Asfia Amirhossein, Novak James I, Mohammed Mazher Iqbal, Rolfe Bernard, Kron Tomas
School of Engineering, Faculty of Science, Engineering and Built Environment, Deakin University, Geelong, Victoria, Australia.
ARC Industrial Transformation Training Centre in Additive Bio-manufacturing, Brisbane, Queensland, Australia.
Phys Imaging Radiat Oncol. 2020 Mar 20;13:30-35. doi: 10.1016/j.phro.2020.03.003. eCollection 2020 Jan.
Radiotherapy is one of the most effective cancer treatment techniques, however, delivering the optimal radiation dosage is challenging due to movements of the patient during treatment. Immobilisation devices are typically used to minimise motion. This paper reviews published research investigating the use of 3D printing (additive manufacturing) to produce patient-specific immobilisation devices, and compares these to traditional devices.
A systematic review was conducted across thirty-eight databases, with results limited to those published between January 2000 and January 2019. A total of eighteen papers suitably detailed the use of 3D printing to manufacture and test immobilisers, and were included in this review. This included ten journal papers, five posters, two conference papers and one thesis.
61% of relevant studies featured human subjects, 22% focussed on animal subjects, 11% used phantoms, and one study utilised experimental test methods. Advantages of 3D printed immobilisers reported in literature included improved patient experience and comfort over traditional methods, as well as high levels of accuracy between immobiliser and patient, repeatable setup, and similar beam attenuation properties to thermoformed immobilisers. Disadvantages included the slow 3D printing process and the potential for inaccuracies in the digitisation of patient geometry.
It was found that a lack of technical knowledge, combined with disparate studies with small patient samples, required further research in order to validate claims supporting the benefits of 3D printing to improve patient comfort or treatment accuracy.
放射治疗是最有效的癌症治疗技术之一，然而，由于治疗过程中患者的移动，提供最佳辐射剂量具有挑战性。固定装置通常用于尽量减少运动。本文回顾了已发表的关于使用3D打印（增材制造）生产患者特异性固定装置的研究，并将其与传统装置进行比较。
在38个数据库中进行了系统综述，结果限于2000年1月至2019年1月期间发表的研究。共有18篇论文详细介绍了使用3D打印制造和测试固定器的情况，并纳入了本综述。其中包括10篇期刊论文、5篇海报、2篇会议论文和1篇论文。
61%的相关研究以人类为研究对象，22%关注动物对象，11%使用模型，一项研究采用实验测试方法。文献中报道的3D打印固定器的优点包括与传统方法相比改善了患者体验和舒适度，以及固定器与患者之间的高度准确性、可重复设置，以及与热成型固定器相似的束衰减特性。缺点包括3D打印过程缓慢以及患者几何形状数字化可能存在不准确之处。
研究发现，由于缺乏技术知识，再加上针对小样本患者的不同研究，需要进一步研究以验证支持3D打印改善患者舒适度或治疗准确性的益处的说法。
