邓秀文,吉喆,姜玉良,等.光学导航联合3D打印模板辅助125I粒子植入治疗头颈复发癌的剂量评估[J].中华放射医学与防护杂志,2021,41(1):3-8.Deng Xiuwen,Ji Zhe,Jiang Yuliang,et al.Dosimetric evaluation of 125I seed implantation assisted by an optical navigation system and a 3D-printing template in the treatment of recurrent head and neck cancers[J].Chin J Radiol Med Prot,2021,41(1):3-8
光学导航联合3D打印模板辅助125I粒子植入治疗头颈复发癌的剂量评估
Dosimetric evaluation of 125I seed implantation assisted by an optical navigation system and a 3D-printing template in the treatment of recurrent head and neck cancers
投稿时间:2020-06-02  修订日期:2020-06-02
DOI:10.3760/cma.j.issn.0254-5098.2021.01.002
中文关键词:  光学导航系统  3D打印非共面模板  放射性粒子植入  剂量学  头颈部复发癌
英文关键词:Optical navigation system  3D-printing template  Radioactive seed implantation  Dosimetry  Recurrent head and neck cancer
基金项目:国家科技部重点研发项目(2019YFB1311300)
作者单位E-mail
邓秀文 北京大学第三医院肿瘤放疗科 100191  
吉喆 北京大学第三医院肿瘤放疗科 100191  
姜玉良 北京大学第三医院肿瘤放疗科 100191  
孙海涛 北京大学第三医院肿瘤放疗科 100191  
郭福新 北京大学第三医院肿瘤放疗科 100191  
范京红 北京大学第三医院肿瘤放疗科 100191  
李卫燕 北京大学第三医院肿瘤放疗科 100191  
王俊杰 北京大学第三医院肿瘤放疗科 100191 junjiewang_edu@sina.cn 
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中文摘要:
      目的 通过对比治疗前后计划的物理剂量学参数,验证光学导航系统联合3D打印模板辅助CT引导放射性125I粒子植入治疗头颈部复发癌的精确性与可行性。方法 纳入2018年12月至2019年12月接受光学导航系统联合3D打印模板辅助CT引导放射性125I粒子植入治疗的头颈部复发癌患者共12例。记录治疗前计划和治疗后计划实际植入针数及粒子数,比较治疗前后计划的90%靶区体积剂量(D90)、匹配周边剂量(MPD)、适形指数(CI)、均匀性指数(HI)、靶区外体积指数(EI)及100%、150%和200%处方剂量体积百分比(V100V150V200)。结果 中位病灶体积31.2 cm3,中位粒子数61.5颗,中位处方剂量130 Gy。治疗前计划的D90、MPD、V100V150V200均值分别为134.2、64.6、93.3、75.3和39.3 Gy,治疗后计划分别为146.7、68.94、97.47、80.40和48.30 Gy,差异无统计学意义(P>0.05)。治疗前后的植入针数、粒子数、CI、HI、EI差异均无统计学意义(P>0.05)。8例治疗后计划剂量质量评价为优(66.6%);4例为良(33.3%)。结论 光学导航系统联合3D打印模板辅助下,粒子植入治疗计划完成质量良好,治疗后各项剂量参数均符合预计划的要求,有良好的应用前景。
英文摘要:
      Objective To verify the accuracy and feasibility of radioactive 125I seed implantation assisted by an optical navigation system and a 3D-printing non-coplanar template in the treatment of recurrent head and neck cancers.Methods A total of 12 patients with recurrent head and neck cancer treated with radioactive 125I seed implantation assisted by an optical navigation system and 3D-printing non-coplanar template were enrolled from Dec 2018 to Dec 2019.The pre-plan and post-implant implantation needle number and implanted seed number were recorded.Meanwhile, their dosimetric parameters were compared, including D90, minimum peripheral dose (MPD), V100, V150, V200, conformity index (CI), external index (EI), and the homogeneity index (HI) of the target volume.Results The median lesion volume was 31.5 cm3, the median number of seeds was 61.5, and the median prescription dose was 130 Gy.The means of the pre-plan D90, MPD, V100, V150 and V200 were 134.2, 64.6, 93.3, 75.3 and 39.3 Gy, respectively, while those of post-implant D90, MPD, V100, V150, and V200 were 146.7, 68.94, 97.47,80.40 and 48.30 Gy, respectively,with no statistically significant difference (P>0.05). Meanwhile, there was no statistically significant difference between the pre-plan and post-implantation needle number, implanted seed number, CI, HI, and EI (P>0.05). In terms of postoperative dose quality assessment, eight cases were rated excellent (66.6%) and four cases were rated good (33.3%). Conclusions Radioactive 125I seed implantation assisted by an optical navigation system and 3D-printing non-coplanar template can be accurately performed in the treatment of recurrent head and neck cancer,with good consistency between pre-plan and post-implant dosimetric parameters and thus of prospective potential in clinical application.
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