模板固定在3D打印模板引导粒子植入头颈部转移癌的重要作用

The importance of template fixation in 3D printing individual template-guided ^(125)I seed implantation for cephalocervical lymph node metastasis

目的探讨模板复位固定对3D打印模板引导粒子植入治疗头颈部转移癌的重要作用。方法回顾分析2015年9月至2017年7月接受3D打印模板引导放射性125I粒子植入的头颈部淋巴结转移癌15例,其中曾行外放疗12例,平均剂量为63 Gy。观察术中模板复位固定情况、术后24 h内并发症,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并比较手术前后各参数差异性。结果所有病例均按计划完成手术,质量评价优、良、中和差级患者分别为11、3、1和0例,未见严重并发症,手术前后粒子数目、靶区体积、90%靶区体积的剂量(D90)和90%、100%、150%处方剂量的靶区体积(V90、V100、V150)差异均无统计学意义。结论模板准确复位固定是实现3D打印模板引导粒子植入治疗头颈部转移癌精准性的重要保证。

Objective To investigate the important role of the restoration and fixation of the template in 3D printing individual template-guided ^（125） I seed implantation for the treatment of lymph node metastasis of cephalocervical region. Methods The clinical data of a total of 15 consecutive patients with cephalocervical lymph node metastasis, who received 3D printing individual template-guided ^（125） I seed implantation during the period from September 2015 to July 2017, were retrospectively analyzed. Among the 15 patients, external radiotherapy was employed in 12 with the mean dose of 63 Gy. The restoration and fixation of 3D printing individual template was under close observation during the whole procedure course. The occurrence of complications within 24 hours after the operation were recorded. According to the British Columbia Cancer Agency（BCCA） Provincial Prostate Brachytherapy Quality Assurance Programme, the quality of ^（125） I seed implantation was evaluated, and the changes of each parameter, including the number of seeds, target volume and dosimetry parameters（D90, V90, V100, V150）, before and after operation were compared.Results the operation was successfully accomplished in all patients according to the plan. The quality of ^（125） I seed implantation was classified into excellent, good, moderate and poor grade, which was observed in 11,3, one and 0 patients respectively. No severe complications occurred. No statistically significant differences in the number of seeds, target volume, 90% target volume dose（D90）, and target volume of 90%, 100%, 150%prescription dose（V90, V100, V150） existed between preoperative data and postoperative ones（P〈0.05）.Conclusion Accurate restoration and fixation of the template is an important guarantee to achieve the accuracy of 3D printing template-guided ^（125） I seed implantation for cephalocervical metastatic cancer.