title: 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.
authors: Department of Radiation Oncology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Gangnam-gu, Seoul, Korea.
authors: Kwangwoo
authors: K
authors: Park
authors: Department of Textiles, Fashion and Merchandising, College of Human Ecology, Seoul National University, Gwanak-gu, Seoul, Korea.
authors: Sungjin
authors: S
authors: Park
authors: Department of Radiation Oncology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Gangnam-gu, Seoul, Korea.
authors: Mi-Jin
authors: MJ
authors: Jeon
authors: Department of Radiation Oncology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Gangnam-gu, Seoul, Korea.
authors: Jinhyun
authors: J
authors: Choi
authors: Department of Radiation Oncology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Gangnam-gu, Seoul, Korea.
authors: Jun Won
authors: JW
authors: Kim
authors: Department of Radiation Oncology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Gangnam-gu, Seoul, Korea.
authors: Yoon Jin
authors: YJ
authors: Cho
authors: Department of Radiation Oncology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Gangnam-gu, Seoul, Korea.
authors: Won-Seok
authors: WS
authors: Jang
authors: Texas A&M Health Science Center College of Medicine, Bryan, Texas, USA.
authors: Yo Sup
authors: YS
authors: Keum
authors: Department of Radiation Oncology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Gangnam-gu, Seoul, Korea.
authors: Ik Jae
authors: IJ
authors: Lee
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care; D011874:Radiometry; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D020266:Radiotherapy, Conformal / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: 3D printer; 3D-printed bolus; MRM; dosimetery; electron conformal therapy