Dosimetric analysis of 3D-printed vaginal cylinder template-guided interstitial adaptive brachytherapy for cervical cancer
10.3760/cma.j.cn113030-20240602-00216
- VernacularTitle:3D打印阴道柱插植在宫颈癌自适应近距离治疗的剂量学研究
- Author:
Cuiping YANG
1
;
Ling RONG
1
;
Lei XU
1
;
Lan SUN
1
;
Boheng WU
1
;
Zihao XU
1
;
Yongrui BAI
1
;
Hongbin CAO
1
Author Information
1. 上海交通大学医学院附属仁济医院放射诊疗科，上海 200127
- Publication Type:Journal Article
- Keywords:
Uterine cervical neoplasms;
Brachytherapy;
Interstitial brachytherapy;
Adaptive brachytherapy;
Individualized 3D-printed vaginal cylinder template;
Dosimet
- From:
Chinese Journal of Radiation Oncology
2025;34(3):265-274
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the advantages of individualized 3D-printed vaginal cylinder template-guided interstitial brachytherapy (3D-p-VC-ISBT) in locally advanced cervical cancer, aiming to provide reference for clinical adaptive brachytherapy.Methods:Clinical data of 20 patients with locally advanced cervical cancer admitted to Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from September, 2021 to August, 2023 were retrospectively analyzed. The median age was 54 years old (32-69 years). Among them, 3 patients were diagnosed with adenocarcinoma and 17 cases of squamous cell carcinoma. According to the treatment method, all patients were divided into intracavitary brachytherapy group (ICBT-plan group, n=10) and 3D-p-VC-ISBT group (3D-p-VC-ISBT treatment-plan group, n=10). A pretreatment plan was designed for each patient undergoing 3D-p-VC-ISBT. The pretreatment plans were formed as the pretreatment-plan group. Dose volume histogram was used to evaluate dose distribution of the targets and organs at risk (OAR). Comparison between two groups was analyzed by Mann-Whitney test and comparison among three treatment plans (ICBT, 3D-p-VC-ISBT treatment-plan and 3D-p-VC-ISBT pretreatment-plan) was analyzed by Kruskal-Wallis test. Results:The mean D 90rel (representing the dose received by 90% volume of the target area divided by the prescription dose) of high-risk clinical target volume (HR-CTV) in 3D-p-VC-ISBT, pretreatment-plan and ICBT-plan groups were 100.47%, 104.66% and 85.91%, respectively. The conformity indexes were 0.66, 0.72 and 0.68, respectively. There was no significant difference in D 0.01 cm3, D 2 cm3 and D 5 cm3 of bladder, rectum and sigmoid colon among the three groups (all P>0.05). For the 3D-p-VC-ISBT treatment-plan group, the D 2 cm3 values of the small intestine at 6 Gy and 7 Gy prescription doses were 169.51 cGy and 111.93 cGy respectively, which were superior to those of the ICBT-plan group (343.07 cGy at 6 Gy prescription, P<0.01). Conclusions:Individualized 3D-p-VC-ISBT is superior to ICBT in terms of dose distribution of HR-CTV, and it can adaptively adjust the insertion plan according to changes in tumor volume and position, making the operation safer and more efficient.
