TY - JOUR
T1 - Three-dimensional printer-aided casting of soft, custom silicone boluses (SCSBs) for head and neck radiation therapy
AU - Chiu, Tsuicheng
AU - Tan, Jun
AU - Brenner, Mathew
AU - Gu, Xuejun
AU - Yang, Ming
AU - Westover, Kenneth
AU - Strom, Tobin
AU - Sher, David
AU - Jiang, Steve
AU - Zhao, Bo
N1 - Publisher Copyright:
© 2017 American Society for Radiation Oncology
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Purpose: Custom tissue compensators provide dosimetric advantages for treating superficial or complex anatomy, but currently available fabrication technology is expensive or impractical for most clinical operations and yields compensators that are difficult for patients to tolerate. We aimed to develop an inexpensive, clinically feasible workflow for generating patient-specific, soft, custom silicone boluses (SCSBs) for head-and-neck (HN) radiation therapy. Methods and materials: We developed a method using 3-dimensional printed parts for generating SCSBs for the treatment of HN cancers. The clinical workflow for generation of SCSBs was characterized inclusive of patient simulation to treatment in terms of resource time and cost. Dosimetric properties such as percentage depth dose and dose profiles were measured for SCSBs using GaF films. Comprehensive measurements were also conducted on an HN phantom. SCSBs were generated and used for electron or photon based radiation treatments of 7 HN patients with lesions at nose, cheek, eye, or ears. In vivo dose measurements with optically simulated luminescence dosimeters were performed. Results: Total design and fabrication time from patient simulation to radiation treatment start required approximately 1 week, with fabrication constituting 1 to 2 working days depending on bolus surface area, volume, and complexity. Computed tomography and dosimetric properties of the soft bolus were similar to water. In vivo dose measurements on 7 treated patients confirmed that the dose deposition conformed to planned doses. Material costs were lower than currently available hard plastic boluses generated with 3-dimensional printing technology. All treated patients tolerated SCSBs for the duration of therapy. Conclusions: Generation and use of SCSBs for clinical use is feasible and effective for the treatment of HN cancers.
AB - Purpose: Custom tissue compensators provide dosimetric advantages for treating superficial or complex anatomy, but currently available fabrication technology is expensive or impractical for most clinical operations and yields compensators that are difficult for patients to tolerate. We aimed to develop an inexpensive, clinically feasible workflow for generating patient-specific, soft, custom silicone boluses (SCSBs) for head-and-neck (HN) radiation therapy. Methods and materials: We developed a method using 3-dimensional printed parts for generating SCSBs for the treatment of HN cancers. The clinical workflow for generation of SCSBs was characterized inclusive of patient simulation to treatment in terms of resource time and cost. Dosimetric properties such as percentage depth dose and dose profiles were measured for SCSBs using GaF films. Comprehensive measurements were also conducted on an HN phantom. SCSBs were generated and used for electron or photon based radiation treatments of 7 HN patients with lesions at nose, cheek, eye, or ears. In vivo dose measurements with optically simulated luminescence dosimeters were performed. Results: Total design and fabrication time from patient simulation to radiation treatment start required approximately 1 week, with fabrication constituting 1 to 2 working days depending on bolus surface area, volume, and complexity. Computed tomography and dosimetric properties of the soft bolus were similar to water. In vivo dose measurements on 7 treated patients confirmed that the dose deposition conformed to planned doses. Material costs were lower than currently available hard plastic boluses generated with 3-dimensional printing technology. All treated patients tolerated SCSBs for the duration of therapy. Conclusions: Generation and use of SCSBs for clinical use is feasible and effective for the treatment of HN cancers.
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U2 - 10.1016/j.prro.2017.11.001
DO - 10.1016/j.prro.2017.11.001
M3 - Article
C2 - 29452869
AN - SCOPUS:85041953524
SN - 1879-8500
VL - 8
SP - e167-e174
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
IS - 3
ER -