| Lyu Jinshuang,Zheng Guangjun,Zhang Shengjie,Yang Jingkui,Yan Weiliang,Shi Shuyuan,Feng Zhen,Zhu Xiaolei,Chai Shude,Wang Junjie.Dosimetry analysis of radioactive seed implantation supported by coplanar template for lung cancer patients with mediastinal lymph node metastases 4R[J].Chinese Journal of Radiological Medicine and Protection,2017,37(7):533-538 |
| Dosimetry analysis of radioactive seed implantation supported by coplanar template for lung cancer patients with mediastinal lymph node metastases 4R |
| Received:March 25, 2017 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.07.012 |
| KeyWords:CT guided Coplanar template Radioactive seeds Brachytherapy treatment planning system Mediastinal lymph node metastasis |
| FundProject: |
| Author Name | Affiliation | E-mail | | Lyu Jinshuang | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Zheng Guangjun | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | xxwtj@sina.com | | Zhang Shengjie | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Yang Jingkui | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Yan Weiliang | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Shi Shuyuan | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Feng Zhen | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Zhu Xiaolei | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Chai Shude | Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China | | | Wang Junjie | Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China | |
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| Abstract:: |
| Objective To compare the planned radiation dose and the actual dose received after 125Ⅰ radioactive seeds implantation supported by coplanar template (CPT) in lung cancer patients with mediastinal node metastases 4R, and to evaluate the clinical efficacy. Methods Totally 32 patients with lung cancer with mediastinal lymph node metastases 4R who had been diagnosed via cellular pathology studies were selected from January 2008 to December 2014. The mediastinal lymph node metastases were treated by CPT-assisted 125Ⅰ radioactive seed implantation. Digital imaging and communications in medicine(DICOM) data were acquired by chest CT scan before implantation, brachytherapy radiation treatment planning system (BTPS) was introduced to carry out the plan, and the prescribed dose(PD) was 120 Gy. CPT was used to control the precision of needle penetration and implantation of radioactive seeds. Computer tomography (CT) was used to ensure the correct position of needles and radioactive seeds. Dose evaluation was performed immediately after implantation and was compared with planned dose using paired t-test. The 6-months postoperative chest CT was conducted to evaluate treatment efficacy according to response evaluation criteria in solid tumors(RECIST Version 1.1). Results All patients went through implantation procedure successfully. Dose evaluation after implantation was as followed. The average dose received (231.9±29.6)Gy, the dose received by 90% of the target(D90) (150.8±16.6) Gy, the dose received by 100% of the target(D100) (100.4±12.6)Gy, the volume of 100%PD covering the target(V100) (94.1±2.6)%, the volume of 200%PD covering the target(V200) (33.0±5.7)%, the conformal index(CI) 0.75±0.06, the external index(EI) (22.7±5.8)%, the average dose received by the superior vena cava (19.3±7.2)Gy, and the average dose received by aorta (12.1±5.1)Gy. Efficacy was followed for 6 months after implantation and the effective rate was 84.37%. There was no serious complications (such as radioactive lung injury,major vascular injury, bleeding, and et al.) occurred in follow-up period. Conclusions CPT assisted CT guided 125Ⅰ radioactive seed implantation in treating mediastinal node metastases 4R can achieve preoperative BTPS, minimize major vascular or organ injury. It is an accurate, effective and safe treatment approach and may be of great value to standardize the procedure of radioactive seed implantation in mediastinal metastases. |
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