Abstract

PurposeElectron radiotherapy is a labor-intensive treatment option that is complicated by the need for field shaping blocks. These blocks are typically made from casting Cerrobend alloys containing lead and cadmium. This is a highly toxic process with limited precision. This work aims to provide streamlined and more precise electron radiotherapy by 3D using printing techniques.MethodsThe 3D printed electron cutout consists of plastic shells filled with 2 mm diameter tungsten ball bearings. Five clinical Cerrobend defined field were compared to the planned fields by measuring the light field edge when mounted in the electron applicator on a linear accelerator. The dose transmitted through the 3D printed and Cerrobend cutouts was measured using an IC profiler ion chamber array with 6 MeV and 16 MeV beams. Dose profiles from the treatment planning system were also compared to the measured dose profiles. Centering and full width half maximum (FWHM) metrics were taken directly from the profiler software.ResultsThe transmission of a 16MeV beam through a 12 mm thick layer of tungsten ball bearings agreed within 1% of a 15 mm thick Cerrobend block (measured with an ion chamber array). The radiation fields shaped by ball bearing filled 3D printed cutout were centered within 0.4 mm of the planned outline, whereas the Cerrobend cutout fields had shift errors of 1–3 mm, and shape errors of 0.5–2 mm. The average shift of Cerrobend cutouts was 2.3 mm compared to the planned fields (n = 5). Beam penumbra of the 3D printed cutouts was found to be equivalent to the 15 mm thick Cerrobend cutout. The beam profiles agreed within 1.2% across the whole 30 cm profile widths.ConclusionsThis study demonstrates that with a proper quality assurance procedure, 3D-printed cutouts can provide more accurate electron radiotherapy with reduced toxicity compared to traditional Cerrobend methods.

Highlights

  • It has been long recognized that custom field shaping blocks used for electron beam therapy complicate and slow down the treatment procedure[1]

  • Dose profiles from the treatment planning system were compared to the measured dose profiles

  • The radiation fields shaped by ball bearing filled 3D printed cutout were centered within 0.4 mm of the planned outline, whereas the Cerrobend cutout fields had shift errors of 1–3 mm, and shape errors of 0.5–2 mm

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Summary

Introduction

It has been long recognized that custom field shaping blocks used for electron beam therapy complicate and slow down the treatment procedure[1]. Transferring the outline from the treatment planning system (TPS) to the cutting tools introduces field shape and placement uncertainties of several millimeters. While many current electron treatments do not require increased accuracy, developments in combination with modern dose calculations and modulating bolus [2,3,4] open up the potential for more advanced therapies, such as mixed beam therapy, which offer increased distal sparing compared to traditional intensity modulated, or volumetric arc radiation therapy photon plans [5, 6]

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