A Customized 3D-Printed Bolus for High-Risk Breast Cancer with Skin Infiltration: A Pilot Study.

Autor: Takanen S; Radiation Oncology Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy., Ianiro A; Medical Physics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy., Pinnarò P; Radiation Oncology Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy., Infusino E; Medical Physics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy., Marucci L; Radiation Oncology Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy., Soriani A; Medical Physics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy., Sanguineti G; Radiation Oncology Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy., Iaccarino G; Medical Physics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy.
Jazyk: angličtina
Zdroj: Current oncology (Toronto, Ont.) [Curr Oncol] 2024 Sep 05; Vol. 31 (9), pp. 5224-5232. Date of Electronic Publication: 2024 Sep 05.
DOI: 10.3390/curroncol31090386
Abstrakt: Background: In high-risk breast cancer patients with skin infiltration, the administration of a uniform dose to superficial tissues is fundamental in order to reduce local skin relapse. A personalized bolus may prevent the potential inadequate dose distribution of a standard bolus due to air gaps between the bolus and the skin. In this pilot study, we introduced into clinical practice the use of a personalized 3D-printed bolus filled with ultrasound transmission gel.
Methods: Seven patients undergoing radiotherapy after mastectomy were selected. A 3D-printed bolus dosimetric assessment was performed with MOSFET dosimeters on an anthropomorphic phantom and, subsequently, on three selected cases with increasing bolus shape irregularity. Acute/late toxicity and local control were assessed.
Results: Overall, for the clinical cases, the percentage median difference between the measured and calculated doses was -2.7% (-7.0-4.9%). The median follow-up was 21 months. After two years, one patient showed G2 pain, one patient manifested G1 telangiectasia, one patient showed G1 hyperpigmentation, and two patients had no relevant toxicity.
Conclusions: A personalized 3D-printed bolus filled with ultrasound gel may easily reproduce the standard bolus' consistency and provide accurate coverage of the target area with tolerable acute/late toxicity grades. This is a pilot study, and further investigations are needed.
Databáze: MEDLINE
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