Purpose:To evaluate a novel 3D printed bolus fabricated from a copper‐plastic composite as a thin flexible, custom fitting device that can replicate doses achieved with conventional bolus techniques.Methods:Two models of bolus were created on a 3D printer using a composite copper‐PLA/PHA. Firstly, boluses were constructed at thicknesses of 0.4, 0.6 and 0.8 mm. Relative dose measurements were performed under the bolus with an Attix Chamber as well as with radiochromic film. Results were compared to superficial Attix Chamber measurements in a water equivalent material to determine the dosimetric water equivalence of the copper‐PLA/PHA plastic. Secondly, CT images of a RANDO phantom were used to create a custom fitting bolus across the anterolateral scalp. Surface dose with the bolus placed on the RANDO phantom was measured with radiochromic film at tangential angles with 6, 10, 10 flattening filter free (FFF) and 18 MV photon beams.Results:Mean surface doses for 6, 10, 10FFF and 18 MV were measured as a percent of Dmax for the flat bolus devices of each thickness. The 0.4 mm thickness bolus was determined to be near equivalent to 2.5 mm depth in water for all four energies. Surface doses ranged from 59–63% without bolus and 85–90% with the custom 0.4 mm copper‐plastic bolus relative to the prescribed dose for an oblique tangential beam arrangement on the RANDO phantom.Conclusion:Sub‐millimeter thickness, 3D printed composite copper‐PLA/PHA bolus can provide a build‐up effect equivalent to conventional bolus. At this thickness, the 3D printed bolus allows a level of flexure that may provide more patient comfort than current 3D printing materials used in bolus fabrication while still retaining the CT based custom patient shape.Funding provided by an intra‐department grant of the University of Minnesota Department of Radiation Oncology
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