3D打印模板较单纯CT引导^(125)I粒子植入头颈部复发转移癌优势研究

Research on the advantages of 3D printing template compared with simple CT-guided ^(125)I seeds implantation in recurrent and metastatic cancer of head and neck

目的探究3D打印模板较单纯CT引导^(125)I粒子植入头颈部复发转移癌优势。方法选择2015年4月至2019年2月河北省人民医院行^(125)I粒子治疗头颈部复发转移癌99例患者(99个病灶),依据是否应用3D打印模板将患者分为3D打印模板组[A组,49例(49个病灶)]、单纯CT引导组[B组,50例(50个病灶)]。评价两组^(125)I粒子植入治疗的质量及疗效;比较两组CT扫描次数、手术时间,单颗粒子植入所需时间;比较两组手术前后靶区体积、粒子数及剂量学参数(D90、V90、V100、V150);观察两组并发症的发生情况。结果两组^(125)I粒子植入治疗的质量比较,差异无统计学意义(P>0.05)。术后2个月,两组局部控制率及有效率比较,差异无统计学意义(P>0.05)。术后3个月,两组局部控制率比较,差异无统计学意义(P>0.05);A组有效率高于B组,差异有统计学意义(P<0.05)。A组手术时间、单颗粒子植入所需时间短于B组,CT扫描次数少于B组,差异有统计学意义(P<0.05)。A组手术前后靶区体积、粒子数及各剂量学参数比较,差异无统计学意义(P>0.05);B组手术前后靶区体积、粒子数、D90、V90比较,差异无统计学意义(P>0.05);术后,B组V100小于术前,V150大于术前,差异有统计学意义(P<0.05)。术后,两组靶区体积、粒子数、D90、V90、V150比较,差异无统计学意义(P>0.05);A组V100大于B组,差异有统计学意义(P<0.05)。A组穿刺疼痛发生率低于B组,差异有统计学意义(P<0.05);两组声音嘶哑发生率比较,差异无统计学意义(P>0.05)。结论与单纯CT引导比较,3D打印模板缩短手术时间,减少扫描次数,并在一定程度上降低并发症的发生率、提高疗效。

Objective To investigate the advantages of 3D printing template compared with simple CT-guided ^(125)I seeds implantation in recurrent and metastatic cancer of head and neck.Methods A total of 99 patients(99 lesions)with recurrent and metastatic cancer of head and neck treated with ^(125)I seeds in Hebei General Hospital from April 2015 to February 2019 were selected,according to whether 3D printing template was applied,they were divided into 3D printing template group(group A,49 cases[49 lesions])and simple CT guided group(group B,50 cases[50 lesions]).The quality and efficacy of ^(125)I seeds implantation were evaluated between two groups;CT scan times,operation time and single seed implantation time were compared between two groups;the target volume,seeds number and dosimetric parameters(D90,V90,V100,V150)before and after operation were compared between two groups;the incidence of complications in two groups were observed.Results There was no significant difference in the quality of ^(125)I seeds implantation between two groups(P>0.05).Two months after operation,there were no significant differences in local control rate and effective rate between two groups(P>0.05).Three months after operation,there was no significant difference in local control rate between two groups(P>0.05);the effective rate of group A was higher than that of group B,and the difference was statistically significant(P<0.05).The operation time and single seed implantation time of group A were shorter than those of group B,and CT scan times were less than those of group B,and the differences were statistically significant(P<0.05).There were no significant differences in target volume,seeds number,and dosimetric parameters in group A before and after operation(P>0.05).There were no significant differences in target volume,seeds number,D90,and V90 in group B before and after operation(P>0.05);after operation,V100 in group B was lower than that before operation,and V150 was higher than that before operation,and the differences were statistically significant(P<0.05).After operation,there were no significant differences in target volume,seeds number,D90,V90,and V150 between two groups(P>0.05);V100 in group A was higher than that in group B,and the differences were statistically significant(P<0.05).The incidence of puncture pain in group A was lower than that in group B,and the difference was statistically significant(P<0.05);there was no significant difference in the incidence of hoarseness between two groups(P>0.05).Conclusion Compared with simple CT guidance,3D printing template can shorten the operation time,reduce the number of scans,reduce the incidence of complications,and improve the efficacy to a certain extent.