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KMID : 1164220190310010075
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Journal of Korean Society for Radiotherapeutic Technology
2019 Volume.31 No. 1 p.75 ~ p.81
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Radiation Therapy Using M3 Wax Bolus in Patients with Malignant Scalp Tumors
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Kwon Da-Eun
Hwang Ji-Hye
Park In-Seo
Yang Jun-Cheol
Kim Su-Jin
You Ah-Young
Won Yeong-Jin
Kwon Kyung-Tae
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Abstract
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Purpose : Helmet type bolus for 3D printer is being manufactured because of the disadvantages of Bolus materials when photon beam is used for the treatment of scalp malignancy. However, PLA, which is a used material, has a higher density than a tissue equivalent material and inconveniences occur when the patient wears PLA. In this study, we try to treat malignant scalp tumors by using M3 wax helmet with 3D printer.
Methods and materials : For the modeling of the helmet type M3 wax, the head phantom was photographed by CT, which was acquired with a DICOM file. The part for helmet on the scalp was made with Helmet contour. The M3 Wax helmet was made by dissolving paraffin wax, mixing magnesium oxide and calcium carbonate, solidifying it in a PLA 3D helmet, and then eliminated PLA 3D Helmet of the surface. The treatment plan was based on Intensity-Modulated Radiation Therapy (IMRT) of 10 Portals, and the therapeutic dose was 200 cGy, using Analytical Anisotropic Algorithm (AAA) of Eclipse.
Then, the dose was verified by using EBT3 film and Mosfet (Metal Oxide Semiconductor Field Effect Transistor: USA), and the IMRT plan was measured 3 times in 3 parts by reproducing the phantom of the head human model under the same condition with the CT simulation room.
Results : The Hounsfield unit (HU) of the bolus measured by CT was 52±37.1. The dose of TPS was 186.6 cGy, 193.2 cGy and 190.6 cGy at the M3 Wax bolus measurement points of A, B and C, and the dose measured three times at Mostet was 179.66±2.62 cGy, 184.33±1.24 cGy and 195.33±1.69 cGy. And the error rates were ?3.71 %, -4.59 %, and 2.48 %. The dose measured with EBT3 film was 182.00±1.63 cGy, 193.66±2.05 cGy and 196±2.16 cGy. The error rates were -2.46 %, 0.23 % and 2.83 %.
Conclusions : The thickness of the M3 wax bolus was 2 cm, which could help the treatment plan to be established by easily lowering the dose of the brain part. The maximum error rate of the scalp surface dose was measured within 5 % and generally within 3 %, even in the A, B, C measurements of dosimeters of EBT3 film and Mosfet in the treatment dose verification. The making period of M3 wax bolus is shorter, cheaper than that of 3D printer, can be reused and is very useful for the treatment of scalp malignancies as human tissue equivalent material. Therefore, we think that the use of casting type M3 wax bolus, which will complement the making period and cost of high capacity Bolus and Compensator
in 3D printer, will increase later.
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KEYWORD
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M3 Wax Bolus, Helmet, IMRT, Mosfet, Gafchromic EBT3 Film
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