Department of Radiation Oncology, Peking University Third Hospital, 49th Huayuan North Street, Haidian District, Beijing, China, 100191.
J Radiat Res. 2021 May 12;62(3):473-482. doi: 10.1093/jrr/rraa144.
The aim of this study was to investigate the safety and accuracy of computed tomography (CT)-guided 125I seed implantation assisted by a three-dimensional printing non-coplanar template (3D-PNCT) for treating pelvic locally recurrent rectal cancer (LRRC) patients. A total of 13 patients with 18 masses received 125I seed implantation. The dosimetric parameters of pre-implantation and post-implantation were calculated to evaluate the quality of 125I seed implantation. Doses delivered to the organs at risk (OAR) were also calculated. Differences between pre-implantation and post-implantation were compared by the paired t-test. The mean number of 125I seeds pre-implantation and post-implantation was 67.1 and 68.8, respectively. The mean values of D90 (dose that was delivered to 90% of the target volume), D100 (dose that was delivered to 100% of the target volume), V100 (the target volume receiving 100% of the prescription dose) and V150 (the target volume receiving 150% of the prescription dose) pre-implantation and post-implantation were 136.6 and 135.2 Gy, 63.5 and 71.0 Gy, 90.3% and 90.3% and 62.1% and 62.2%, respectively. Dosimetric outcomes were evaluated quantitatively using the dose volume indices, i.e. coverage index (CI), external volume index (EI) and relative dose homogeneity index (HI). The mean values of those indices pre-implantation and post-implantation were 0.62 and 0.61, 0.31 and 0.33, and 0.31 and 0.31, respectively. The mean doses delivered to OAR pre-implantation and post-implantation for the bladder (D2cc) and bowel (D2cc) were 33.4 and 34.4 Gy, and 58.6 and 61.8 Gy, respectively. The parameters mentioned above fitted well, and no significant difference was found among them. It is concluded that CT-guided 125I seed implantation assisted by 3D-PNCT could be a safe and accurate salvage modality for treating LRRC patients; the ideal pre-prescription dose could be achieved. Also, addition of 3D-PNCT could minimize radiation damage to the surrounding normal tissues.
本研究旨在探讨 CT 引导下 125I 种子植入术联合三维打印非共面模板（3D-PNCT）治疗盆腔局部复发性直肠癌（LRRC）患者的安全性和准确性。共 13 例 18 个病灶患者接受了 125I 种子植入术。计算植入前和植入后的剂量学参数，以评估 125I 种子植入的质量。还计算了危及器官（OAR）的剂量。采用配对 t 检验比较植入前后的差异。植入前和植入后的 125I 种子平均数量分别为 67.1 个和 68.8 个。植入前和植入后的 D90（靶区接受 90%处方剂量的剂量）、D100（靶区接受 100%处方剂量的剂量）、V100（接受 100%处方剂量的靶区体积）和 V150（接受 150%处方剂量的靶区体积）的平均值分别为 136.6 和 135.2 Gy、63.5 和 71.0 Gy、90.3%和 90.3%、62.1%和 62.2%。使用剂量体积指数（如覆盖指数（CI）、外部体积指数（EI）和相对剂量均匀性指数（HI））对剂量学结果进行定量评估。植入前和植入后的平均指数值分别为 0.62 和 0.61、0.31 和 0.33、0.31 和 0.31。植入前和植入后膀胱（D2cc）和肠道（D2cc）的平均 OAR 剂量分别为 33.4 和 34.4 Gy 和 58.6 和 61.8 Gy。上述参数拟合良好，差异无统计学意义。结论：CT 引导下 125I 种子植入术联合 3D-PNCT 治疗 LRRC 患者是一种安全、准确的挽救治疗方法，可达到理想的预处方剂量。此外，添加 3D-PNCT 可以最大限度地减少对周围正常组织的辐射损伤。
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