Jörg Licher, Julia Achenbach, Janett Köhn, Markus Diefenhardt, Maximilian Fleischmann, Claus Rödel, Nikolaos Tselis, Ulla Ramm, Christian Scherf
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引用次数: 0
Abstract
Purpose: Facial skin cancer of 42 elderly frail patients was treated with individualised 3D-printed mould applicators for high-dose-rate (HDR) brachytherapy. The dosimetric outcome was compared to conventionally manufactured individual moulds used before.
Methods: Tumour-adapted HDR brachytherapy source paths were pre-planned and dosimetrically optimised in the brachytherapy treatment planning system (TPS) using computed tomography (CT) data and considered in the design of the patient-individual moulds. Dosimetric outcome for the planning target volumes and organs at risk were statistically evaluated and compared for pre-planning, final clinical treatment planning with TG-43 formalism and retrospective tissue, material and CT density related TG-186 calculations.
Results: Pre-planning allows reliable brachytherapy source paths design to achieve intended dosimetric clinical goals. The 3D-printed patient-specific moulds show a clear advantage in the dosimetric coverage of the target volume (improving D90 from 98.3% to 104.3%) and the protection of the relevant organs at risk (reduction up to 30% of maximum Dose). With the 3D-printed moulds only minor deviations were observed for TG-43 and TG-186 dose recalculations of the treated plans.
Conclusion: Customised 3D printed moulds offer a safe and efficient technique to treat facial skin cancer in critical locations and complex clinical situations with HDR brachytherapy. The two-step planning process results in reliable PTV dose coverage and efficient sparing of eye lenses and eyeballs. Dosimetric outcome and interfractional position reproducibility with 3D printed moulds were superior to conventionally manufactured facial moulds with respect to the clinical goals.
期刊介绍：
Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research.
Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.
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