CN108187242A - Personalized silica gel indemnity for adjusting target of prophylactic radiotherapy dosage and preparation method thereof - Google Patents
Personalized silica gel indemnity for adjusting target of prophylactic radiotherapy dosage and preparation method thereof Download PDFInfo
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- CN108187242A CN108187242A CN201711480439.9A CN201711480439A CN108187242A CN 108187242 A CN108187242 A CN 108187242A CN 201711480439 A CN201711480439 A CN 201711480439A CN 108187242 A CN108187242 A CN 108187242A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/103—Treatment planning systems
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/103—Treatment planning systems
- A61N5/1031—Treatment planning systems using a specific method of dose optimization
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1048—Monitoring, verifying, controlling systems and methods
- A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y10/00—Processes of additive manufacturing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
- A61N5/1048—Monitoring, verifying, controlling systems and methods
- A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
- A61N2005/1051—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam using an active marker
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
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Abstract
The present invention relates to a kind of for adjusting personalized silica gel indemnity of target of prophylactic radiotherapy dosage and preparation method thereof, including skin expanding part, normal structure expanding part and telltale mark line.According to patient target area inner skin and the silica gel indemnity that normal organ profile to be protected is needed to pass through 3D printing technique personalized customization uneven gauge, indemnity is enable preferably to be bonded skin, the distance that the indemnity of uneven gauge can make treatment region indemnity surface reach deep normal structure is identical, pass through injectivity optimizing, both nearly skin target area Radiotherapy dosimetry can have been improved, the uniform purpose of target area internal dose can also be reached, it can preferably protect deep normal organ again to a certain extent, meet the marrow of modern accurate radiotherapy, it improves curative effect and reduces the side effect of patient's radiotherapy to the full extent.In addition, using medical silica-gel reverse mould device silica gel reverse mould, low manufacture cost, speed is fast, and economically or better than direct silica gel prints in terms of application.
Description
Technical field
The present invention relates to medical material fields, specifically provide a kind of personalized silica gel for being used to adjust target of prophylactic radiotherapy dosage
Indemnity and its preparation method and application.
Background technology
In recent years, tumor incidence is constantly increasing, three big main means of the radiotherapy as oncotherapy, due to damage
Hinder small, side effect is low, significant in efficacy, is widely applied in clinic.The most crucial content of modern accurate radiotherapy is exactly to put
The accurate of dosage is treated, due to the objective reality of radiotherapy buildup effect, superficial target area usually requires tissue indemnity when treating
To adjust Radiotherapy dosimetry.
At present, traditional tissue indemnity (bolus) is general silica gel, in uniform thickness, it is impossible to be bonded human body well
Skin, there are gaps with skin during treatment, aggravate skin injury, it is impossible to obtain ideal Radiotherapy dosimetry, can not play protection
The purpose of normal organ.One kind is based on 3D printing technique radiotherapy tissue equivalent indemnity (application number
201610506056.3), though individuation customizes, skin attachement can be solved the problems, such as, thickness is uniform, in adjustment target area agent
Fail to show its value in terms of amount and protection deep normal organ, and the marrow of accurate radiotherapy is exactly to give target area accurately to control
It treats dosage and gives and normally jeopardize the less irradiation of organ.
Invention content
In view of the above-mentioned problems, the object of the present invention is to provide a kind of for adjusting the personalized silica gel of target of prophylactic radiotherapy dosage benefit
Repay object and preparation method thereof.Skin can be preferably bonded by personalized customization, due to the uneven thickness of tissue, superposition
Ray can be made to reach the thickness uniformity of internal normal organ after uneven gauge silica gel indemnity.Treatment tumour can be reached
Purpose, promote curative effect, and can utmostly reduce side effect, Gospel is brought to tumor patient.
It is a kind of for adjusting the personalized silica gel indemnity of target of prophylactic radiotherapy dosage, including skin expanding part, normal group in vivo
Knit expanding part and telltale mark line;Internal normal structure expanding part is an integral structure with skin expanding part, internal normal structure
Expanding part is located above skin expanding part, and telltale mark line is located at silica gel indemnity upper surface, and silica gel indemnity lower surface can be with
Target area skin fits closely;Skin expanding part can cover entire radiotherapy region, thickness 2-10mm;Internal normal structure extends out
Portion, which can cover radiotherapy region, needs normal organ to be protected, upper surface shape and radiotherapy region important organ or needs
Histoorgan (lung tissue, heart, nerve etc.) outer surface of protection is consistent, is with radiotherapy region important organ or needs to protect
The histoorgan of shield is diffused into outside the innermost part of skin subject to other than skin expanding part.The two can both improve after combining
Entire nearly skin target area Radiotherapy dosimetry, can also make target area inner rays reach the distance phase of normal organ in radiotherapy region
Together, normal organ is protected.
Further, telltale mark line includes horizontal axis telltale mark line and longitudinal axis telltale mark line.
Further, personalized silica gel indemnity skin expanding part is formed by uniformly extending out skin surface 2-10mm,
Personalization fitting skin, and the nearly skin part radiological dose of tumour can be increased.
Further, normal structure expanding part is by uniformly extending out radiation in personalized uneven gauge silica gel indemnity body
Treatment region important organ needs histoorgan (lung tissue, heart, nerve etc.) outer surface to be protected to be formed, it is ensured that silicon
The distance that glue compensation exterior surface reaches deep normal structure everywhere is identical, by injectivity optimizing, can preferably protect photograph
Penetrate region normal organ.
Further, skin flared portions run Boolean add operation with normal structure flared portions, are merged together, and
It is reference according to the corresponding scanning bed position in the lesion center of measurement and off-centered distance in the data lateral surface merged
Horizontal axis telltale mark line and longitudinal axis telltale mark line are set on indemnity surface, can be used for being accurately positioned the position of indemnity in use
It puts.
The above-mentioned direct silica gel printing of personalization uneven gauge silica gel indemnity is still immature, and speed is slow, of high cost, still cannot
Applied to clinic.Fused Deposition Modeling (FDM), Stereolithography method (StereoLithography, SL or SLA) technology at present
Comparative maturity using thin-walled printing type, prints hollow mould, using medical silica-gel reverse mould device silica gel reverse mould, is fabricated to
This is low, and speed is fast, better than direct silica gel printing.
It is a kind of as follows for adjusting the personalized silica gel indemnity preparation method of target of prophylactic radiotherapy dosage:
(1) Patients Treated by Radiotherapy initial vacuum pad is fixed, and scanning enhancing positioning CT determines lesion locations, measures and record in lesion
The corresponding scanning bed position of the heart and off-centered distance.
(2) the corresponding bed in lesion central core face is moved to by scanning bed, opens CT laser localized light comparings, and in patient skin
Corresponding position sketches out horizontal axis telltale mark line.
(3) patient is removed into CT scan region, the special laser localized light comparing of radiotherapy is opened, according to lesion off center
Distance adjustment laser line position, and sketch out longitudinal axis telltale mark line in patient skin corresponding position.
(4) CT picture of patient is transferred in 3D design softwares, skin is extended out into 2-10mm intending radiotherapy region, is protected
The uneven indemnity most thin thickness of card, obtains skin expanding part.It will intend radiotherapy region important organ or need tissue to be protected
Organ (lung tissue, heart, nerve etc.) outer surface is extended out, and with important organ or needs histoorgan to be protected apart from skin
It is diffused into outside innermost part subject to other than skin expanding part, and records thickness, obtain internal normal structure expanding part, Ke Yibao
The distance that card silica gel compensation exterior surface reaches deep normal organ everywhere is identical, by injectivity optimizing, can preferably protect
To irradiation area normal organ.
(5) CT picture of patient is transferred to TPS (radiotherapy treatment planning system), the thickness of record is input to TPS plans
System simulates indemnity thickness and the distance of exposure dose, depth and lesion apart from normal organ according to needed for tumour everywhere
Deng calculating required transmitted intensity, make radiotherapy planning.
(6) by skin flared portions and normal structure flared portions operation Boolean add fortune in 3D design softwares after errorless
It calculates, is merged together, and in the data lateral surface merged, bed position and deviation are scanned according to the lesion center of measurement is corresponding
The distance at center set in indemnity upper surface horizontal axis telltale mark line and longitudinal axis telltale mark line (mark line can be cylinder,
Prism or other readily discernible shapes).It is matched with printer Slice Software, accurately calculating printing wall thickness is simultaneously outer expands accordingly
Thickness compensation.
(7) stl file is exported as, is sliced and transmits by the way of zero padding using the dedicated Slice Software of 3D printer
To printer printing shaping, thickness error caused by printing is utmostly obviated, ensures that the thickness of silica gel indemnity everywhere is accurate
Really, while the time-write interval is reduced, reduces printing cost, shorten indemnity fabrication cycle.
(8) hollow mould of printing shaping is put into dedicated medical silica-gel reverse mould device, there is fixed dress in reverse mould device
It puts, ensureing 3D printing object, thickness is constant everywhere, pours into silica gel molding, model is taken out after curing, remove printed matter, obtains uneven thickness
The silica gel indemnity of degree.
Indemnity of the present invention can be used for the Radiotherapy dosimetry compensation of human body or animal body tissue cancer everywhere, shallow including skin table
Tumour, breast cancer, head and neck neoplasm etc..Indemnity is not limited only to photon, electron ray in terms of Radiotherapy dosimetry is adjusted,
Available for proton or heavy particle therapy etc..
The present invention is intended to provide it is a kind of for adjusting personalized silica gel indemnity of target of prophylactic radiotherapy dosage and preparation method thereof,
According to patient target area inner skin and normal organ profile to be protected is needed to pass through 3D printing technique personalized customization uneven gauge
Silica gel indemnity, enables indemnity to be preferably bonded skin, can make treatment region indemnity by the indemnity of uneven gauge
The distance that surface reaches deep normal organ is identical, by injectivity optimizing, can both improve nearly skin target area Radiotherapy dosimetry, and also might be used
To reach the uniform purpose of target area internal dose, deep normal organ can be preferably protected again to a certain extent, is met existing
For the marrow of accurate radiotherapy, improve curative effect and reduce the side effect of patient's radiotherapy to the full extent.In addition, using medical silicon
Glue reverse mould device silica gel reverse mould, low manufacture cost, speed is fast, economically or in terms of application is better than direct silica gel
Printing.
Description of the drawings
A kind of personalized silica gel indemnity diagrammatic cross-sections for being used to adjust target of prophylactic radiotherapy dosage of Fig. 1;
A kind of 45 degree of diagrammatic cross-sections of personalized silica gel indemnity for being used to adjust target of prophylactic radiotherapy dosage of Fig. 2;
A kind of personalized silica gel indemnity use state diagrams for being used to adjust target of prophylactic radiotherapy dosage of Fig. 3;
In Fig. 1-3:1- normal structure expanding parts;2- skin expanding parts;3- horizontal axis telltale mark lines;4- longitudinal axis telltale marks
Line;5- human skin mark lines;8- lung tissues;7- hearts;6- skins;9- soft tissues.
Specific embodiment
The present invention is described in further details with reference to specific embodiment and attached drawing.
The personalized silica gel indemnity for being used to adjust target of prophylactic radiotherapy dosage as shown in Figs. 1-3, extends out including normal structure
Portion 1, skin expanding part 2, horizontal axis telltale mark line 3, vertical pivot telltale mark line 4.Internal normal structure expanding part 1 is extended out with skin
Portion 2 is an integral structure, and internal normal structure expanding part 1 is located at 2 top of skin expanding part, horizontal axis telltale mark line 3 and vertical pivot
Telltale mark line 4 is located at silica gel indemnity upper surface, and silica gel indemnity lower surface can be fitted closely with target area skin;Skin extends out
Portion 2 can cover entire radiotherapy region, thickness 2-10mm;Internal normal structure expanding part 1, which can cover radiotherapy region, to be needed
Normal organ to be protected, internal 1 upper surface shape of normal structure expanding part and radiotherapy region important organ or needs to protect
The histoorgan outer surface of shield is consistent, be with radiotherapy region important organ or need histoorgan to be protected apart from skin most
It is diffused into outside the part of depths subject to other than skin expanding part 2.
The above-mentioned preparation method of personalized silica gel indemnity for adjusting target of prophylactic radiotherapy dosage includes the following steps:
(1) on the fixed CT scan bed of Patients Treated by Radiotherapy initial vacuum pad, Enhanced CT is carried out, determines lesion locations, is measured simultaneously
Record the corresponding scanning bed position in lesion center and off-centered distance.
(2) the corresponding bed in lesion central core face is moved to by scanning bed, opens CT laser localized light comparings, and in patient skin
Corresponding position sketches out horizontal axis telltale mark line.
(3) patient is removed into CT scan region, the special laser localized light comparing of radiotherapy is opened, according to lesion off center
Distance adjustment laser line position, and sketch out longitudinal axis telltale mark line at the corresponding patient skin of laser rays.
(4) CT picture of patient is transferred in 3D design softwares, skin is extended out into 5mm intending radiotherapy region, is ensured
Uneven indemnity most thin thickness, obtains skin expanding part.It will intend radiotherapy region important organ or need organizer to be protected
Official (lung tissue, heart, nerve etc.) outer surface is extended out, with important organ or need histoorgan to be protected apart from skin most
It is diffused into outside the part of depths subject to other than skin expanding part, and records thickness, obtain internal normal structure expanding part, it is ensured that
The distance that silica gel compensation exterior surface reaches deep normal organ everywhere is identical, by injectivity optimizing, can preferably protect
Irradiation area normal organ.
(5) CT picture of patient is transferred to TPS (radiotherapy treatment planning system), the thickness of record is input to TPS plans
System simulates indemnity thickness and the distance of exposure dose, depth and lesion apart from normal organ according to needed for tumour everywhere
Deng calculating required transmitted intensity, make radiotherapy planning.
(6) by skin flared portions and normal structure flared portions operation Boolean add fortune in 3D design softwares after errorless
It calculates, is merged together, and in the data lateral surface merged, bed position and deviation are scanned according to the lesion center of measurement is corresponding
The distance at center sets horizontal axis telltale mark line and longitudinal axis telltale mark line cylinder in indemnity upper surface.And it is sliced with printer
Software matches, and accurate calculating printing wall thickness is simultaneously outer to expand respective thickness compensation.
(7) stl file is exported as, is printed, by the way of zero padding using individual layer using the dedicated Slice Software of 3D printer
It is sliced and is transferred to printer printing shaping, utmostly obviate thickness error caused by printing, ensure that silica gel indemnity is each
The thickness at place is accurate, while reduces the time-write interval, reduces printing cost, shortens indemnity fabrication cycle.
(8) hollow mould of printing shaping is put into dedicated medical silica-gel reverse mould device, there is fixed dress in reverse mould device
It puts, ensureing 3D printing object, thickness is constant everywhere, pours into silica gel molding, model is taken out after curing, remove printed matter, obtains uneven thickness
The silica gel indemnity of degree.
A kind of personalized silica gel indemnity for being used to adjust target of prophylactic radiotherapy dosage as shown in Figs. 1-3 is obtained, including normal
Organizing expanding part 1 is obtained by extending out lung tissue 8 and heart 7, and skin expanding part 2 is obtained by extending out skin 6, and horizontal axis is fixed
Position mark line 3, vertical pivot telltale mark line 4 are corresponded with human skin mark line 5, and for treating when accurately resets indemnity.
The specifically used method of above-mentioned indemnity is:
Vacuum pad resets when patient radiation treats, by indemnity horizontal axis telltale mark line 3, longitudinal axis telltale mark line 4 and people
The alignment of body skin mark line 5 resets, it is ensured that uneven gauge indemnity is identical with design position, and when treatment is tight with skin attachement
It is close, indemnity surface is made to reach lung, the distance of heart everywhere after the application of uneven gauge silica gel indemnity equal, it is excellent by dosage
Change, can not only achieve the purpose that treat tumour but also internal lungs, heart, big blood vessel can be protected, reduce side effect.
More than case study on implementation is merely to illustrate technical scheme of the present invention, rather than its limitations.Other are with reference to aforementioned implementation
Case carries out the present invention modification of structure or technical principle or modifies replacement or assembling for partial content, not
The essence of corresponding technical solution is made to be detached from the spirit and scope of technical solution of the present invention.
The content not being described in detail in this specification belongs to the prior art well known to professional and technical personnel in the field.
Claims (8)
1. a kind of personalized silica gel indemnity for being used to adjust target of prophylactic radiotherapy dosage, it is characterised in that:Including skin expanding part, body
Interior normal structure expanding part and telltale mark line;Internal normal structure expanding part is an integral structure with skin expanding part, in vivo
Normal structure expanding part is located above skin expanding part, and telltale mark line is located at silica gel indemnity upper surface, under silica gel indemnity
Surface can be fitted closely with target area skin;Skin expanding part can cover entire radiotherapy region, thickness 2-10mm;It is normal in vivo
Tissue expanding part, which can cover radiotherapy region, needs normal organ to be protected, internal normal structure expanding part upper surface shape with
Radiotherapy region important organ needs histoorgan outer surface to be protected consistent, be with radiotherapy region important organ or
Histoorgan to be protected is needed to be diffused into outside the innermost part of skin subject to other than skin expanding part.
2. it is used to adjust the personalized silica gel indemnity of target of prophylactic radiotherapy dosage according to claim 1, it is characterised in that:Positioning
Mark line includes horizontal axis telltale mark line and longitudinal axis telltale mark line.
3. the personalized silica gel indemnity according to claim 1 or claim 2 for being used to adjust target of prophylactic radiotherapy dosage, it is characterised in that:
Skin expanding part is formed by uniformly extending out skin surface, personalization fitting skin.
4. the personalized silica gel indemnity according to claim 1 or claim 2 for being used to adjust target of prophylactic radiotherapy dosage, it is characterised in that:
Internal normal structure expanding part is by uniformly extending out radiotherapy region important organ or needing histoorgan appearance to be protected
Face is formed.
5. it is used to adjust the preparation side of the personalized silica gel indemnity of target of prophylactic radiotherapy dosage according to claim 1-4 is any
Method, it is characterised in that:It can be molded by direct silica gel 3D printing;Fused Deposition Modeling, Stereolithography method can also be used
Technology uses thin-walled printing type, prints hollow mould, uses medical silica-gel reverse mould device silica gel reverse mould.
6. according to any preparation sides for being used to adjust the personalized silica gel indemnity of target of prophylactic radiotherapy dosage of claim 1-4
Method, it is characterised in that:The specific steps are:
(1) Patients Treated by Radiotherapy initial vacuum pad is fixed, and scanning enhancing positioning CT determines lesion locations, measures and record lesion center pair
The scanning bed position and off-centered distance answered;
(2) the corresponding bed in lesion central core face is moved to by scanning bed, opens CT laser localized light comparings, and correspond in patient skin
Place sketches out horizontal axis telltale mark line;
(3) patient is removed into CT scan region, the special laser localized light comparing of radiotherapy is opened, according to the distance of lesion off center
Laser line position is adjusted, and longitudinal axis telltale mark line is sketched out in patient skin corresponding position;
(4) CT picture of patient is transferred in 3D design softwares, skin is extended out into 2-10mm intending radiotherapy region, obtains skin
Skin expanding part;It will intend radiotherapy region important organ or histoorgan outer surface to be protected needed to extend out, with important dirty
Device needs histoorgan to be protected to be diffused into outside the innermost part of skin subject to other than skin expanding part, and record thickness
Degree, obtains internal normal structure expanding part;
(5) CT picture of patient is transferred to TPS planning systems, the thickness of record is input to system, simulates indemnity thickness
And the distance of exposure dose, depth and lesion apart from normal structure according to needed for tumour, required transmitted intensity is calculated, is made
Radiotherapy planning;
(6) skin flared portions and normal structure flared portions are merged together, and on the outside of the data merged after errorless
Face, according to the corresponding scanning bed position in the lesion center of measurement and off-centered distance setting horizontal axis telltale mark line and the longitudinal axis
Telltale mark line;It is matched with printer Slice Software, accurate calculating printing wall thickness is simultaneously outer to expand respective thickness compensation;
(7) stl file is exported as, is sliced and is transferred to by the way of zero padding using the dedicated Slice Software of 3D printer and beaten
Print machine printing shaping;
(8) hollow mould of printing shaping is put into medical silica-gel reverse mould device, there is fixing device in reverse mould device, ensure that 3D is beaten
Printing object, thickness is constant everywhere, pours into silica gel molding, model is taken out after curing, remove printed matter, obtain personalized silica gel indemnity.
7. for adjusting the application of the personalized silica gel indemnity of target of prophylactic radiotherapy dosage according to claim 1-4 is any,
It is characterized in that:For human body or animal body everywhere lesion tissue Radiotherapy dosimetry compensation.
8. for adjusting the application of the personalized silica gel indemnity of target of prophylactic radiotherapy dosage according to claim 1-4 is any,
It is characterized in that:The radiotherapy includes photon, electron ray, proton or heavy particle therapy.
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CN116271567A (en) * | 2023-01-29 | 2023-06-23 | 溧阳市人民医院 | Compensator fixer for breast cancer radiotherapy |
CN116271567B (en) * | 2023-01-29 | 2023-10-03 | 溧阳市人民医院 | Compensator fixer for breast cancer radiotherapy |
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