Individualized 3D-printed bolus promotes precise postmastectomy radiotherapy in patients receiving breast reconstruction

Frontiers in Oncology, 2023 · DOI: 10.3389/fonc.2023.1239636 · Published: December 12, 2023

Simple Explanation

This study evaluates the use of 3D-printed boluses in breast cancer patients undergoing breast reconstruction and postmastectomy radiotherapy (PMRT) to improve dose distribution and reduce skin toxicities. The 3D-printed bolus ensures adequate dose coverage to the chest wall while minimizing the dose to organs at risk (OARs), leading to acceptable skin toxicity levels. The 3D-printed bolus provides better conformance to the chest wall compared to traditional boluses, reducing air gaps and improving dose uniformity.

Study Duration

October 2019 to July 2021

Participants

30 patients receiving breast reconstruction and PMRT

Evidence Level

Not specified

Key Findings

1
The 3D-printed bolus ensures the dose coverage of the planning target volume (PTV) with a homogeneity index (HI) of 0.12.
2
The bolus demonstrated excellent conformability with minimal air gaps between the bolus and the chest wall.
3
The bolus had acceptable dosage limits of organs at risk (OARs) and skin toxicity (grade 1, 76.0%; grade 2, 21.0%; grade 3, 3.3%).

Research Summary

This study evaluated the efficacy and safety of 3D-printed tissue compensations in breast cancer patients receiving breast reconstruction and postmastectomy radiotherapy (PMRT). The 3D-printed bolus ensures sufficient skin dose, uniform dosage in chest wall, excellent vital organ limits and acceptable skin toxicity in this patient subset. The study concludes that the customized 3D-printed bolus offers advantages in terms of dose uniformity and controllable skin toxicities.

Practical Implications

Improved Dose Uniformity

3D-printed boluses can provide more uniform radiation dose distribution to the chest wall, ensuring better treatment efficacy.

Reduced Skin Toxicities

The use of 3D-printed boluses can help in controlling and minimizing skin toxicities associated with PMRT.

Enhanced Precision Radiotherapy

The individualized nature of 3D-printed boluses allows for a more precise radiotherapy strategy for patients undergoing breast reconstruction and PMRT.

Study Limitations

1
Single-center clinical study with a limited sample size.
2
Lack of data on the effect of radiation on breast prosthesis capsular contracture.
3
No extended follow-up to analyze the survival outcomes of the study population.

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