Journal of Radiation Research and Radiation Processing, Volume. 41, Issue 3, 030307(2023)

Dosimetric difference analysis of various bolus regimens in post-mastectomy intensity modulated radiotherapy

Ruijun NIU, Yuexiao QI, Na TAO, Qing GUO, Xiyi WEI, Liying GAO**, Fali TAO, Tingting LIU, Jianqiang CHENG, and Shihong WEI*
Author Affiliations
  • Gansu Provincial Cancer Hospital, Lanzhou 730050, China
  • show less

    The study aimed to analyze and compare dosimetric differences with various thicknesses and frequencies of bolus in post-mastectomy intensity-modulated radiotherapy. Based on the Oncentra4.1 treatment planning system, Thirty-eight post-mastectomy patients were selected randomly between 2017 and 2021. Three sets of simulated treatment planning with 5_mm all, 5_mm half, and 10_mm half virtual boluses were formed. A total prescribed dose of 50 Gy regimen was delivered in 25 fractions over 5 weeks, in which half-time bolus was used for 15 out of 25 fractions. The dosimetric parameters of target areas, skin, and organs at risk were compared. Furthermore, normal tissue complication probability (NTCP) was evaluated for the skin. Regarding the D2, D50, V90, V95, and V115 of the clinical target volume, the 5_mm all bolus group was prominently better than other groups, and the D50 and V90 of the clinical target volumes were statistically significant (p < 0.05). Regarding the D2, D50, D95, D98, Dmax, V90, V95, V115, homogeneity index (HI), and conformity index of the planning target volume, the 5_mm thick bolus group was prominently better than other groups, and the D50, D95, D98, V90, V95, and HI of the clinical target volumes were statistically significant (p < 0.05). For organs at risk, there was no statistical significance for the three planning groups, but the 5_mm all bolus group was prominently better than other groups in the V45 of the esophagus, V30, V40, and Dmax of the heart, V50, Dmax, and Dmean of the humerus head, V20, V30, and Dmax of the left lung, Dmax and Dmean of the thyroid, and Dmean of the trachea. Calculated with the 5_mm all bolus, the mean dose, V40, V45, and V50 for the skin structure, were all higher than other bolus regimens, while the dose maxima (Skinmax and V55) were all lower than others. Regarding the skin radiobiological evaluation, the NTCP of the 5_mm all bolus group was prominently better than other groups and was statistically significant (p < 0.05). Besides, the monitor unit of 5_mm all bolus regimen was the minimum compared with other groups and was statistically significant (p < 0.05). Therefore, the 5_mm all bolus group can not only improve the dose but also reduce the hot dose of skin and target volume, as well as reduce the NTCP. Our study provides a clinical reference in the delivery of post-mastectomy radiotherapy.

    Tools

    Get Citation

    Copy Citation Text

    Ruijun NIU, Yuexiao QI, Na TAO, Qing GUO, Xiyi WEI, Liying GAO, Fali TAO, Tingting LIU, Jianqiang CHENG, Shihong WEI. Dosimetric difference analysis of various bolus regimens in post-mastectomy intensity modulated radiotherapy[J]. Journal of Radiation Research and Radiation Processing, 2023, 41(3): 030307

    Download Citation

    EndNote(RIS)BibTexPlain Text
    Save article for my favorites
    Paper Information

    Category: Research Articles

    Received: Aug. 11, 2022

    Accepted: Feb. 6, 2023

    Published Online: Jul. 24, 2023

    The Author Email:

    DOI:10.11889/j.1000-3436.2022-0083

    Topics