Application of the pre-plan-based 3D-printed guide template in interstitial implantation brachytherapy of cervical cancer
10.3760/cma.j.cn112271-20240219-00062
- VernacularTitle:基于预计划的3D打印导板在宫颈癌近距离插植治疗中的应用
- Author:
Qiang ZHAO
1
;
Xiangyang WU
;
Yunfeng MU
;
Guoqing WANG
Author Information
1. 陕西省肿瘤医院放疗医院，西安 710061
- Keywords:
3D printing;
Cervical cancer;
Interstitial implantation brachytherapy
- From:
Chinese Journal of Radiological Medicine and Protection
2024;44(10):827-834
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To present a method of modeling 3D-printed guide templates (3DPGTs) strictly based on pre-plans for the interstitial implantation brachytherapy of cervical cancer, and elucidate the advantages of 3DPGTs in the interstitial implantation brachytherapy of cervical cancer.Methods:This study retrospectively selected six cases of locally advanced cervical cancer treated with interstitial implantation brachytherapy using 3DPGTs. Based on the CT images of 3DPGTs and pre-plans, the mechanical precision of 3DPGTs was verified through image registration. The dosimetric differences were compared between the 3DPGT treatment plan and the pre-plan/the freehand implantation plan. The dosimetric parameters included the volume and D90 for the high-risk clinical target volume (HR-CTV), and the D2 cm 3, D1 cm 3, and D0.1 cm 3 for the bladder, rectum, intestine, and sigmoid. Results:The 3DPGTs modeled using the method strictly based on pre-plans exhibited relatively high mechanical precision, with deviations all below 1 mm. Regarding the D90 of the HR-CTV, the 3DPGT treatment plan resulted in a dose of (713.37±143.26) cGy, reduced by 6.95% ( z= -1.98, P<0.05) compared to the (766.62±145.97) cGy in the pre-plan, and increased by 107.6% ( z= -1.89, P<0.05) compared to the (343.56±188.72) cGy in the freehand implantation plan. For dosimetric parameters of organs at risk (OARs), no statistical differences were observed ( P>0.05) between the 3DPGT treatment plan and the pre-plan/the freehand implantation plan. Conclusions:The method of modeling 3DPGTs for cervical cancer proposed in this study demonstrates high accuracy. Hence, the dose for the HR-CTV can be substantially increased under the condition that the OARs are protected from over-irradiation.
