[1]赵秀娟,钟明松,吴海燕,等.3D打印模具在宫颈癌近距离治疗中重复使用可行性研究[J].陆军军医大学学报(原第三军医大学学报),2022,44(18):1874-1880.
　ZHAO Xiujuan,ZHONG Mingsong,WU Haiyan,et al.Feasibility of repeated using 3D printed applicator in brachytherapy for cervical cancer[J].J Amry Med Univ (J Third Mil Med Univ),2022,44(18):1874-1880.
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3D打印模具在宫颈癌近距离治疗中重复使用可行性研究(/HTML )
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陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
44卷
期数:
2022年第18期
页码:
1874-1880
栏目:
临床医学
出版日期:
2022-09-30

文章信息/Info

Title:
Feasibility of repeated using 3D printed applicator in brachytherapy for cervical cancer
作者:
赵秀娟; 钟明松; 吴海燕; 陈杜可; 王冬
重庆大学附属肿瘤医院：妇科肿瘤中心，肿瘤放射治疗中心
Author(s):
ZHAO Xiujuan1;  ZHONG Mingsong2;  WU Haiyan2;  CHEN Duke1;  WANG Dong1
1Gynecological Oncology Center, 2Treatment Center of Radiation Oncology, Chongqing University Cancer Hospital, Chongqing, 400030, China
 
关键词:
宫颈癌; 近距离治疗; 3D打印模具; 重复使用
Keywords:
cervical cancer;  brachytherapy;  3D printing applicator;  repeated using
分类号:
R319; R730.53; R737.33
文献标志码:
A
摘要:
目的通过对比3D打印模具在宫颈癌近距离治疗中预计划与多次实际治疗计划的剂量学，探讨同一模具在同一患者治疗过程中重复使用的可行性。方法收集2019年11月至2020年7月本院收治的接受根治性放疗宫颈鳞癌患者10例，同步放化疗联合3D打印模具辅助近距离治疗。比较3D打印模具预计划与多次实际治疗计划参数：CT扫描次数，高危临床靶区（high risk clinical target area，HR-CTV）体积和D90剂量、靶区适形指数（conformity index，CI），危及器官（organs at risk，OARs）2 cm3接收到的吸收剂量（D2cc）；分析患者近期疗效及2年局部控制率（local control rates, LCR）、无病生存率（disease free survival， DFS）、总生存率（overall survival， OS）。两种计划参数对比采用配对样本t检验，患者生存结局采用Kaplan-Meier生存分析。结果共设计3D打印模具10个、完成84次CT扫描、47次实际治疗；预计划与第1次实际治疗HR-CTV体积及CI差异无统计学意义（P>0.05），近距离治疗次数越多，HR-CTV体积越小，且靶区CI越好；HR-CTV D90及OARs均满足临床要求；中位随访23.5个月，2年的LCR、DFS、OS分别为100%、90%、80%。结论3D打印模具可重复用于同一宫颈癌患者近距离治疗，但伴随肿瘤退缩需根据CT定位调整进针深度。
 
Abstract:

ObjectiveTo explore the feasibility of repeated use of the same mold in the brachytherapy of cervical cancer by comparing the dosimetry of the 3D-printed vaginal applicator in the pre-plan and actual treatment plan in the brachytherapy of cervical cancer. MethodsA total of 10 patients with cervical squamous cell carcinoma who received radical radiotherapy in our hospital from November 2019 to July 2020 were reruited in this study. All patients received concurrent radiotherapy and chemotherapy combined with 3D printed applicator assisted brachytherapy. Dosimetric parameters, including CT scan frequency, high risk clinical target area (HR-CTV) volume and D90 dose, conformity index (CI), Dose (D2cc, the absorbed dose received by 2 cm3 of OARs) variation in organs at risk (OARs), and short-term efficacy and 2-year survival outcome of local control rates (LCR), disease free survival (DFS) and overall survival (OS) were compared the parameters of 3D printed mold pre-planning and multiple actual treatment plans. Paired samples t test was used to compare the parameters of pre-planning and actual treatment plans. Kaplan-Meier survival analysis was applied to analyze the survival outcomes of the patients. ResultsTen 3D printing applicators were designed, and a total of 84 CT scans and 47 practical treatments were completed. Only the target volume and CI of the first actual treatment plan were similar to those of the pre-plan, but the difference was not statistically significant (P>0.05). The more times of close treatment, the smaller HR-CTV volume was and the better CI of target area was. Both HR-CTV D90 dose and the OARs dose met clinical requirement. During the median follow-up of 23.5 months,  the 2-year LCR, DFS and OS were 100%, 90% and 80%, respectively.  ConclusionThe 3D-printed vaginal applicator can be used repeatedly for brachytherapy of the same cervical cancer patient, but the needle depth needs to be adjusted by CT positioning.

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更新日期/Last Update: 2022-09-23