Clinical Research Papers:
Clinical application of 3D-printed-step-bolus in post-total-mastectomy electron conformal therapy
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Kwangwoo Park1, Sungjin Park2, Mi-Jin Jeon1, Jinhyun Choi1, Jun Won Kim1, Yoon Jin Cho1, Won-Seok Jang1, Yo Sup Keum3 and Ik Jae Lee1
1 Department of Radiation Oncology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Gangnam-gu, Seoul, Korea
2 Department of Textiles, Fashion and Merchandising, College of Human Ecology, Seoul National University, Gwanak-gu, Seoul, Korea
3 Texas A&M Health Science Center College of Medicine, Bryan, Texas, USA
Ik Jae Lee, email:
Keywords: 3D-printed bolus, 3D printer, MRM, electron conformal therapy, dosimetery
Received: June 20, 2016 Accepted: October 19, 2016 Published: October 23, 2016
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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