Beijing Da Xue Xue Bao Yi Xue Ban. 2017 Jun 18;49(3):506-511.
To compare the dosimetric data between the preoperative plans and postoperative verification in personalized 3D printed template-assisted and computed tomography (CT) image-guided 125-iodine seed implantation for supraclavicular metastatic tumor, and to evaluate the accuracy and feasibility at the dosimetry level.
A total of 14 patients with supraclavicular metastatic tumor (including 15 lesions) who received 3D printed template assisted and CT image-guided 125-iodine seed implantation in Department of Radiation Oncology of Peking University Third Hospital from January to September 2016 were enrolled. There were 8 males and 6 females, aged from 46 to 79 years (mean age: 59.9 years). The Karnofsky performance score (KPS) was from 60 to 90 (median of 80). There were one patient who had not received radiotherapy before, and one patient had received radiotherapy, but the dose was unknown. The remaining 12 patients had received radiotherapy, with the median of 60 Gy (20-70 Gy), and one of them with the dose unknown. All the patients underwent preoperative enhanced CT scan, preoperative planning design, 3D printing template, puncture and particle implantation, the prescription dose from 110 Gy to 150 Gy. Comparisons of the dosimetric parameters between the postoperative verification and preoperative plans were made by paired t-test. The dose parameters inclu-ded D, V, V, V, matched peripheral dose (mPD), conformal index (CI), and external index (EI). The agreement was evaluated between the preoperative planning and postoperative actual dose parameters using Bland-Altman analysis. Bland-Altman plot showed the difference against the average of preoperative planning and postoperative actual dose parameters with limits of agreement (LoA) (broken lines).
The difference of all the data between pre- and postoperation, included D, V, V, V, mPD, and CI, which was not statistically significant (P>0.05). EI was statistically significant (P<0.05). There was poor consistency of D, V, V, V, and mPD, but better consistency of CI and EI.
Personalized 3D printed template-assisted and CT image-guided 125-iodine seed implantation for supraclavicular metastatic tumor is accurate and feasible.
比较个性化三维打印模板辅助及计算机断层扫描（CT）图像引导下125碘粒子植入治疗锁骨上转移瘤术前计划与术后验证的剂量学数据，从剂量学层面评估其准确性及可行性。
选取2016年1月至9月在北京大学第三医院放疗科接受三维打印模板辅助及CT图像引导下125碘粒子植入治疗的14例锁骨上转移瘤患者（共15个病灶）。其中男性8例，女性6例，年龄46～79岁（平均年龄59.9岁）。卡氏功能状态评分（KPS）为60～90分（中位数80分）。1例患者术前未接受过放疗，1例患者曾接受过放疗，但剂量不详。其余12例患者接受过放疗，中位数剂量为60 Gy（20～70 Gy），其中1例剂量不详。所有患者均接受术前增强CT扫描、术前计划设计、三维打印模板、穿刺及粒子植入，处方剂量为110 Gy至150 Gy。采用配对t检验比较术后验证与术前计划的剂量学参数。剂量参数包括D、V、V、V、匹配周边剂量（mPD）、适形指数（CI）及外扩指数（EI）。采用Bland-Altman分析评估术前计划与术后实际剂量参数之间的一致性。Bland-Altman图显示差异值相对于术前计划和术后实际剂量参数平均值的关系，并给出一致性界限（LoA）（虚线）。
术前与术后所有数据（包括D、V、V、V、mPD及CI）的差异无统计学意义（P>0.05）。EI有统计学意义（P<0.05）。D、V、V、V及mPD的一致性较差，但CI和EI的一致性较好。
个性化三维打印模板辅助及CT图像引导下125碘粒子植入治疗锁骨上转移瘤准确、可行。
