Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
Department of Radiation Oncology, Dalian Medical University Second Affiliated Hospital, Dalian, China.
J Gynecol Oncol. 2021 Mar;32(2):e15. doi: 10.3802/jgo.2021.32.e15. Epub 2020 Nov 25.
To investigate the safety and efficacy of 3-dimensional (3D) printing non-coplanar templates (PNCT) assisted computer tomography (CT) guided radioactive I seed implantation (RISI) for the treatment of recurrent cervical carcinoma (RCC) after external beam radiotherapy (EBRT).
A total of 103 patients with inoperable post-EBRT RCC were included in this retrospective study. A total of 111 lesions received RISI. Eight lesions were at the pelvic center, 75 lesions were at the pelvic lateral, and 28 lesions were extra-pelvic metastasis. The median prescription dose was 120 Gy. The primary end points were adverse events and local control (LC), and the secondary end points were overall survival (OS) and progression-free survival.
Grade 2 adverse events of acute nausea, diarrhea, and pollakiuria occurred in 1, 2, and 1 patient, respectively. One patient suffered from grade 3 acute proctitis. Late toxicity was observed in 2 patients with rectovaginal fistula. No grade 5 toxicity occurred. The 3-year LC and OS rates were 75.1% and 20.8%, respectively. The median OS was 17 months. The multivariate analysis showed that the minimum dose received by the "hottest" 90% of the gross tumor volume (D) ≥130 Gy, squamous cell carcinoma, hemoglobin ≥80 g/L and good short-term efficacy (complete response or partial response) were independent predictors of LC and OS (all p<0.05).
3D-PNCT assisted CT-guided RISI is a safe, effective, and minimally invasive modality for RCC. The hemoglobin level, pathological type, dose distribution and short-term efficacy are considered as independent factors for clinical outcomes.
研究 3 维（3D）打印非共面模板（PNCT）辅助计算机断层扫描（CT）引导放射性碘 125 种子植入（RISI）治疗外照射放疗（EBRT）后复发性宫颈癌（RCC）的安全性和疗效。
回顾性分析 103 例 EBRT 后无法手术的 RCC 患者，共 111 个病灶接受 RISI 治疗。8 个病灶位于盆腔中心，75 个病灶位于盆腔侧，28 个病灶位于盆腔外转移。中位处方剂量为 120 Gy。主要终点为不良事件和局部控制（LC），次要终点为总生存（OS）和无进展生存。
1 例患者出现急性恶心、腹泻和多尿，分别为 2 级、2 级和 1 级。1 例患者发生 3 级急性直肠炎。2 例患者出现直肠阴道瘘晚期毒性。无 5 级毒性。3 年 LC 和 OS 率分别为 75.1%和 20.8%。中位 OS 为 17 个月。多因素分析显示，肿瘤最大直径（D）≥130 Gy、鳞癌、血红蛋白≥80 g/L 和短期疗效良好（完全缓解或部分缓解）是 LC 和 OS 的独立预测因素（均 P<0.05）。
3D-PNCT 辅助 CT 引导 RISI 是治疗 RCC 的一种安全、有效、微创的方法。血红蛋白水平、病理类型、剂量分布和短期疗效是影响临床疗效的独立因素。
