AbstractObjective To develop three-dimensional (3D) printed tissue compensators for irregular body surface in radiotherapy. Methods Pre-clinical evaluation was made among human phantoms with no tissue compensators, commercially available tissue equivalent bolus, and 3D printed tissue compensators. Perineal computed tomography (CT) images were acquired from the above three human phantoms with the same prescription dose to the same target volume (D95%=100 cGy). Intensity-modulated radiotherapy plans for the three human phantoms were designed using the same treatment planning system. The dosimetric parameters of planning target volume (PTV) were compared between the three plans. The dosimetric parameters were evaluated among 10 patients who were treated with 3D printed tissue compensators. Results The electron density of the selected material was 1.00-1.01. The phantoms with no tissue compensators, commercially available tissue equivalent bolus, and 3D printed tissue compensators had Dmax of 182.9, 118.9, and 114.8 cGy, Dmean of 146.2, 107.7, and 104.1 cGy, and homogeneity index (HI) of 0.565, 0.15, and 0.11 for PTV, respectively. All the 10 patients had highly personalized 3D printed tissue compensators with satisfactory dose homogeneity (HI=0.03-0.15 with a median of 0.06). Five patients with Paget′s disease of penis and scrotum benefited from the support and fixation by 3D printed tissue compensators. Conclusions The highly personalized 3D printed tissue compensators can provide a positioning support for patients and effectively increase the dose to the skin.
Zhang Min,Zhao Bo,Yin Jinpeng et al. Application of new three-dimensional printed tissue compensators in radiotherapy[J]. Chinese Journal of Radiation Oncology, 2017, 26(2): 210-214.
Zhang Min,Zhao Bo,Yin Jinpeng et al. Application of new three-dimensional printed tissue compensators in radiotherapy[J]. Chinese Journal of Radiation Oncology, 2017, 26(2): 210-214.
[1] Martin JB,Tsang C,Peter Y,et al. Effects on skin dose from unwanted air gaps under bolus in photon beam radiotherapy[J].Radiat Measure,2000,32(3):201-204. [2] 李承军,胡健,张爱华,等.6 MV X 线时组织等效补偿膜与人体空气间隙对表面剂量的影响[J].医疗卫生装备,2011,32(3):83-84. Li CJ,Hu J,Zhang AH,et al. Surface Dose Perturbation Due to Air Gap Between Patient and Bolus for 6 MV X-ray[J].Chin Med Equip J,2011,32(3):83-84. [3] Camilleri J,Laprie A,Kerjean P,et al. Ep-1242,optimization of dose prescription in skin carcinomas radiotherapy:how to use boluses effectively?[J].Radiother Oncol,2012,103(Suppl 1):s475-476. [4] 刘星,覃强,罗美华.自制阴茎固定装置作阴茎癌放疗[J].四川肿瘤防治,2006,19(4):272-273. Liu X,Qin Q,Luo MH.The self-made fixing device for penis penis cancer radiotherapy[J]. Sichuan tumor prevention and treatment,2006,19(4):272-273. [5] Lobb E.Bolus-dependent dosimetric effect of positioning errors for tangential scalp radiotherapy with helical tomotherapy[J].Med Dosim,2014,39(1):93-97.DOI:10.1016/j.meddos.2013.10.005. [6] George HP,Marsha DM,John AA,et al. A custom three-dimensional electron bolus technique for optimization of postmastectomy irradiation[J].Int J Radiat Oncol Biol Phys,2001,51(4) 1142-1151.