Xu Qingtao,Lou Pengrong,Zhou Jianliang,et al.Dosimetric study on 3D printed individualized molds in postoperative three-dimensional brachytherapy for endometrial cancer[J].Chinese Journal of Radiological Medicine and Protection,2024,44(5):410-414
Dosimetric study on 3D printed individualized molds in postoperative three-dimensional brachytherapy for endometrial cancer
Received:July 25, 2023  
DOI:10.3760/cma.j.cn112271-20230725-00019
KeyWords:3D printed  Endometrial cancer  Three-dimensional brachytherapy
FundProject: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)
Author NameAffiliationE-mail
Xu Qingtao Department of Radiation Oncology and Chemotherapy, First Affiliated Hospital of Ningbo University, Ningbo 315000, China  
Lou Pengrong Department of Radiation Oncology and Chemotherapy, First Affiliated Hospital of Ningbo University, Ningbo 315000, China  
Zhou Jianliang Department of Radiation Oncology and Chemotherapy, First Affiliated Hospital of Ningbo University, Ningbo 315000, China  
Wang Binbing Department of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou 310022, China  
Ren Jiangping Department of Radiation Oncology and Chemotherapy, First Affiliated Hospital of Ningbo University, Ningbo 315000, China fyyrenjiangping@nbu.edu.cn 
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Abstract::
      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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