| Wang Yong,Sun Yanze,Han Wenmin,et al.Application of visualized thermosensitive color-changing bolus in postmastectomy radiotherapy for breast cancer[J].Chinese Journal of Radiological Medicine and Protection,2025,45(5):431-437 |
| Application of visualized thermosensitive color-changing bolus in postmastectomy radiotherapy for breast cancer |
| Received:August 08, 2024 |
| DOI：10.3760/cma.j.cn112271-20240808-00301 |
| KeyWords:Breast cancer Postmastectomy radiotherapy (PMRT) Visualized thermosensitive Tissue compensator (bolus) |
| FundProject:“十四五”江苏省医学重点学科建设单位(肿瘤治疗学科)(JSDW202236);苏州市科技计划(医疗卫生科技创新)项目(SKY2022167);苏州大学附属第二医院科研预研基金(SDFEYHT2429) |
| Author Name | Affiliation | E-mail | | Wang Yong | Department of Radiotherapy Oncology, Second Affiliated Hospital of Soochow University, Institute of Radiotherapy Oncology, Soochow University, Suzhou Key Laboratory for Radiation Oncology, Suzhou 215004, China | | | Sun Yanze | Department of Radiotherapy Oncology, Second Affiliated Hospital of Soochow University, Institute of Radiotherapy Oncology, Soochow University, Suzhou Key Laboratory for Radiation Oncology, Suzhou 215004, China | syzkk0109@163.com | | Han Wenmin | Department of Radiotherapy Oncology, Second Affiliated Hospital of Soochow University, Institute of Radiotherapy Oncology, Soochow University, Suzhou Key Laboratory for Radiation Oncology, Suzhou 215004, China | | | Qian Jianjun | Department of Radiotherapy Oncology, Second Affiliated Hospital of Soochow University, Institute of Radiotherapy Oncology, Soochow University, Suzhou Key Laboratory for Radiation Oncology, Suzhou 215004, China | | | Zhao Peifeng | Department of Radiotherapy Oncology, Second Affiliated Hospital of Soochow University, Institute of Radiotherapy Oncology, Soochow University, Suzhou Key Laboratory for Radiation Oncology, Suzhou 215004, China | | | Chen Liesong | Department of Radiotherapy Oncology, Second Affiliated Hospital of Soochow University, Institute of Radiotherapy Oncology, Soochow University, Suzhou Key Laboratory for Radiation Oncology, Suzhou 215004, China | | | Zhu Yaqun | Department of Radiotherapy Oncology, Second Affiliated Hospital of Soochow University, Institute of Radiotherapy Oncology, Soochow University, Suzhou Key Laboratory for Radiation Oncology, Suzhou 215004, China | | | Tian Ye | Department of Radiotherapy Oncology, Second Affiliated Hospital of Soochow University, Institute of Radiotherapy Oncology, Soochow University, Suzhou Key Laboratory for Radiation Oncology, Suzhou 215004, China | |
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| Abstract:: |
| Objective To explore the feasibility and advantages of applying visualized thermosensitive color-changing bolus in postmastectomy radiotherapy (PMRT) for breast cancer. Methods Forty patients with breast cancer treated with PMRT in the Second Affiliated Hospital of Soochow University from June 2023 to June 2024 were prospectively selected. They were randomly divided into test and control groups (also referred to as groups A and B, respectively), with 20 patients in each group. Group A, underwent two CT scans: the first scan without bolus (image A1) and the second scan with visualized thermosensitive color-changing bolus (image A2). They were treated with visualized thermosensitive color-changing bolus. Group B also underwent two CT scans: the first scan without bolus (image B1) and the second scan with conventional commercial bolus (image B2), and then were treated with conventional commercial bolus. In the radiotherapy planning, images A1 and A2 were designed as A1-Plan and A2-Plan, and A3-Plan was created by transferring the A1-Plan onto image A2. Images B1 and B2 were designed as B1-Plan and B2-Plan, and B3-Plan was created by transferring the B1-Plan onto image B2. The radiation fields and target optimization functions were identical. The dosimetric differences and skin toxicity reactions between different plans were compared. Results In Group A, A1-Plan and A2-Plan manifested no statistically significant differences (P > 0.05) in the doses to organs at risk (OARs), including the ipsilateral lung (V5 Gy, V10 Gy, V20 Gy), heart (Dmean), contralateral breast (Dmean), and skin (Dmax and Dmean), target homogeneity index (HI), conformity index (CI), prescription dose volume (V50 Gy), depth of maximum dose (Dmax), and monitor unit (MU). In Group B, B3-Plan compared to B1-Plan showed reduced V50 Gy (89.9% vs. 95%), HI (0.153 vs. 0.136), and CI (0.817 vs. 0.810), while the two plans displayed no statistically significant differences in doses to OARs. In contrast, A3-Plan and B3-Plan exhibited statistically significant differences (t = 2.78, 2.29, -0.47, 0.51, 3.13, P < 0.05) in V50 Gy (94.05% vs. 89.90%), Dmax (5665.4 cGy vs. 5 632.7 cGy), HI (0.148 vs. 0.163), CI (0.83 vs. 0.82), and skin Dmean (5153.6 cGy vs. 5048.2 cGy). Compared to the conventional commercial bolus of the same thickness, the visualized thermosensitive color-changing bolus yielded a significantly reduced air cavity volume (3833 mm3 vs. 21498 mm3, t = -9.65, P < 0.05). Both groups experienced only grade I skin toxicity reactions. Conclusions Compared to the conventional commercial bolus of the same thickness, the visualized thermosensitive color-changing bolus shows a more effective dosimetric distribution in terms of target coverage, HI, and CI, a higher fit to the skin, highly visualized air cavity, and higher positional repeatability in fractionated radiotherapy, demonstrating high practicality and safety. |
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