terufumi; Shikama, Naoto; Kurokawa, Chie; Hara, Naoya; Oshima, Masaki; Sasai, Keisuke

doi:10.1016/j.meddos.2020.08.001

Cited by 10 publications

(5 citation statements)

References 11 publications

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“…As a basic experiment in our hospital, we measured the skin dose under the 1-, 2-, 3-, or 5-mm bolus on the chest wall using a phantom. We con rmed the previous nding that the mean surface dose of a 1-mm-thick daily bolus approximated that of a halftime 5-mm-thick bolus [10].…”

Section: Introductionsupporting

confidence: 86%

A prospective feasibility study of a 1-mm bolus for postmastectomy radiotherapy

Kawamoto

Shikama

Kurokawa

et al. 2020

Preprint

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BackgroundThere remains wide variation in the use of chest wall boluses for postmastectomy radiotherapy (PMRT). Therefore, we aimed to prospectively evaluate the use of a 1-mm-thick daily tissue-equivalent bolus in patients who received PMRT using thermoluminescent dosimeters (TLDs) and skin toxicity assessment.Materials and MethodsWe collected data from patients with a 1-mm-thick daily bolus during PMRT at The Juntendo University Hospital. The surface dose was measured in vivo under the 1-mm-thick bolus on the chest wall. We assessed the acute skin toxicity weekly during PMRT, and 1, 2, 4, and 12 weeks after the completion of PMRT.ResultsA total of 19 patients aged 32 − 79 years old received PMRT from July 2019 to January 2020. All patients completed the protocol treatment without interruptions, and the median follow-up was 32 weeks. In vivo dosimetry analysis revealed surface doses between 77% and 113% of the prescribed dose, with a mean of 92% of the prescribed radiation dose, and a standard deviation of 7% being delivered. Grade 2 dermatitis was found in 10 patients (53%), and Grade 3 dermatitis was found in one patient (5%). All cases of Grade 2 and 3 dermatitis were improved 4 weeks after PMRT. There were no cases of Grade 4 dermatitis and no chest wall recurrences during the treatment or follow-up period.ConclusionsThe 1-mm-thick daily bolus is a feasible regimen for PMRT, with appropriate dose buildup and acceptable skin toxicity without treatment interruptions.Trial registrationThe University Hospital Medical Information Network Clinical Trials Registry, UMIN000035773. Registered 1 July 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000040622

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Section: Introductionsupporting

confidence: 86%

A prospective feasibility study of a 1-mm bolus for postmastectomy radiotherapy

Kawamoto

Shikama

Kurokawa

et al. 2020

Preprint

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“…3D printing bolus can accurately fit the surface, which can reduce the dose deviation [ 2 , 3 ], reduce the radiation dose of the distal organ at risk (OAR) (such as heart and lung) [ 4 ], and reduce the setup time [ 2 ]. However, 3D printing bolus usually requires a second CT scan for simulation [ 5 , 6 ], more than 10 h of segmentation and printing [ 2 , 7 ], and may be more financial costs than commercial bolus [ 2 , [6] , [7] , [8] ]. To avoid the second CT scan and reduce the waiting time for treatment start, Dipasquale G et al [ 6 ] used a high-resolution surface-scanner to produce bolus models to avoid the second CT scan and reduce waiting time for treatment.…”

Section: Introductionmentioning

confidence: 99%

Application of thermoplastic elastomer (TPE) bolus in postmastectomy radiotherapy

Gong

Dai²,

Wang³

et al. 2022

The Breast

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“…To deliver prescription doses to tumors close to the surface, more doses are delivered even if there is no tumor in the maximum dose depth [10][11][12]. To overcome these drawbacks, a bolus is used to treat photon beams, allowing as much dose to be delivered to the tumor [11,13,14]. Properties that adhere closely to the skin are essential for use as a bolus.…”

Section: Introductionmentioning

confidence: 99%

Assessing Commercial CLEANBOLUS Based on Silicone for Clinical Use

Son

Jung

Park

et al. 2021

Progress in Medical Physics

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We investigated the properties of CLEANBOLUS based on silicone with suitable characteristics for clinical use. Methods:We evaluated the characteristics of CLEANBOLUS and compared the results with the commercial product (Super-Flex bolus). Also, we conducted physical evaluations, including shore hardness, element composition, and elongation break. Transparency was investigated through the measured absorbance within the visible region (400-700 nm). Also, dosimetric characteristics were investigated with surface dose and beam quality. Finally, the volume of unwanted air gap was investigated based on computed tomography images for breast, chin, and nose using Super-Flex bolus and CELANBOLUS.Results: CLEANBOLUS showed excellent physical properties for a low shore hardness (000-35) and elongation break (>1,000%). Additionally, it was shown that CLEANBOLUS is more transparent than Super-Flex bolus. Dosimetric results obtained through measurement and calculation have an electron density similar to water in CLEANBOLUS. Finally, CLEANBOLUS showed that the volume of unwanted air gap between the phantom and each bolus is smaller than Super-Flex bolus for breast, chin, and nose. Conclusions:The physical properties of CLEANBOLUS, including excellent adhesive strength and lower shore hardness, reduce unwanted air gaps and ensure accurate dose distribution. Therefore, it would be an alternative to other boluses, thus improving clinical use efficiency.

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Dosimetric assessment of bolus for postmastectomy radiotherapy

Cited by 10 publications

References 11 publications

A prospective feasibility study of a 1-mm bolus for postmastectomy radiotherapy

A prospective feasibility study of a 1-mm bolus for postmastectomy radiotherapy

Application of thermoplastic elastomer (TPE) bolus in postmastectomy radiotherapy

Assessing Commercial CLEANBOLUS Based on Silicone for Clinical Use

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