The clinical application of 3D-printed minimally-invasiveguided template in the inter-stitial brachytherapy treatment of postoperative recurrent cervical cancer
10.3969/j.issn.1000-8179.2018.24.883
- VernacularTitle:3D打印微创导向模板在术后复发性宫颈癌近距离治疗中的临床应用
- Author:
Xiangkun YUAN
1
;
Mangmang CUI
;
Junjun MIAO
;
Lei GAO
;
Jianwei HU
;
Dandan TIAN
;
Yongxia ZHANG
Author Information
1. 河北省沧州中西医结合医院放化疗二科(河北省沧州市061000
- Keywords:
postoperative recurrent cervical cancer;
three-dimensional-printed minimally-invasive guided template;
interstitial brachy-therapy
- From:
Chinese Journal of Clinical Oncology
2018;45(24):1258-1262
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the application of 3D-printed minimally-invasiveguided template in the treatment of recurrent cer-vical cancer after surgery, assisting interstitial brachytherapy. Methods: From July 2017 to April 2018, a total of 10 patients admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei province with recurrent cervical cancer after radi-cal surgery underwent the 3D-printed customized template-assisted interstitial brachytherapy. According to the specific conditions of patients, different vaginal localization templates were selected for CT simulation localization. The main guidance needle space distribu-tion was designed, and 3D minimally-invasive guidance templates were printed. Then, needles were inserted according to the main guide channel of the template commissioned by medical photosensitive resin. The high-risk clinical target volume (HR-CTV) of 6 Gy/fraction was administered (4 to 6 fractions). Results: Overall, 10 patients were treated with implantation for a total of 52 times. Treat-ment with average scanning CT number for each brachytherapy was (1.58±0.70) times. The average elapsed time for each brachythera-py implant treatment, from plug implant to inserting planting needle satisfactorily with the location of the tumor, was (10.88±2.94) minutes. The mean number of metal needles used was (5.69±1.91) in each brachytherapy. The mean D90 value for high-risk clinical tar-get volume (HR-CTV) was (6.41±0.29) Gy. The cumulative D2cm3 values for the bladder, rectum, and sigmoid colon were (4.75±0.37) Gy, (3.93±0.26) Gy, and (4.33±0.24) Gy, respectively. After 3 months of treatment, the efficacy was evaluated in 8 cases with CR and 2 cas-es with PR. Conclusions: The technology of 3D-printed minimally-invasive guided template shows the advantage of accurate location and superior repeatability in the application of interstitial brachytherapy in treating recurrent cervical cancer after operation, which in-volves less time and insertion needles. The patients had minor aches and few complications. The tumor shrank significantly, which indi-cated a bright future of the technology's clinical application.
