{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:46:51Z","timestamp":1788436011599,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T00:00:00Z","timestamp":1640217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81760547"],"award-info":[{"award-number":["81760547"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We compared the dosimetry, application, and acute toxicity of a 3D\u2010printed and a conventional bolus for postmastectomy radiotherapy (PMRT) with volumetric modulated arc therapy (VMAT).<\/jats:p><jats:p>Materials and Methods Eligible patients (<jats:italic>n<\/jats:italic>\u00a0=\u00a075) with PMRT breast cancer were randomly selected to receive VMAT with a conventional bolus or a 3D\u2010printed bolus. The primary endpoint was a 10% decrease in the mean heart dose to left\u2010sided breast cancer patients. The secondary endpoint was a 5% decrease in the mean ipsilateral lung dose to all patients. A comparative analysis was carried out of the dosimetry, normal tissue complication probability (NTCP), acute skin toxicity, and radiation pneumonitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to a conventional bolus, the mean heart dose in left\u2010sided breast cancer was reduced by an average of 0.8\u00a0Gy (5.5\u00a0\u00b1\u00a01.3\u00a0Gy vs. 4.7\u00a0\u00b1\u00a00.8\u00a0Gy, <jats:italic>p\u00a0<\/jats:italic>=\u00a00.035) and the mean dose to the ipsilateral lung was also reduced by an average of 0.8\u00a0Gy (12.4\u00a0\u00b1\u00a01.0\u00a0Gy vs. 11.6\u00a0\u00b1\u00a00.8\u00a0Gy, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001). The values for V<jats:sub>50Gy<\/jats:sub> of the PTV of the chest wall for the 3D\u2010printed and conventional boluses were 95.4\u00a0\u00b1\u00a00.6% and 94.8\u00a0\u00b1\u00a00.8% (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.026) and the values for the CI of the entire PTV were 0.83\u00a0\u00b1\u00a00.02 and 0.80\u00a0\u00b1\u00a00.03 (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001), respectively. The NTCP for the 3D\u2010printed bolus was also reduced to an average of 0.14% (0.32\u00a0\u00b1\u00a00.19% vs. 0.18\u00a0\u00b1\u00a00.11%, <jats:italic>p\u00a0<\/jats:italic>=\u00a00.017) for the heart and 0.45% (3.70\u00a0\u00b1\u00a00.67% vs. 3.25\u00a0\u00b1\u00a00.18%, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001) for the ipsilateral lung. Grade 2 and Grade 1 radiation pneumonitis were 0.0% versus 7.5% and 14.3% versus 20.0%, respectively (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.184).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The 3D\u2010printed bolus may reduce cardiopulmonary exposure in postmastectomy patients with volumetric modulated arc therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.4496","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T20:54:13Z","timestamp":1640292853000},"page":"1037-1047","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A clinical trial to compare a 3D\u2010printed bolus with a conventional bolus with the aim of reducing cardiopulmonary exposure in postmastectomy patients with volumetric modulated arc therapy"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5075-727X","authenticated-orcid":false,"given":"Yun","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Jiangxi Cancer Hospital of Nanchang University  Nanchang PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuling","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Jiangxi Cancer Hospital of Nanchang University  Nanchang PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenggou","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Jiangxi Cancer Hospital of Nanchang University  Nanchang PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinghui","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Jiangxi Cancer Hospital of Nanchang University  Nanchang PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Kuang","sequence":"additional","affiliation":[{"name":"School of Public Health Nanchang University  Nanchang PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingfeng","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Jiangxi Cancer Hospital of Nanchang University  Nanchang PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiliang","family":"Ying","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Jiangxi Cancer Hospital of Nanchang University  Nanchang PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxian","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Jiangxi Cancer Hospital of Nanchang University  Nanchang PR 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