3D打印个体化模板联合CT引导^(125)I粒子植入治疗恶性肿瘤质量评价

Feasibility of 3D print individual template combined with CT-guided ^(125)I seed implantation for malignant tumors

目的对3D打印个体化模板联合CT引导125I粒子植入术后验证的剂量学参数进行评价,探讨其治疗肿瘤的可行性。方法收集2015年12月至2016年7月住院患者30例,全部患者术前行CT模拟定位,设计并应用3D打印机打印个体化模板。手术时,将患者进行复位、模板与体表术区对合、按术前计划进针、植入粒子,术后即刻行CT扫描,进行剂量学验证。按照英国哥伦比亚癌症研究中心粒子植入质量评价标准对植入质量进行评价。结果 30例患者均成功设计并打印个体化模板。28例技术成功,其中22例患者术后实际植入粒子数与术前计划一致,另外6例给予术中优化。术后验证评价结果,优:14例;良:10例;中:4例;差:0例。2例技术失败。结论3D打印个体化模板联合CT引导粒子植入治疗恶性肿瘤能够保证粒子植入质量控制的实施,值得临床推广应用。

Objective To evaluate the feasibility of 3D print individual template and CT-guided125 I seed implantation for malignant tumors. Methods A total of 30 patients were involved in this study. Before125 I seed implantation,the patients received CT simulation orientation as the predicted posture. The individual template was designed by the brachytherapy treatment planning system（BTPS）,and printed by 3D print technique. Every patient received125 I seed implantation under the guidance of 3D print individual template and CT scan. After implantation,treatment quality was evaluated with CT and BTPS. Results The 3D print individual templates were successfully designed and manufactured. Of all 30 cases,28 were successfully implanted with the 3D print templates,and 2 failed. Of the 28 successful cases,22 had the same number of seeds implanted as scheduled before operation,and the other 6 cases optimized the number of seeds during operation. Postoperative evaluation indicated that 14（50. 0%） cases had excellent implants,10（35. 7%） had good implants,4（14. 3%） had suboptimal implants,and no case had poor implants. Conclusion The3 D print individual template and CT-guided125 I seed implantation appears to be a feasible,safe and effective modality for the treatment of malignant tumors.