Abstract： Objective To compare the preoperative and postoperative dosimetric results of radioactive seed implantation assisted by 3D printing template in the treatment of chest malignant tumor, and to examine the effect this technique on the precision of radioactive seed implantation. Methods A total of 21 patients who received 3D printing template-assisted CT-guided 125I seed implantation for chest tumors in 2016 were included in the study. The prescribed dose of the treatment was 110-180 Gy. Preoperative planning, individual template production, and puncture and seed implantation were performed in all patients, and the postoperative dosimetric results were then compared with the preoperative plan by assessing various dosimetric parameters including D90, MPD, V100, V150, CI, EI, and HI of gross tumor volume (GTV), D2cc of the spinal cord and aorta, and Dmean and V20 of the affected side of the lung. Statistical analysis was performed using the Wilcoxon non-parametric test. Results A total of 21 3D printing templates were designed and produced. The mean GTV volume (preoperative) of all patients was 77.1 cm3, and the mean number of implanted seeds was 68. In addition, the mean D90 of the postoperative GTV was 147.3 Gy. There were slight changes in the dosimetric parameters after treatment (P>0.05). Conclusions 3D printing template allows for accurate positioning and implantation of radioactive seeds during the treatment of chest tumor. Postoperative dosimetric parameters were consistent with those in the preoperative planning, indicating that the 3D printing template provides high precision for the treatment of chest tumor.
Ji Zhe,Jiang Yuliang,Guo Fuxin et al. Dosimetric assessment of CT-guided radioactive seed implantation assisted by 3D printing non-coplanar template in treatment of chest malignant tumor[J]. Chinese Journal of Radiation Oncology, 2017, 26(7): 754-758.
[1] Keyes M,Crook J,Morton G,et al. Treatment options for localized prostate cancer[J].Can Fam Physician,2013,59(12):1269-1274. [2] Wang JJ,Yuan HS,Li JN,et al. Interstitial permanent implantation of 125I seeds as salvage therapy for re-recurrent rectal carcinoma[J].Int J Colorectal Dis,2009,24(4):391-399.DOI:10.1007/s00384-008-0628-4. [3] Wang ZM,Lu J,Liu T,et al. CT-guided interstitial brachytherapy of inoperable non-small cell lung cancer[J].Lung Cancer,2011,74(2):253-257.DOI:10.1016/j.lungcan.2011.03.006. [4] Meng N,Jiang YL,Wang JJ,et al. Permanent implantation of iodine-125 seeds as a salvage therapy for recurrent head and neck carcinoma after radiotherapy[J].Cancer Invest,2012,30(3):236-242.DOI:10.3109/07357907.2012.654869. [5] Rembowska AME,Cook M,Hoskin PJ,et al. The stepping source dosimetry system as an extension of the manchester system[J].Radiother Oncol,1996,39(S1):S25.DOI:10.1016/0167-8140(96)87900-X. [6] Huang MW,Liu SM,Zheng L,et al. A digital model individual template and CT-guided 125I seed implants for malignant tumors of the head and neck[J].J Radiat Res,2012,53(6):973-977.DOI:10.1093/jrr/rrs046. [7] Wang H,Wang JJ,Jiang YL,et al. The investigation of 125I seed implantation as a salvage modality for unresectable pancreatic carcinoma[J].J Exp Clin Cancer Res,2013,32:106.DOI:10.1186/1756-9966-32-106. [8] Zhu LH,Jiang YL,Wang JJ,et al. An investigation of 125I seed permanent implantation for recurrent carcinoma in the head and neck after surgery and external beam radiotherapy[J].World J Surg Oncol,2013,11:60.DOI:10.1186/ 1477-7819-11-60. [9] Cao QQ,Wang H,Meng N,et al. CT-guidance interstitial 125Iodine seed brachytherapy as a salvage therapy for recurrent spinal primary tumors[J].Radiat Oncol,2014,9:301.DOI:10.1186/s13014-014-0301-8. [10] Meng N,Zhang XM,Liao AY,et al. Management of recurrent alveolar soft-part sarcoma of the tongue after external beam radiotherapy with iodine-125 seed brachytherapy[J].Head Neck,2014,36(12):E125-E128.DOI:10.1002/hed.23648. [11] Jiang P,Liu C,Wang J,et al. Computed tomography (CT)-guided interstitial permanent implantation of 125I seeds for refractory chest wall metastasis or recurrence[J].Technol Cancer Res Treat,2015,14(1):11-18.DOI:10.7785/tcrt.2012.500402. [12] van′t Riet A,Mak ACA,Moerland MA,et al. A conformation number to quantify the degree of conformality in brachytherapy and external beam irradiation:application to the prostate[J].Int J Radiat Oncol Biol Phys,1997,37(3):731-736.DOI:10.1016/S0360-3016(96)00601-3. [13] Saw CB,Suntharalingam N.Quantitative assessment of interstitial implants[J].Int J Radiat Oncol Biol Phys,1991,20(1):135-139.DOI:10.1016/0360-3016(91)90149-X. [14] 张宏涛,底学敏,于慧敏,等.3D打印模板引导 125I粒子植入术前术后剂量对比[J].中华医学杂志,2016,96(9):712-715.DOI:10.3760/cma.j.issn.0376-2491.2016.09.010. Zhang HT,Di XM,Yu HM,et al. Dose comparison between pre and post operation of 125I seeds implantation guided by 3D print tamplate[J].Nat Med J China,2016,96(9):712-715.DOI:10.3760/cma.j.issn.0376-2491.2016.09.010. [15] 吉喆,姜玉良,郭福新,等.3D打印个体化非共面模板辅助放射性粒子植入治疗恶性肿瘤的剂量学验证[J].中华放射医学与防护杂志,2016,36(9):662-666.DOI:10.3760/cma.j.issn.0254-5098.2016.09.005. Ji Z,Jiang YL,Guo FC,et al. Dosimetry verification of radioactive seed implantation for malignant tumor assisted by 3D printing individual guide template[J].Chin J Radiol Med Prot,2016,36(9):662-666.DOI:10.3760/cma.j.issn.0254-5098.2016.09.005. [16] 姜玉良,王皓,吉喆,等.CT引导辅助3D打印个体化非共面模板指导 125I粒子治疗盆腔复发肿瘤剂量学研究[J].中华放射肿瘤学杂志,2016,25(9):959-964.DOI:10.3760/cma.j.issn.1004-4221.2016.09.012. Jiang YL,Wang H,Ji Z,et al. Computed tomography image-guided and personalized 3D printed template-assisted 125-iodine seed implantation for recurrent pelvic tumor:a dosimetric study[J].Chin J Radiat Oncol,2016,25(9):959-964.DOI:10.3760/cma.j.issn.1004-4221.2016.09.012. [17] 王皓,王俊杰,姜玉良,等.3D打印模板联合CT引导 125I粒子治疗盆腔复发直肠癌的剂量学分析[J].中华医学杂志,2016,96(47):3782-3786.DOI:10.3760/cma.j.issn.0376-2491.2016.47.003. Wang H,Wang JJ,Jiang YL,et al. CT guidance 125I seed implantation for pelvic reeurrent rectal cancer assisted by 3D printing individual non-coplanar template[J].Nat Med J China,2016,96(47):3782-3786.DOI:10.3760/cma.j.issn.0376-2491.2016.47.003. [18] Salembier C,Lavagnini P,Nickers P,et al. Tumour and target volumes in permanent prostate brachytherapy:a supplement to the ESTRO/EAU/EORTC recommendations on prostate brachytherapy[J].Radiother Oncol,2007,83(1):3-10.DOI:10.1016/j.radonc.2007.01.014. [19] Ettinger DS,Wood DE,Akerley W,et al. Non-small cell lung cancer,version 1.2015[J].J Natl Compr Canc Netw,2014,12(12):1738-1761. [20] 杨瑞杰,姜玉良,李金娜,等.复发性直肠癌CT引导 125I粒子植入的剂量学验证[J].中国肿瘤,2009,18(10):848-850. Yang RJ,Jiang YL,Li JN,et al. Dosimetric verification of CT-guided 125I seed implant ation in recurrent rectal cancer[J].Chin Cancer,2009,18(10):848-850.
2017, Vol. 26 
