Related Experiment Video
Updated: Aug 28, 2025
Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer
Xiran Wang1, Jianling Zhao2, Zhongzheng Xiang1
1Department of Head and Neck and Mammary Oncology, West China Hospital, Sichuan University, Chengdu, China.
Purpose:
To investigate the values of a 3D-printed bolus ensuring the precise postmastectomy chest wall radiation therapy for breast cancer.
Methods And Materials:
In the preclinical study on the anthropomorphic phantom, the 3D-printed bolus was used for dosimetry and fitness evaluation. The dosimetric parameters of planning target volume (PTV) were assessed, including Dmin, Dmax, Dmean, D95%, homogeneity index (HI), conformity index (CI), and organs at risk (OARs). The absolute percentage differences (|%diff|) between the theory and fact skin dose were also estimated, and the follow-up was conducted for potential skin side effects.
Results:
In preclinical studies, a 3D-printed bolus can better ensure the radiation coverage of PTV (HI 0.05, CI 99.91%), the dose accuracy (|%diff| 0.99%), and skin fitness (mean air gap 1.01 mm). Of the 27 eligible patients, we evaluated the radiation dose parameter (median(min-max): Dmin 4967(4789-5099) cGy, Dmax 5447(5369-5589) cGy, Dmean 5236(5171-5323) cGy, D95% 5053(4936-5156) cGy, HI 0.07 (0.06-0.17), and CI 99.94% (97.41%-100%)) and assessed the dose of OARs (ipsilateral lung: Dmean 1341(1208-1385) cGy, V5 48.06%(39.75%-48.97%), V20 24.55%(21.58%-26.93%), V30 18.40%(15.96%-19.16%); heart: Dmean 339(138-640) cGy, V30 1.10%(0%-6.14%), V40 0.38%(0%-4.39%); spinal cord PRV: Dmax 639(389-898) cGy). The skin doses in vivo were Dtheory 208.85(203.16-212.53) cGy, Dfact 209.53(204.14-214.42) cGy, and |%diff| 1.77% (0.89-2.94%). Of the 360 patients enrolled in the skin side effect follow-up study (including the above 27 patients), grade 1 was the most common toxicity (321, 89.2%), some of which progressing to grade 2 or grade 3 (32, 8.9% or 7, 1.9%); the radiotherapy interruption rate was 1.1%.
Conclusion:
A 3D-printed bolus can guarantee the precise radiation dose on skin surface, good fitness to skin, and controllable acute skin toxicity, which possesses a great clinical application value in postmastectomy chest call radiation therapy for breast cancer.
