目的:本研究通过使用离子室测量和计算的剂量值,在剂量学性质和适用性方面,比较了标准商业丸剂材料(Superfab)与定制制备的硅酮牙科印模材料(CDIM)和橡皮泥材料(PDM)。
方法:通过将牙科印模硅酮材料与足够的水混合以保持约1.0g/cm3的密度来制备CDIM团块。通过以0.5-1cm的厚度覆盖10X10cm2的面积,将制备的团块材料施加在RW3实心体模上。在施加和不施加推注材料的情况下分别进行离子室测量。在CT中扫描设置,并使用扫描数据在TPS中重复相同的程序,其中使用了铅笔束卷积剂量计算算法。为了比较推注材料对组织的影响,Superflab推注和CDIM推注在乳房切除术后瘢痕上的厚度为1cm,并对TPS进行剂量计算.
结果:在比较Superfab的剂量测定值之后,CDIM和PDM,我们获得了superfab和CDIM之间有统计学意义的结果.对于PDM,用TPS和离子室测量获得的结果表明,由于其材料特性,不适合用于放射治疗应用。对于在疤痕组织上的五个随机点获得的模拟皮肤剂量值,Superfab和CDIMTPS计算结果的比较无统计学意义.
结论:CDIM易于制备并应用于不规则的乳房切除术疤痕组织,可防止在应用表面形成气隙。特别是对于弯曲的解剖区域,如疤痕组织,将推注材料纳入治疗计划方案将降低应用中的剂量不确定性.在放疗应用中使用CDIM作为Superfab的替代品是安全的,而PDM由于其材料特性在临床实践中没有用。
OBJECTIVE: This study compares standard commercial bolus material (Superflab) to custom prepared silicone dental impression material (CDIM) and play dough material (PDM) with respect to dosimetric properties and applicability by using ion chamber measurement and calculated dose values.
METHODS: The CDIM bolus was prepared by mixing dental impression silicone material with enough water to maintain a density of about 1.0 g/cm3. The prepared bolus material is applied on an RW3 solid phantom by covering 10x10 cm2 area with 0.5-1 cm thickness. Ion chamber measurements were performed separately with and without bolus material application. The setup was scanned in CT and the same procedure was repeated in the TPS using the scan data, in which the Pencil Beam Convolution dose calculation algorithm was used. To compare the effect of bolus material on tissue, the Superflab bolus and CDIM bolus were applied with 1 cm of thickness on postmastectomy scar and dose calculations on TPS were performed.
RESULTS: After comparison of the dosimetric values for Superflab, CDIM and PDM, we obtained statistically meaningful results between superflab and CDIM. For PDM, the results obtained with TPS and ion chamber measurements indicated that, it is not suitable to use in radiotherapy application due to its material properties. For the simulated skin dose values obtained at five random points on the scar tissue, the comparison of Superflab and CDIM TPS calculation results were not statistically significant.
CONCLUSIONS: The CDIM is easy to prepare and apply on irregular mastectomy scar tissue and it prevents formation of air gaps in the application surface. Especially for curved anatomical regions such as scar tissue, inclusion of the bolus material in treatment planning protocol will reduce dose uncertainty in application. It is safe to use CDIM as an alternative to Superflab in radiotherapy application, whereas PDM is not useful in clinical practice due to its material properties.