Volumetric Modulated Arc Therapy With Patient-Specific 3D-Printed Bolus for Definitive Treatment of Nasal Basal Cell Carcinoma: A Case Series
4 affiliations
- 1St. Luke’s University Health Network, Department of Dermatology, Easton, Pennsylvania
- 2Drexel University College of Medicine, Philadelphia, Pennsylvania
- 3St. Luke’s University Health Network, Department of Radiation Oncology, Easton, Pennsylvania
- 4Temple/St. Luke’s Lewis Katz School of Medicine, Bethlehem, Pennsylvania
Abstract
Purpose: Nasal basal cell carcinoma (BCC) poses unique challenges for radiation therapy, particularly because of its proximity to critical structures and the cosmetic implications of treatment. This report explores the implementation of volumetric modulated arc therapy (VMAT) using patient-specific 3D-printed bolus to optimize treatment delivery and outcomes. The objective of this study was to describe the technique, feasibility, dosimetry, toxicity, and early clinical outcomes of VMAT combined with patient-specific 3D-printed bolus for nasal BCC.
Methods and Materials: A total of 7 patients with histologically confirmed nasal BCC were treated with VMAT. Treatment plans were created using a custom 3D-printed 1-cm bolus tailored to each patient’s unique nasal anatomy.
Results: Seven patients completed treatment for BCC of the nose, nasal ala, dorsum, or bridge. All patients received 6000 cGy in 200 cGy daily fractions. Acute toxicities were generally self-limited with no grade 3 or higher acute skin toxicity. At a median follow-up of 13 months (range, 3-23 months), there were no reported recurrences. There was no fibrosis, cartilage necrosis, or deformation of the native nasal contour.
Conclusions: VMAT combined with patient-specific 3D-printed bolus is a feasible treatment approach for selected patients with nasal BCC, with mild acute toxicity, favorable clinician-observed anatomic outcomes, acceptable doses to adjacent ocular structures, and no recurrences observed at early follow-up.
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BibTeX
@article{fernau2026volumetric,
title = {{Volumetric Modulated Arc Therapy With Patient-Specific 3D-Printed Bolus for Definitive Treatment of Nasal Basal Cell Carcinoma: A Case Series}},
author = {Erika Fernau and Jennifer Jones and William Faunce and Bhartesh Shah and Benjamin Foster},
journal = {Advances in Radiation Oncology},
year = {2026},
month = sep,
doi = {10.1016/j.adro.2026.102212},
url = {https://doi.org/10.1016/j.adro.2026.102212},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Volumetric Modulated Arc Therapy With Patient-Specific 3D-Printed Bolus for Definitive Treatment of Nasal Basal Cell Carcinoma: A Case Series
AU - Erika Fernau
AU - Jennifer Jones
AU - William Faunce
AU - Bhartesh Shah
AU - Benjamin Foster
PY - 2026
DA - 2026/09/11
JO - Advances in Radiation Oncology
DO - 10.1016/j.adro.2026.102212
UR - https://doi.org/10.1016/j.adro.2026.102212
AB - Purpose: Nasal basal cell carcinoma (BCC) poses unique challenges for radiation therapy, particularly because of its proximity to critical structures and the cosmetic implications of treatment. This report explores the implementation of volumetric modulated arc therapy (VMAT) using patient-specific 3D-printed bolus to optimize treatment delivery and outcomes. The objective of this study was to describe the technique, feasibility, dosimetry, toxicity, and early clinical outcomes of VMAT combined with patient-specific 3D-printed bolus for nasal BCC. Methods and Materials: A total of 7 patients with histologically confirmed nasal BCC were treated with VMAT. Treatment plans were created using a custom 3D-printed 1-cm bolus tailored to each patient’s unique nasal anatomy. Results: Seven patients completed treatment for BCC of the nose, nasal ala, dorsum, or bridge. All patients received 6000 cGy in 200 cGy daily fractions. Acute toxicities were generally self-limited with no grade 3 or higher acute skin toxicity. At a median follow-up of 13 months (range, 3-23 months), there were no reported recurrences. There was no fibrosis, cartilage necrosis, or deformation of the native nasal contour. Conclusions: VMAT combined with patient-specific 3D-printed bolus is a feasible treatment approach for selected patients with nasal BCC, with mild acute toxicity, favorable clinician-observed anatomic outcomes, acceptable doses to adjacent ocular structures, and no recurrences observed at early follow-up.
SN - 2452-1094
ER -