Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-13T01:23:10.267Z Has data issue: false hasContentIssue false
  • English
  • Français

The use of 3D printing within radiation therapy to improve bolus conformity: a literature review

Published online by Cambridge University Press:  23 March 2017

Rebecca Pugh ,
Kelly Lloyd ,
Mark Collins  and
Angela Duxbury
Rebecca Pugh*
Affiliation:
Radiation Treatment, Wellington Blood and Cancer Centre, Wellington Regional Hospital, Wellington, New Zealand
Kelly Lloyd
Affiliation:
Radiation Treatment, Wellington Blood and Cancer Centre, Wellington Regional Hospital, Wellington, New Zealand
Mark Collins
Affiliation:
Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
Angela Duxbury
Affiliation:
Journal of Radiotherapy in Practice, Cambridge University Press, Cambridge, UK
*
Correspondence to: Rebecca Pugh, Radiation Treatment, Level 2, Wellington Blood and Cancer Centre, Wellington Regional Hospital, Private Bag 7902, Riddiford Street, Newtown, Wellington, New Zealand. Tel: +64 4 806 2000. E-mail: Becky.pugh@ccdhb.org.nz
Get access Rights & Permissions [Opens in a new window]

Abstract

Background and purpose

In radiotherapy (RT) bolus material is used to increase skin dose and eliminate the ‘skin-sparing’ effect. Bolus fabrication is limited to the expertise of the practitioner and is time and resource intensive for both patients and staff to construct bolus. In addition, prefabricated bolus does not always conform to irregular surfaces resulting in variations to dose distribution at the skin surface. The purpose of this paper is to ascertain whether it is feasible to improve bolus conformity within radiation therapy by using a 3D printer to fabricate bolus.

Method

A literature review was conducted that utilised Boolean terminology and included keywords; (‘3d’ OR ‘3-dimensional’ OR ‘three dimensional’) ‘bolus’ OR ‘boli’ conform*, (‘Radiation therapy’ OR ‘radiotherapy’) Printing.

Results

Several key papers were identified and critically evaluated based of the title of the feasibility of improving bolus conformity with the used of 3D printing. Several fabrication material devices were explored.

Findings

The literature advocates that fused deposition modelling fabrication device clear polylactic acid material to be an adequate product to construct 3D printed bolus and conform to irregular surfaces. 3D bolus would prove advantageous for volumetric arc therapy/intensity modulated radiation therapy techniques as literature has shown the presence of air gaps, small field sizes and large beam obliquity can result in a >10% dose reduction at skin surface.

Keywords

bolusradiotherapyradiotherapy planning3D printing
Type
Literature Reviews
Information
Journal of Radiotherapy in Practice , Volume 16 , Issue 3 , September 2017 , pp. 319 - 325
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Dunham, S 2015; Surgeon’s Helper: 3D printing is revolutionizing health care (Op-Ed). http://www.livescience.com/49913-3d-printing-revolutionizing-health-care.html. Accessed on 17th December 2015.Google Scholar
2. Zou, W, Fisher, T, Zhang, M et al. Potential of 3D printing technologies for fabrication of electron bolus and proton compensators. J Appl Med Phys 2015; 16 (4): 90–98.Google Scholar
3. Shin-wook, K, Hun-Joo, S, Chul, SK. A customized bolus produced using a 3-dimentional printer for radiotherapy. PLoS One 2013; 9 (10): e110746.Google Scholar
4. Su, S, Moaran, K, Robar, J. Design and production of 3D printed bolus for electron radiation therapy. J Appl Med Phys 2014; 4 (15): 194–211.Google Scholar
5. International Commission of Radiation Units and measurements report (ICRU). Prescribing, recording and reporting proton-beam therapy. J ICRU 2007; 7 (2).Google Scholar
6. SIGN 2014; Critical appraisal: notes and checklists. Healthcare improvement Scotland. http://www.sign.ac.uk/methodology/checklists.html Accessed on 5th January 2017.Google Scholar
7. Butson, M, Martin, J, Cheung, Tsang et al. Effects on skin dose from unwanted air gaps under bolus in photon beam radiotherapy. Radiat Meas 2000; 32 (3): 201–204.Google Scholar
8. Khan, Y, Villarreal-Bearajas, E, Udowics, M et al. Clinical and dosimetric implications of air gaps between bolus and skin surface during radiation therapy. J Cancer Therapy 2013; 4 (7): 1251–1255.Google Scholar
9. Burleson, S, Baker, J, Hsia, A et al. Use of 3D printers to create a patient-specific 3D bolus for external bean therapy. J Appl Med Phys 2015; 3 (16): 166–178.Google Scholar
10. Yeo, A. Clinically implementation of automated 3D printing technique to introduce better fitted bolus on patients undergoing radiotherapy (Lecture), 10th November 2015. Physics Department, Radiation Oncology Victoria, Genesis Care, VIC, Australia.Google Scholar
11. Kim, S-W, Shin, H-J, Kay, C et al. A customized bolus produced using a 3-dimensional printer for radiotherapy. PLoS One 2014; 9 (10): 1–8.Google Scholar
12. Harris, W. Howstuffworks: how 3D-bioprinting works. 2013 http://health.howstuffworks.com/medicine/modern-technology/3-d-bioprinting.htm. Accessed on 17th December 2015.Google Scholar