Main Session
Sep
28
PQA 04 - Breast Cancer, Patient Reported Outcomes/QoL/Survivorship, Functional Radiation Medicine, Hematologic Malignancies, Palliative Care, and International/Global Oncology
2830 - Use of 3D-Printed Bolus and Immobilization Devices in Testicular Lymphoma Radiotherapy: A Retrospective Dosimetric and Technical Feasibility Study
Presenter(s)
Vikas Pandey, MD, MBBS - University of Manitoba/Cancer Care Manitoba, Winnipeg, MB
V. K. Pandey1, V. Pareek1, D. K. Sasaki2, R. Lee2, and A. K. Dubey1; 1Department of Radiation Oncology, CancerCare Manitoba, Winnipeg, MB, Canada, 2Department of Medical Physics, CancerCare Manitoba, Winnipeg, MB, Canada
Purpose/Objective(s):
Scrotal irradiation for primary testicular lymphoma (PTL) remains technically challenging due to the superficial and mobile nature of the target volume. Conventional bolus and immobilization techniques often result in setup variability and dose heterogeneity. Advances in three-dimensional (3D) printing offer opportunities to develop patient-specific solutions that improve precision and reproducibility.Materials/Methods:
We conducted a retrospective analysis of patients with testicular lymphoma treated with scrotal radiotherapy using a novel customized 3D-printed scrotal shell that serves as a bolus, immobilization device, and fiducial reference (three gold seeds embedded in the scrotal shell) for image-guided radiotherapy. Demographic, treatment, dosimetric, setup, and toxicity data were extracted from institutional databases. Setup reproducibility was assessed using recorded daily positional variations, and treatment-related toxicities were graded according to RTOG criteria.Results:
Eleven patients were included, with a median age of 72 years. Diffuse large B-cell lymphoma accounted for 91% of cases, and all patients received systemic chemotherapy followed by curative-intent radiotherapy. Treatment was delivered using 3D conformal radiotherapy (82%) or volumetric modulated arc therapy (18%). The 3D-printed scrotal shell demonstrated excellent setup reproducibility with minimal daily positional variation and no systematic setup errors. All treatment plans met quality assurance requirements without requiring adaptive replanning. Acute toxicity was limited to Grade I skin reactions in all patients, with no Grade =2 toxicities or treatment interruptions observed.Conclusion:
The use of a patient-specific 3D-printed scrotal shell for radiotherapy of testicular lymphoma is feasible and reproducible, providing consistent dosimetric coverage with minimal setup variability and low acute toxicity. This approach represents a practical and scalable solution to improve precision in scrotal irradiation and warrants further evaluation in larger prospective studies.