Novel intraoperative radiotherapy utilizing prefabricated custom three-dimensionally printed high-dose-rate applicators
| Autor: | Antonio L. Damato, Evan B. Rosen, Hilda E. Stambuk, Alexander S. Drew, Brandon S. Imber, Suzanne L. Wolden, Gil'ad N. Cohen, Ian Ganly, Evan Matros, Leonard H. Wexler |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Neoplasm Residual medicine.medical_treatment Brachytherapy Article 030218 nuclear medicine & medical imaging 03 medical and health sciences Intraoperative Period 0302 clinical medicine Neoplasms medicine High doses Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Child Base of skull business.industry Radiotherapy Planning Computer-Assisted Soft tissue Equipment Design Radiation therapy Oncology 030220 oncology & carcinogenesis Printing Three-Dimensional Female Radiotherapy Adjuvant Radiology Dose rate business Intraoperative radiotherapy Preoperative imaging |
| Zdroj: | Brachytherapy |
| ISSN: | 1873-1449 |
| Popis: | Background Intraoperative radiotherapy (IORT) is an effective strategy for the delivery of high doses of radiotherapy to a residual tumor or resection cavity with relative sparing of nearby healthy tissues. This strategy is an important component of the multimodality management of pediatric soft tissue sarcomas, particularly in cases where patients have received prior courses of external beam radiotherapy. Purpose Tumor beds with significant topographic irregularity remain a therapeutic challenge because existing IORT technologies are typically most reliable with flat surfaces. To address this limitation, we have developed a novel strategy to create custom, prefabricated high-dose-rate (HDR)-IORT applicators designed to match the shape of an anticipated surgical cavity. Methods and Materials Silastic applicators are constructed using three-dimensional (3D) printing and are derived from volumetric segmentation of preoperative imaging. Results HDR preplanning with the applicators improves dosimetric accuracy and minimizes incremental operative time. In this report, we describe the fabrication process for the 3D-printed applicators and detail our experience utilizing this strategy in two pediatric patients who underwent HDR-IORT as part of complex base of skull sarcoma resections. Conclusions Early experience suggests that usage of the custom applicators is feasible, versatile for a variety of clinical situations, and enables the uniform delivery of high superficial doses of radiotherapy to irregularly shaped surgical cavities. |
| Databáze: | OpenAIRE |
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