Son Jaeman, Kang Seonghee, Jin Jegal, Park Hyojun, Lee Inbum, Huh Yoonsuk, Choi Chang Heon, Kim Jung-In, Wu Hong-Gyun
Department of Radiation Oncology, Seoul National University Hospital, Seoul 03080, Republic of Korea.
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
J Clin Med. 2025 May 28;14(11):3796. doi: 10.3390/jcm14113796.
: The use of a patient-specific bolus in radiation therapy is critical for achieving precise dose delivery, particularly for irregular anatomical surfaces. Conventional boluses often suffer from poor conformity and air gaps, leading to suboptimal dose distribution. This study aimed to develop and evaluate a novel bolus fabrication method using the mold-and-casting (M&C) technique, which integrates 3D printing and flexible silicone materials to address these limitations. : The proposed workflow includes CT imaging, 3D modeling, mold fabrication via 3D printing, and silicone casting to produce a patient-specific bolus. The process is followed by quality assurance steps and clinical application. Geometric accuracy was assessed through surface matching and cross-sectional comparisons, and dosimetric performance was evaluated using in vivo measurements with MOSFET detectors. The biocompatibility of the silicone material was tested according to standardized cytotoxicity, skin sensitization, and irritation protocols. : The fabricated boluses demonstrated high geometric fidelity, with volumetric and surface discrepancies of less than 3% compared to the planned structures. Dosimetric evaluations indicated that maximum dose differences remained within the clinically acceptable range of ±5%, confirming accurate dose delivery. Biocompatibility tests confirmed that the silicone material is safe for clinical use. : The M&C method offers a streamlined approach to patient-specific bolus fabrication that integrates well into existing clinical workflows. Compared to traditional sheet boluses, it significantly reduces air gaps and enhances surface dose uniformity. These findings support the clinical potential of this technique to improve both precision and efficiency in radiation therapy.
在放射治疗中使用针对患者的个体化填充物对于实现精确的剂量输送至关重要，特别是对于不规则的解剖表面。传统的填充物常常存在贴合性差和气隙问题，导致剂量分布不理想。本研究旨在开发并评估一种使用模具铸造（M&C）技术的新型填充物制造方法，该方法整合了3D打印和柔性硅酮材料以解决这些局限性。
所提出的工作流程包括CT成像、3D建模、通过3D打印制造模具以及硅酮浇铸以生产针对患者的个体化填充物。该过程之后是质量保证步骤和临床应用。通过表面匹配和横截面比较评估几何精度，并使用MOSFET探测器进行体内测量来评估剂量学性能。根据标准化的细胞毒性、皮肤致敏和刺激方案测试硅酮材料的生物相容性。
制造出的填充物显示出高几何保真度，与计划结构相比，体积和表面差异小于3%。剂量学评估表明最大剂量差异保持在临床可接受的±5%范围内，证实了剂量输送的准确性。生物相容性测试证实硅酮材料在临床上使用是安全的。
M&C方法为针对患者的个体化填充物制造提供了一种简化的方法，能够很好地融入现有的临床工作流程。与传统的片状填充物相比，它显著减少了气隙并提高了表面剂量均匀性。这些发现支持了该技术在提高放射治疗的精度和效率方面的临床潜力。
