3D打印胸壁硅胶bolus制作及临床前研究  

Fabrication and pre-clinical application of patient-specific 3D sificone rubber bolus for chest wall

作　　者：侯彦杰[1] 于江平 王永强 刘焕茹 黎妲[1] 徐晶晶 周军涛[1] 孟瑞娟[1] 秦志新 李险峰[1] Hou Yanjie;Yu Jiangping;Wang Yongqiang;Liu Huanru;Li Da;Xu Jingjing;Zhou Juntao;Meng Ruijuan;Qin Zhixin;Li Xianfeng(Department of Radiation Oncolog;Department of Nuclear Medicine,First Hospital,Shanxi Medical University,Taiyuan 030001,China;Department of Radiation Oncology,Shanxi Tumor Hospital,Taiyuan 030013,China;Department of Radiation Oncology,Qingdao Chengyang People＇s Hospital,Qingdao 266109,China)

机构地区：[1]山西医科大学第一医院放疗科,太原030001 [2]山西医科大学第一医院核医学科,太原030001 [3]山西省肿瘤医院放疗科,太原030013 [4]青岛市城阳区人民医院放疗科,266109

出　　处：《中华放射肿瘤学杂志》2018年第9期835-838,共4页Chinese Journal of Radiation Oncology

摘　　要：目的 探讨利用3D打印技术用于制作胸壁个性化硅胶组织补偿物与常规bolus及直接3D打印的PLA材料（3D-PLA材料）bolus的优势并验证其临床特性.方法 基于定位CT图像获取2例乳腺癌改良根治术后放疗患者的胸壁数据,使用3D打印硅胶倒模的设计方法,建立制作胸壁3D打印硅胶bolus（3D-SRB）.分别验证3D-SRB、常规bolus和3D-PLA与胸壁的贴合性,通过Eclipse计划系统比较虚拟计划和使用3种组织补偿物后的剂量学参数.结果 本研究成功设计并制作了一套硬度与常规bolus类似的3D-SRB.3D打印的组织补偿物（3D-SRB和3D-PLA）无论是在胸壁贴合性方面还是实际计划剂量分布方面均优于常规bolus;且3D-SRB在重复性、患者舒适性及胸壁贴合性方面优于3D-PLA.在剂量学方面,3D-SRB组与虚拟计划重复性最好,其次是3D-PLA,最后是常规bolus.结论 应用间接法3D打印的胸壁硅胶bolus在实际操作中是可行,具有较高的临床应用价值. Objective To apply 3D printing technology to fabricate patient-specific silicone tissue compensators for the chest wall and compare the advantages and clinical characteristics between conventional bolus and 3D-printed PLA materials. Methods The chest wall data of two breast cancer patients undergoing mastectomy were obtained based upon the CT images. A patient-specific 3D printing silicone rubber bolus （3D-SRB） was designed and fabricated. The conformability of 3D-SRB,3D-PLA and conventional bolus to the chest wall were validated. Ecipse8. 6 planning system was adopted to statistically compare the dosimetric parameters of virtual plan with those after using three tissue compensators. Results The 3D-SRB was successfully designed and fabricated with a similar hardness to conventional bolus. During the process of validating conformability and radiotherapy planning,3D-SRB and 3D-PLA were superior to conventional bolus in terms of conformability to chest wall and planning dosimetric distribution.3D-SRB was advantageous in repeatability, conformability and comfortable experience compared with 3D-PLA. Regarding dosimetric parameters,3D-SRB yielded the highest repeatability with the virtual plan, followed by 3D-PLA and conventional bolus. Conclusion It is applicable to utilize 3D-SRB as the patient-specific compensators for the chest wall,which is of significance in clinical practice.

关 键 词：三维打印 个性化组织补偿物 硅胶 乳腺肿瘤 

分 类 号：TP391.73[自动化与计算机技术—计算机应用技术] R730.55[自动化与计算机技术—计算机科学与技术] R737.9[医药卫生—肿瘤]