3D打印共面坐标模板辅助CT引导放射性<sup>125</sup>I粒子植入治疗恶性肿瘤剂量学分析

doi:10.3760/cma.j.issn.1004-4221.2017.09.016

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Abstract

Objective To compare the pre-and post-operative tumor target volume and to examine the consistency in physical dosimetric parameters of organs at risk (OAR) following 3D-printed coplanar template (3D-PCT)-assisted and CT-guided radioactive seed implantation. Methods The 3D-printed coplanar template was designed using a computer software, and the coordinate system was established where the center was used as the basis for setting the x axis and y axis. Crosses defining the center of treatment were drawn on the patient’s body and matched with the corresponding central point, x axis, and y axis of the coplanar template. 3D-PCT-assisted and CT-guided radioactive seed implantation was performed based on the pre-operative plan, and the pre-operative, operative, and post-operative plans were designed to evaluate the target tumor volume and the normal dose received by the tissues. In addition, dosimetric parameters, including D₉₀(minimum dose received by 90% of the gross target volume), V₁₀₀, V₁₅₀, V₂₀₀(percentage of GTV that received 100%, 150%, and 200% of the prescribed dose, respectively), minimum peripheral dose (MPD), conformal index (CI), external index (EI), and homogeneity index (HI) in the pre-operative and post-operative plans were also assessed and compared using the Wilcoxon test. Results Fourteen patients treated in our institution from August to October, 2016 were included in this study. The median age of the patients was 61.5 years, and the median Karnofsky Performance Scale score was 80. A total of 14 lesions from the 14 patients were treated by seed implantation in the neck (n=4), chest (n=3), abdomen (n=5), and pelvis (n=2). Of the 14 patients that underwent implantation, 8 had previously received radiation therapy, and 6 had not received radiation therapy. Dosage optimization was performed for all patients during the operation. The median activity of the implanted seeds was 0.625 mCi (0.55-0.75 mCi,1 Ci=3.7×10¹⁰ Bq), and the preoperatively planned median number of needling and implanted seeds were 9(4-34) and 45.5(10-162), respectively. However, the actual median number of needling and implanted seeds were 9.5(4-34) and 45.5(10-162), respectively. Dosimetric analysis showed that there were no significant changes in tumor volume (P=0.135), D₉₀(P=0.208), MPD (P=0.104), V₁₀₀(P=0.542), V₁₅₀(P=0.754), V₂₀₀(P=0.583), CI (P=0.426), EI (P=0.326), and HI (P=0.952) after implantation. Conclusions 3D-PCT guidance and dosage optimization can result in good consistency between pre-and post-operative plans for radioactive seed implantation. 3D-PCT is a convenient and cheap technique suitable for large-scale clinical application.

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	Peng Ran
	Jiang Yuliang
	Ji Zhe
	Guo Fuxin
	Sun Haitao
	Fan Jinghong
	Li Xu
	Wang Junjie

Key words： Three-dimensional-printing co-planar template ¹²⁵I seed CT-guidance Dosimetric parameters Maliganent tumor

Received: 02 March 2017

Corresponding Authors: Wang Junjie,Email:junjiewang_edu@sina.cn

Cite this article:

Peng Ran,Jiang Yuliang,Ji Zhe et al. Dosimetric analysis of 3D-printed coplanar template-assisted and CT-guided ¹²⁵I seed implantation for the treatment of malignant tumors[J]. Chinese Journal of Radiation Oncology, 2017, 26(9): 1062-1066.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2017.09.016 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2017/V26/I9/1062

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