Application of thermoplastic elastomer (TPE) bolus in postmastectomy radiotherapy |
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Affiliation: | 1. Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China;2. Department of Respiratory Critical Care Medicine/Thoracic Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China;3. Department of Radiotherapy/Department of Head and Neck Oncology, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China |
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Abstract: | PurposeTo assess the planned dose, in vivo dosimetry, acute skin toxicity, pain, and distress using Thermoplastic Elastomer (TPE) bolus for postmastectomy radiotherapy (PMRT).Material and methodsThirty-two PMRT patients with TPE bolus (17 patients for 25 fractions, 15 patients for the first 20 fractions) were selected for the study. The acute skin toxicity, pain, and psychological distress were assessed from the first treatment week to the fourth week after the end of treatment. At the first treatment, the MOSFET was used in vivo dosimetry measurement.ResultsIn vivo dosimetry with the bolus, the dose deviation ranged from −6.22% to −1.56% for 5 points. The presence of grade 1 and 2 skin toxicity reached its peak (70.0% and 13.3%) in the sixth week. Two patients (6.6%) with 25 fractions bolus experienced moist desquamation in the fifth and seventh week, with pain score 2 and 3, and interruptions of 3 and 5 days, respectively. The incidence of pain score 1, 2, and 3 peaked in the fifth (33.3%), fourth (33.3%), and seventh (10.0%) week. No patients experienced grade 3 skin toxicity and severe pain. One patient had significant anxiety, and two patients had significant depression.ConclusionThe TPE bolus can accurately fit skin and improve the surface dose to more than 90%. Twenty fractions with TPE bolus had similar skin toxicity and pain to those without bolus and did not increase patients' distress and clinical workload, compared with the literature's data, which is an alternative to the 3D printing bolus for PMRT. |
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Keywords: | TPE bolus Postmastectomy radiotherapy In vivo dosimetry Skin toxicity Pain CI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" Conformity Index PTV" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" Planning Target Volume HI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" Homogeneity Index VMAT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" Volumetric Modulated Arc Therapy TPE" },{" #name" :" keyword" ," $" :{" id" :" kwrd0080" }," $$" :[{" #name" :" text" ," _" :" Thermoplastic Elastomer PMRT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0090" }," $$" :[{" #name" :" text" ," _" :" Postmastectomy Radiation Therapy DT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0100" }," $$" :[{" #name" :" text" ," _" :" Distress Thermometer GAD-7" },{" #name" :" keyword" ," $" :{" id" :" kwrd0110" }," $$" :[{" #name" :" text" ," _" :" Generalized Anxiety Disorder 7-item Scale PHQ-9" },{" #name" :" keyword" ," $" :{" id" :" kwrd0120" }," $$" :[{" #name" :" text" ," _" :" Patient Health Questionnaire-9 OAR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0140" }," $$" :[{" #name" :" text" ," _" :" Organ at Risk PRV" },{" #name" :" keyword" ," $" :{" id" :" kwrd0150" }," $$" :[{" #name" :" text" ," _" :" Planning Risk Volume CBCT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0160" }," $$" :[{" #name" :" text" ," _" :" Cone Beam Computer Tomography IMRT" },{" #name" :" keyword" ," $" :{" id" :" pc_l4G2NXWMRd" }," $$" :[{" #name" :" text" ," _" :" Intensity-Modulated Radiation Therapy |
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