Abstract
Radiotherapy is one of the most effective cancer treatment techniques, however, delivering the optimal radiation dosage is challenging due to movements of the patient during treatment. Immobilisation devices are typically used to minimise motion. This paper reviews published research investigating the use of 3D printing (additive manufacturing) to produce patient-specific immobilisation devices, and compares these to traditional devices. A systematic review was conducted across thirty-eight databases, with results limited to those published between January 2000 and January 2019. A total of eighteen papers suitably detailed the use of 3D printing to manufacture and test immobilisers, and were included in this review. This included ten journal papers, five posters, two conference papers and one thesis. 61% of relevant studies featured human subjects, 22% focussed on animal subjects, 11% used phantoms, and one study utilised experimental test methods. Advantages of 3D printed immobilisers reported in literature included improved patient experience and comfort over traditional methods, as well as high levels of accuracy between immobiliser and patient, repeatable setup, and similar beam attenuation properties to thermoformed immobilisers. Disadvantages included the slow 3D printing process and the potential for inaccuracies in the digitisation of patient geometry. It was found that a lack of technical knowledge, combined with disparate studies with small patient samples, required further research in order to validate claims supporting the benefits of 3D printing to improve patient comfort or treatment accuracy.
Highlights
Radiotherapy is one of the most common treatments to stop the proliferation of cancerous cells, with almost half of cancer patients receiving radiotherapy during some period of their treatment [1,2,3]
While there is a general consensus that 3D printed immobilisers are a promising replacement for traditional immobilisers, thermoformed face masks, the low volume of studies, and the low number of human, animal or phantom subjects included in the studies, means that further research is required to validate claims of providing improved performance or comfort
This remains a small sample size and further research on human subjects is required in order to properly evaluate 3D printed immobilisers
Summary
Radiotherapy is one of the most common treatments to stop the proliferation of cancerous cells, with almost half of cancer patients receiving radiotherapy during some period of their treatment [1,2,3]. Immobilisation devices are frequently used to minimise patient movements during radiation treatments, thereby ensuring the radiation dose is localised predominantly on the tumour site. This approach limits exposure of healthy cells to radiation, while allowing reproducibility of setup on a day-today basis [4]. A total of eighteen papers suitably detailed the use of 3D printing to manufacture and test immobilisers, and were included in this review. This included ten journal papers, five posters, two conference papers and one thesis. Conclusion: It was found that a lack of technical knowledge, combined with disparate studies with small patient samples, required further research in order to validate claims supporting the benefits of 3D printing to improve patient comfort or treatment accuracy
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