3D打印技术在宫颈癌近距离放射治疗中的应用

Application of 3D Printing Technique Combined with Brachytherapy in Cervical Cancer

近距离放射治疗是宫颈癌患者根治性放射治疗中必不可少的一部分,然而传统近距离放射治疗的施源器对部分术后残端复发或偏心性或大体积宫颈癌患者存在置入困难、不能适应个体化的局部病灶、剂量分布不理想等问题,继而影响疗效及预后。3D打印技术可以为患者设计个体化的施源器。3D打印技术与近距离放射治疗相结合,可以提高放射治疗的准确性。目前3D打印技术在宫颈癌近距离放射治疗中的应用主要包括构建宫颈癌模型,进行术前规划,显示肿瘤形状以及肿瘤与周围组织的解剖关系。同时还包括制作个性化施源器,减少空气间隙发生,以实现精确剂量分布。此外还包括设计平行/斜行插植针道施源器,优化针道和靶区剂量分布。综述宫颈癌近距离放射治疗中3D打印技术在上述领域的应用现状,讨论开发3D打印所需材料、系统建立及图像引导所面临的挑战。

Brachytherapy is an essential part of radical radiotherapy of cervical cancer.However,traditional brachytherapy applicators are difficult to be placed,cannot be adapted to individualized local lesions,and have unsatisfactory dose distribution for some patients with recurrent postoperative stumps or eccentric or large cervical cancer,which then affects the efficacy and prognosis.Personalized radiotherapy products can be designed for each patient by utilizing 3D printing technology.Combination of 3D printing technology and brachytherapy can effectively improve accuracy of radiotherapy.The application of 3D printing technology in cervical cancer brachytherapy mainly includes the construction of cervical cancer model to preoperative planning and display tumor shape as well as anatomic relationship between tumor and surrounding tissues.It also includes the production of personalized applicator to reduce the occurrence of air gaps to achieve precise dose distribution.In addition,the design of parallel/oblique needle channel applicator and the optimization of needle channel and target dose distribution are also included.Applications of 3D printing technology in brachytherapy of cervical cancer have been summarized in the afore-mentioned areas.At the same time,the challenges in the development of 3D printing materials,system establishment and image guidance have been discussed.