徐庆涛,娄鹏荣,周建良,王彬冰,任江平.3D打印个体化模具在子宫内膜癌术后三维后装治疗中的剂量学研究[J].中华放射医学与防护杂志,2024,44(5):410-414
3D打印个体化模具在子宫内膜癌术后三维后装治疗中的剂量学研究
Dosimetric study on 3D printed individualized molds in postoperative three-dimensional brachytherapy for endometrial cancer
投稿时间:2023-07-25  
DOI:10.3760/cma.j.cn112271-20230725-00019
中文关键词:  3D打印  子宫内膜癌  三维后装治疗
英文关键词:3D printed  Endometrial cancer  Three-dimensional brachytherapy
基金项目:浙江省放射肿瘤学重点实验室开放课题(2022ZJCCRAD07);宁波市自然科学基金(2017A610168)
作者单位E-mail
徐庆涛 宁波大学附属第一医院肿瘤放化疗科, 宁波 315000  
娄鹏荣 宁波大学附属第一医院肿瘤放化疗科, 宁波 315000  
周建良 宁波大学附属第一医院肿瘤放化疗科, 宁波 315000  
王彬冰 浙江省肿瘤医院放射物理室, 杭州 310022  
任江平 宁波大学附属第一医院肿瘤放化疗科, 宁波 315000 fyyrenjiangping@nbu.edu.cn 
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中文摘要:
      目的 探讨3D打印个体化模具辅助子宫内膜癌术后三维后装治疗中的剂量学优势。方法 回顾性选取宁波大学附属第一医院21例早期子宫内膜癌术后患者的三维后装治疗计划,利用北京科霖众计划系统,在已实施的个体化模具组基础上,为每位患者设计虚拟单通道柱状施源器计划,所有计划均采用三维逆向模拟退火的算法。比较两组计划靶区90%、98%和100%体积接受的最低剂量(D90、D98、D100)以及适形指数(CI)、均匀度(HI)、超剂量体积指数(OI);同时,对比两组危及器官膀胱、直肠、小肠和尿道的0.01、1、2以及5 cm3所接受的最大剂量(D0.01 cm3D1 cm3D2 cm3以及D5 cm3)差异。结果 两组计划都能满足临床需求。在靶区所受剂量方面,两组计划靶区D90、D98、D100没有明显差异,但是个体化模具组靶区剂量的CI、HI均优于单通道组靶区,而靶区OI指数小于单通道计划(t=-3.21、-5.99、6.25,P<0.05)。在危及器官所受剂量方面,个体化模具组膀胱、直肠、尿道所受剂量D1 cm3D2 cm3D5 cm3相比单通道组均有明显降低(t=3.18、3.21、3.77、7.97、8.92、10.92、2.54、3.46、4.28,P<0.05);小肠由于距离靶区比较远,在两组计划中所受剂量差异不明显(P>0.05)。结论 3D打印个体化模具在子宫内膜癌术后三维近距离治疗中靶区均匀度、适形指数更优,而且膀胱、直肠、尿道所受剂量更低,具有推广价值。
英文摘要:
      Objective To explore the dosimetric advantages of 3D printed individualized molds in assisting postoperative three-dimensional brachytherapy (3D BT) for endometrial cancer. Methods The 3D BT plans of 21 postoperative patients with early-stage endometrial cancer at the First Affiliated Hospital of Ningbo University were retrospectively selected as the individualized mold group (the mold group). On this basis, virtual single-channel cylindrical applicator plans that employed a 3D inverse simulated annealing algorithm were designed for all the patients using the Beijing Colins Planning System (the single-channel group). Comparisons were made between the two groups of plans regarding the minimum doses exposed to 90%, 98%, and 100% of target area (D90, D98, and D100), conformity index (CI), homogeneity index (HI), and overdose index (OI), as well as the maximum doses exposed to 0.01, 1, 2, and 5 cm3organs at risk (bladder, rectum, small intestine, and urethra) (D0.01 cm3, D1 cm3, D2 cm3, and D5 cm3). Results Both groups met clinical requirements. For doses to target volumes, there was no significant difference in D90, D98, and D100 between both groups, with the mold group demonstrating superior CI and HI but lower OI compared to the single-channel group (t=-3.21, -5.99, 6.25, P<0.05). Concerning the doses exposed to organs at risk, the mold group displayed significantly reduced D1 cm3, D2 cm3, and D5 cm3 for the bladder, rectum, and urethra compared to the single-channel group (t=3.18, 3.21, 3.77, 7.97, 8.92, 10.92, 2.54, 3.46, 4.28, P < 0.05). There was no significant difference in the doses exposed to the small intestine between both groups (P > 0.05) due to the large distance from the small intestine to the target volumes. Conclusions 3D printed individualized molds exhibit advantages in terms of the homogeneity and conformity indices of target volumes in postoperative three-dimensional brachytherapy for endometrial cancer, accompanied by low doses exposed to the bladder, rectum, and urethra, thereby holding the potential for broader application.
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