Dosimetric Characterization of 3D Printed Bolus with Polylactic Acid (PLA) in Breast Cancer External Beam Radiotherapy

Document Type : Original Paper

Authors

1 Departement of Physics, Faculty of Mathematics and Natural Science, Universitas Andalas, Padang, West Sumatra, Indonesia

2 Andalas University Hospital, Padang, West Sumatra, Indonesia

Abstract

Introduction: In this study, 3-Dimention (3D) polylactic acid (PLA) bolus were characterized as human tissue equivalent and specially designed for use in electron radiotherapy of breast cancer.
Material and Methods: This study uses the main material PLA with variations in the infill percentage when printing, which is  (20, 40, 60, 80, and 100) %. Dosimetric characterization included measuring the value of Relative Electron Density (RED) and measuring the absorbed dose using LINAC 15 MeV, which was tested using a breast mannequin and compared with a commercial bolus at Andalas University Hospital.
Results: The results showed that the 3D bolus made of PLA provided uniformity in terms of thickness so that every part of the body surface covered by the bolus would get an even dose. 3D bolus made of PLA in all variations in the infill percentage had a RED value equivalent to human tissue. They can help ensure that the bolus does not significantly change the radiation dose distribution, achieving optimal treatment outcomes. However, a bolus with an infill percentage of 20% has a RED value closest to the breast RED, which is 0.99 and can absorb radiation of 1.98 Gy more optimally compared to a commercial bolus that can absorb 1.97 Gy from 2 Gy doses given.
Conclusion: The 3D bolus made of PLA can be an effective alternative for treating breast cancer using electron radiotherapy.

Keywords

Main Subjects

References

  1. da Luz FAC, da Costa Marinho E, Nascimento CP, de Andrade Marques L, Duarte MBO, Delfino PFR, et al. The effectiveness of radiotherapy in preventing disease recurrence after breast cancer surgery. Surg Oncol. 2022;41:101709. Available from: https://doi.org/10.1016/j.suronc.2022.101709.
  2. Sutanto H, Eko H, Gede JW, Santi. AY, Suparman Suppa Astri SS. Bolus Berbahan Silicone dan Natural Rubber. Semarang: Undip Press. 2018. Available from: https://clinicsofsurgery.com/uploads/IMG_936135.pdf
  3. Rumgay H, Shield K, Charvat H, Ferrari P, Sornpaisarn B, Obot I, et al. Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study. Lancet Oncol. 2021;22(8):1071–
  4. Podgorsak EB. Radiation Oncology Physics: A Handbook for Teachers and Students, [Internet]. Vienna: IAEA; 2019. Available from: https://ecommons.aku.edu/pakistan_fhs_mc_radiat_oncol/16
  5. Wang KM, Rickards AJ, Bingham T, Tward JD, Price RG. Technical note: Evaluation of a silicone-based custom bolus for radiation therapy of a superficial pelvic tumor. J Appl Clin Med Phys [Internet]. 2022;(January 2021):1– Available from: https://doi.org/10.1002/acm2.13538
  6. Fan J, Xu G, Yang D, Chen W, Zhang D, Wang M, et al. Fabrication and Application of 3D Printed Bolus for Optimizing Radiotherapy in Superficial Tumor. Clin Surg [Internet]. 2021;06(12). Available from: https://clinicsofsurgery.com/uploads/IMG_936135.pdf
  7. Lobo D, Banerjee S, Srinivas C, Ravichandran R, Putha SK, Saxena PP, et al. Influence of air gap under bolus in the dosimetry of a clinical 6 MV photon beam. Journal of Medical Physics. 2020 Jul 1;45(3):175-81. Available from: https://doi.org/10.4103/jmp.JMP_53_20.
  8. Park SY, Choi CH, Park JM, Chun M, Han JH, Kim JI. A patient-specific polylactic acid bolus made by a 3D printer for breast cancer radiation therapy. PloS one. 2016 Dec 8;11(12):e0168063. Available from: https://doi.org/ 10.1371/journal.pone.0168063
  9. Lizondo M, Latorre-Musoll A, Ribas M, Carrasco P, Espinosa N, Coral A, et al. Pseudo skin flash on VMAT in breast radiotherapy: optimization of virtual bolus thickness and HU values. Physica Medica. 2019 Jul 1;63:56-62.
  10. Schneider U, Pedroni E, Lomax A. The calibration of CT Hounsfield units for radiotherapy treatment planning. Physics in Medicine & Biology. 1996;41(1):111.
  11. Li JS, Pawlicki T, Deng J, Jiang SB, Mok E, Ma CM. Validation of a Monte Carlo dose calculation tool for radiotherapy treatment planning. Physics in Medicine & Biology. 2000 Oct 1;45(10):2969.
  12. Ricotti R, Ciardo D, Pansini F, Bazani A, Comi S, Spoto R, et al. Dosimetric characterization of 3D printed bolus at different infill percentage for external photon beam radiotherapy. Phys Medica. 2017;39:25– Available from: https://doi.org/10.1016/j.ejmp.2017.06.004.
  13. Chantika L. Perbandingan Dosis Serap Bolus Berbahan Plastisin Dengan Bolus Berbahan Silicone Rubber. 2021.
  14. Endarko E, Aisyah S, Carina CC, Nazara T, Sekartaji G, Nainggolan A. Evaluation of dosimetric properties of handmade bolus for megavoltage electron and photon radiation therapy. Journal of Biomedical Physics & Engineering. 2021 Dec;11(6):735.
  15. Hellstrom, Kristina, Atila, Dan Lucian. A Broad Literature Review of Density Measurements of Liquid Cast Iron. Metals (Basel). 2017;7:165–
  16. Diaz-Merchan JA, Martinez-Ovalle SA, Vega-Carrillo HR. Characterization of a novel material to be used as bolus in radiotherapy with electrons. Appl Radiat Isot [Internet]. 2022;183:110154. Available from: https://doi.org/10.1016/j.apradiso.2022.110154
  17. Lu Y, Song J, Yao X, An M, Shi Q, Huang X. 3D Printing Polymer-based Bolus Used for Radiotherapy. Int J Bioprinting. 2021;7(4):27–
  18. Ren L, Wang Y, Xie Y, Chen Y, Zhou Z, Liu D. Dosimetric characteristics of 3D-printed bolus for postmastectomy radiotherapy. ournal Radiother Pract. 2019;18(2):184–
  19. Hariyanto AP, Fachrina UM, Levina A, Endarko E, dan Bambang HS. Fabrication and characterization of bolus material using propylene glycol for radiation therapy. Iran J Med Phys. 2020;70(3):161– Available from: http://eprints.mums.ac.ir/18713/
  20. Poon I, Fung KW, Lam KO, Cheung FW, Yu PK, Tung SY. Dosimetric impact of 3D-printed bolus in postmastectomy radiotherapy. Technol Cancer Res Treat. 2017;16(4):425–
  21. Yang J, Xu S, Zhu T, Ding X, Chen J. Dosimetric evaluation of 3D-printed bolus for chest wall radiotherapy. J Appl Clin Med Phys. 2017;18(3):44–
  22. Zou W, Fisher T, Zhang M, Kim L, Chen T, Narra V, et al. Potential of 3D printing technologies for fabrication of electron bolus and proton compensators. J Appl Clin Med Phys. 2015;16(3):90– Available from: https://doi.org/10.1093/jrr/rrac013.
  23. Hosseini FS, Baghani HR, Robatjazi M, Mowlavi AA, Porouhan P. Performance evaluation of buildup bolus during external radiotherapy of mastectomy patients: treatment planning and film dosimetry. Medical & Biological Engineering & Computing. 2023 Feb;61(2):435-44.
  24. Sasaki T, Kohno R, Shimizu Y. Development of a patient-specific bolus using 3D printing for intensity-modulated radiation therapy. J Radiat Res. 2016;57(6):712–

 

 

 

 

 

 

Iranian Journal of Medical Physics
Volume 21, Issue 3 - Serial Number 3
May and June 2024
Pages 211-216

Files

History

  • Receive Date: 21 December 2022
  • Revise Date: 09 April 2023
  • Accept Date: 12 April 2023

Share

How to cite

Statistics