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

 Kwangwoo Park  ;  Sungjin Park  ;  Mi-Jin Jeon  ;  Jinhyun Choi  ;  Jun Won Kim  ;  Yoon Jin Cho  ;  Won-Seok Jang  ;  Yo Sup Keum  ;  Ik Jae Lee 
 ONCOTARGET , Vol.8(15) : 25660-26558, 2017 
Journal Title
Issue Date
Aged ; Breast Neoplasms/pathology ; Breast Neoplasms/radiotherapy* ; Breast Neoplasms/surgery ; Female ; Humans ; Mastectomy ; Middle Aged ; Neoplasm Staging ; Postoperative Care ; Radiometry ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Conformal/methods* ; Treatment Outcome ; Tumor Burden
3D printer ; 3D-printed bolus ; MRM ; dosimetery ; electron conformal therapy
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.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Park, Kwang Woo(박광우) ORCID logo https://orcid.org/0000-0002-9843-7985
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Jang, Won Seok(장원석)
Jeon, Mi Jin(전미진)
Cho, Yoon Jin(조윤진)
Choi, Jinhyun(최진현)
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