江萍,郭福新,姜玉良,吉喆,彭冉,孙海涛,范京红,李旭,李卫燕,王俊杰.3D打印非共面模板辅助CT引导125Ⅰ粒子植入治疗盆腔复发子宫颈癌的剂量学研究[J].中华放射医学与防护杂志,2017,37(7):490-494
3D打印非共面模板辅助CT引导125Ⅰ粒子植入治疗盆腔复发子宫颈癌的剂量学研究
3D-printing non-coplanar template assisted CT-guided 125Ⅰ seed implantation on pelvic recurrent cervical cancer
投稿时间:2017-02-28  
DOI:10.3760/cma.j.issn.0254-5098.2017.07.003
中文关键词:  3D打印非共面模板  宫颈癌  粒子植入  近距离治疗  剂量
英文关键词:3D-printing non-coplanar tempalte  Cervical cancer  Seed implantation  Brachytherapy  Dosimetry
基金项目:首都临床特色应用研究与成果推广项目(Z151100004015171)
作者单位E-mail
江萍 100191 北京大学第三医院肿瘤放疗科  
郭福新 100191 北京大学第三医院肿瘤放疗科  
姜玉良 100191 北京大学第三医院肿瘤放疗科  
吉喆 100191 北京大学第三医院肿瘤放疗科  
彭冉 100191 北京大学第三医院肿瘤放疗科  
孙海涛 100191 北京大学第三医院肿瘤放疗科  
范京红 100191 北京大学第三医院肿瘤放疗科  
李旭 100191 北京大学第三医院肿瘤放疗科  
李卫燕 100191 北京大学第三医院肿瘤放疗科  
王俊杰 100191 北京大学第三医院肿瘤放疗科 junjiewang_edu@sina.cn 
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中文摘要:
      目的 通过评估术前、术后治疗计划的物理剂量学参数,阐明利用3D打印非共面模板(3D-PNCT)辅助CT引导125Ⅰ粒子植入治疗盆腔复发子宫颈癌的精确性。方法 盆腔复发宫颈癌患者9例,术前均行CT模拟机扫描定位图像传送粒子治疗计划系统(B-TPS)行术前计划,打印3D-PNCT,模板复位,插植粒子针并植入粒子,记录术前计划和术中实际植入针数和粒子数,比较计划靶区剂量学参数适形指数(CI)、均匀性指数(HI)和靶区外体积指数(EI);90%靶区体积剂量(D90)、匹配周边剂量(mPD,即D100),100%、150%和200%处方剂量体积百分比V100V150V200结果 患者GTV术前、术后平均体积差异无统计学意义(P>0.05)。术前粒子总数675颗,术后669颗。术前粒子针总数138根,术后132根。针道角度偏差平均1.99°±2.94°(0°~13°)。术前和术后CI、EI和HI、靶区D90、MPD、V100V150V200剂量参数差异均无统计学意义(P>0.05)。结论 3D-PNCT辅助CT引导125Ⅰ粒子植入治疗盆腔复发宫颈癌可获得较好的术前、术后治疗计划匹配和植入精确性。
英文摘要:
      Objective To investigate the accuracy of 3D-printing non-coplanar template (3D-PNCT) assisted 125Ⅰ seed implantation with CT guidance in the pelvic recurrent cervical between the pre-plan and post-plan dosimetric parameters. Methods Nine patients with pelvic recurrent cervical cancer received 125Ⅰ seed implantation under CT guidance assisted with 3D-PNCT. A pre-plan based brachytherapy treatment planning system (B-TPS) assisted with 3D-PNCT for seed needle depth, direction and angle was designed. The dosimetry parameters including homogeneity index (HI), dose of 90% target volume (D90), mPD, volume percent of 100%, 150% and 200% prescribed dose V100, V150 and V200 and organ at risk between the pre-plan and post-plan were compared. Results Total seeds number was 675 (median 44, 25-114) according to pre-plan, and 669 (median 47, 25-113) seeds were implanted actually. 138 needles need implant according to preplan, and 132 needles was implanted actually. The median angle deviation was 1.99°±2.94°(0°-13°). There was no significant difference of HI, EI and CI between per-and post-plan. The differences of D90, MPD, V100, V150 and V200 between pre-and post-plan were not significant. Conclusions The confidence of pre-plan and post-plan for 3D-PNCT assisted 125Ⅰ seed implantation in the pelvic recurrent cervical cancer could be accurately performed under CT guidance.
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