Discussion
palate, palates
ADVERSE REACTIONS
Currently, there are various oral stents used to address mucosal damage and local adverse reactions caused by IMRT. Therefore, it is necessary to search for better materials to improve the accuracy and efficacy of oral trays. In this study, we compared the positioning errors and organ doses between patients receiving treatment without a tray, patients using an oral tray constructed with 3D printing technology, and patients using a simple glass bottle placed in the mouth. Our data unraveled that this individualized oral stent produced based on the oral structure of patients can be ideally adapted to the oral environment of patients and protect oral buccal mucosa, tongue, hard palate, soft palate, posterior pharyngeal wall, and other normal tissues.Clinically, 3D printing technology has been widely used in surgery. This technology mainly uses continuous layer-by-layer printing and stratifies 3D mathematical model data to finally form a 3D solid stent, which can be used to simulate the surgical process for precise surgery. The 3D printing technology has many advantages, such as improving manufacturing accuracy, simplifying tedious production processes, saving cost and human resources, shortening production time, and achieving personalized production [3D-printed oral stents produced from PLA were used in precision radiotherapy for OPC patients in the current study. PLA was selected as a material for the main piece because of its biodegradability, biocompatibility, and strength [In addition, our results illustrated that the lower mean ± standard deviations of the 3D-printed oral stent group in X axis (left and right), Y axis (up and down), and Z axis (front–back) directions, indicating that 3D-printed oral stent is more stable as oral stents than other equipment, such as simple glass bottle, and nonstent. Furthermore, according to the CTCAE v.5.0, the 3D-printed oral stent group displayed a lower adverse response rate in the hard palate mucosa than the simple glass bottle and nonstent groups, with a significant difference. Of course, we also observed no substantial difference in the dose received by the hard and soft palates among the three groups and a reduction in the dose received by the upper cheek in the simple glass bottle and nonstent groups, indicating that the application of simple glass bottles with mouth remains to be investigated.