Poltorak Michal, Banatkiewicz Pawel, Poltorak Lukasz, Sobolewski Piotr, Zimon Damian, Szwast Maciej, Walecka Irena
The National Institute of Medicine of the Ministry of the Interior and Administration, Warsaw, Poland.
Electrochemistry@Soft Interfaces Team, Department of Inorganic and Analytical Chemistry, Faculty of Chemistry, University of Lodz, Lodz, Poland.
J Contemp Brachytherapy. 2024 Apr;16(2):156-169. doi: 10.5114/jcb.2024.137357. Epub 2024 Mar 28.
Brachytherapy is a type of radiation therapy, in which a radiation source is placed directly or close to a tumor. It is commonly used to treat skin cancer, and enables precise irradiation treatment of affected area (planning target volume - PTV) while minimizing exposure dose to surrounding healthy tissue (organs at risk - OARs). Recently, the use of 3D printing has begun revolutionizing brachytherapy, as it allows manufacturing of custom-designed applicators for unique shape of skin topography, tumor, and surrounding tissues. Outcome of the combination of 3D printing and brachytherapy has several advantages over traditional treatment planning methods. Some of the advantages are intuitive, whereas others can be concluded from a literature overview as follows: 1) Possibility of developing patient-specific applicators that precisely match the shape of tumor area; 2) Reduction of the time required for applicator production, especially when custom-made devices are needed; 3) Reduction of manufacturing costs; 4) Treatment procedures improvement; 5) Improvement of safety measures accelerated by the development of smart materials (e.g., polymer filaments with admixture of heavy elements); 6) Possibility of nearly instant adjustment into tumor treatment (applicators can be changed as the tumor is changing its shape); and 7) Applicators designed to securely fit to treatment area to hold radioactive source always in the same place for each fraction. Consequently, tumor-provided dose is accurate and leads to effective treatment. In this review paper, we investigated the current state-of-the-art of the application of 3D printing in brachytherapy. A number of existing reports were chosen and reviewed in terms of printing technology, materials used, treatment effectiveness, and fabrication protocols. Furthermore, the development of future directions that should be considered by collaborative teams bridging different fields of science, such as medicine, physics, chemistry, and material science were summarized. With the indicated topics, we hope to stimulate the innovative progress of 3D printing technology in brachytherapy.
近距离放射治疗是一种放射治疗方法，其中放射源直接放置在肿瘤处或靠近肿瘤。它通常用于治疗皮肤癌，能够对受影响区域（计划靶区 - PTV）进行精确的照射治疗，同时将对周围健康组织（危及器官 - OARs）的暴露剂量降至最低。最近，3D打印的应用开始彻底改变近距离放射治疗，因为它允许制造针对皮肤表面、肿瘤和周围组织的独特形状定制设计的施源器。3D打印与近距离放射治疗相结合的结果相对于传统治疗计划方法具有几个优点。其中一些优点很直观，而其他优点可以从文献综述中总结如下：1）开发与肿瘤区域形状精确匹配的患者特异性施源器的可能性；2）减少施源器生产所需的时间，特别是在需要定制设备时；3）降低制造成本；4）改善治疗程序；5）通过智能材料（例如含有重元素混合物的聚合物细丝）的开发加速安全措施的改进；6）几乎可以即时调整以适应肿瘤治疗（随着肿瘤形状的变化可以更换施源器）；7）设计的施源器能够牢固地贴合治疗区域，使放射源在每次分割时始终保持在同一位置。因此，肿瘤所接受的剂量准确，从而实现有效的治疗。在这篇综述论文中，我们研究了3D打印在近距离放射治疗中的应用现状。选择了一些现有报告，并从打印技术、使用的材料、治疗效果和制造方案等方面进行了综述。此外，还总结了跨医学、物理、化学和材料科学等不同科学领域的合作团队应考虑的未来发展方向。通过上述主题，我们希望激发3D打印技术在近距离放射治疗中的创新进展。
