Bolus Use in Postmastectomy Radiation Therapy for Breast Cancer: A Systematic Literature Review

Introduction Tissue-equivalent boluses are used to increase the skin surface dose in patients with breast cancer undergoing postmastectomy radiotherapy. Boluses made from various materials have been developed and applied in clinical practice. However, there is currently no international standardizat...

Full description

Saved in:
Bibliographic Details
Main Authors: Fengyan Li MD, Wendie Hu MS, Hanzong Li MS, Bohan Li MS, Yaxue Wang MS
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Technology in Cancer Research & Treatment
Online Access:https://doi.org/10.1177/15330338251344521
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850122627203465216
author Fengyan Li MD
Wendie Hu MS
Hanzong Li MS
Bohan Li MS
Yaxue Wang MS
author_facet Fengyan Li MD
Wendie Hu MS
Hanzong Li MS
Bohan Li MS
Yaxue Wang MS
author_sort Fengyan Li MD
collection DOAJ
description Introduction Tissue-equivalent boluses are used to increase the skin surface dose in patients with breast cancer undergoing postmastectomy radiotherapy. Boluses made from various materials have been developed and applied in clinical practice. However, there is currently no international standardization for their use. This study aimed to analyze the advantages and disadvantages of using compensatory membranes (boluses), identify the optimal patient population for their postoperative application, and determine the most suitable types of compensatory membranes for use in postoperative radiotherapy for breast cancer. Methods This study includes a systematic literature review of sources such as websites, books, and articles from January 2013 to December 2023. We analyzed and compared studies on the use of compensatory membranes in postoperative radiotherapy for breast cancer, evaluating differences among various bolus materials as well as the impact of using no bolus. Outcomes such as patient responses and prognosis were also assessed. After excluding abstracts, reviews, and other non-research articles, a total of 32 studies were included in the analysis. Results 3D-printed boluses and brass mesh boluses show promise as alternatives to traditional bolus materials, with potential for broader clinical application. The use of a bolus can increase the incidence of acute radiation-induced toxicities, without significant improvements in long-term patient prognosis. For patients receiving chest wall radiotherapy after breast cancer surgery, bolus use may be considered selectively, especially in those with high-risk factors. Conclusion Currently, there is no unified standard for bolus use in breast cancer patients undergoing chest wall radiotherapy following modified radical mastectomy. This review provides a critical evaluation of existing literature, summarizing the available bolus materials and their influence on radiotherapy outcomes in postoperative breast cancer treatment.
format Article
id doaj-art-adca2d3ce4e646a1b9fa1cc84de25a2f
institution OA Journals
issn 1533-0338
language English
publishDate 2025-06-01
publisher SAGE Publishing
record_format Article
series Technology in Cancer Research & Treatment
spelling doaj-art-adca2d3ce4e646a1b9fa1cc84de25a2f2025-08-20T02:34:47ZengSAGE PublishingTechnology in Cancer Research & Treatment1533-03382025-06-012410.1177/15330338251344521Bolus Use in Postmastectomy Radiation Therapy for Breast Cancer: A Systematic Literature ReviewFengyan Li MD0Wendie Hu MS1Hanzong Li MS2Bohan Li MS3Yaxue Wang MS4 Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou P. R. of China Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou P. R. of China Biomedical Forensic Science, Boston University Chobanian & Avedisian School of Medicine: Graduate Medical Sciences, Boston, MA, USA Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou P. R. of China Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou P. R. of ChinaIntroduction Tissue-equivalent boluses are used to increase the skin surface dose in patients with breast cancer undergoing postmastectomy radiotherapy. Boluses made from various materials have been developed and applied in clinical practice. However, there is currently no international standardization for their use. This study aimed to analyze the advantages and disadvantages of using compensatory membranes (boluses), identify the optimal patient population for their postoperative application, and determine the most suitable types of compensatory membranes for use in postoperative radiotherapy for breast cancer. Methods This study includes a systematic literature review of sources such as websites, books, and articles from January 2013 to December 2023. We analyzed and compared studies on the use of compensatory membranes in postoperative radiotherapy for breast cancer, evaluating differences among various bolus materials as well as the impact of using no bolus. Outcomes such as patient responses and prognosis were also assessed. After excluding abstracts, reviews, and other non-research articles, a total of 32 studies were included in the analysis. Results 3D-printed boluses and brass mesh boluses show promise as alternatives to traditional bolus materials, with potential for broader clinical application. The use of a bolus can increase the incidence of acute radiation-induced toxicities, without significant improvements in long-term patient prognosis. For patients receiving chest wall radiotherapy after breast cancer surgery, bolus use may be considered selectively, especially in those with high-risk factors. Conclusion Currently, there is no unified standard for bolus use in breast cancer patients undergoing chest wall radiotherapy following modified radical mastectomy. This review provides a critical evaluation of existing literature, summarizing the available bolus materials and their influence on radiotherapy outcomes in postoperative breast cancer treatment.https://doi.org/10.1177/15330338251344521
spellingShingle Fengyan Li MD
Wendie Hu MS
Hanzong Li MS
Bohan Li MS
Yaxue Wang MS
Bolus Use in Postmastectomy Radiation Therapy for Breast Cancer: A Systematic Literature Review
Technology in Cancer Research & Treatment
title Bolus Use in Postmastectomy Radiation Therapy for Breast Cancer: A Systematic Literature Review
title_full Bolus Use in Postmastectomy Radiation Therapy for Breast Cancer: A Systematic Literature Review
title_fullStr Bolus Use in Postmastectomy Radiation Therapy for Breast Cancer: A Systematic Literature Review
title_full_unstemmed Bolus Use in Postmastectomy Radiation Therapy for Breast Cancer: A Systematic Literature Review
title_short Bolus Use in Postmastectomy Radiation Therapy for Breast Cancer: A Systematic Literature Review
title_sort bolus use in postmastectomy radiation therapy for breast cancer a systematic literature review
url https://doi.org/10.1177/15330338251344521
work_keys_str_mv AT fengyanlimd bolususeinpostmastectomyradiationtherapyforbreastcancerasystematicliteraturereview
AT wendiehums bolususeinpostmastectomyradiationtherapyforbreastcancerasystematicliteraturereview
AT hanzonglims bolususeinpostmastectomyradiationtherapyforbreastcancerasystematicliteraturereview
AT bohanlims bolususeinpostmastectomyradiationtherapyforbreastcancerasystematicliteraturereview
AT yaxuewangms bolususeinpostmastectomyradiationtherapyforbreastcancerasystematicliteraturereview