Qiu Bin, Jiang Yuliang, Ji Zhe, Sun Haitao, Fan Jinghong, Li Weiyan, Shao Yuxia, Jiang Ping, Wang Junjie
Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
Department of Radiation Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2021 Mar 31;11:664996. doi: 10.3389/fonc.2021.664996. eCollection 2021.
To evaluate the accuracy of individualized 3D-printing template-assisted I radioactive seed implantation (3D-PT assisted I RSI) for recurrent/metastatic head and neck cancer.
From February 2017 to January 2020, clinical data of 41 patients (mean age, 58.5 ± 16.1 years; 28 males) with recurrent (48.8%)/metastatic (51.2%) head and neck cancer underwent individualized 3D-PT assisted I RSI under CT guidance in a single institute were retrospectively reviewed. Total 430 seed needles [mean, 10.5 (range 3-17) per patient] were inserted.
All seed needles were inserted manually in a single attempt with the technical success rate of 100% without major perioperative complications. The mean needle's entrance deviation was 0.090 cm (95% Confidence Interval, 0.081-0.098). The mean intraoperative depth and angle of the needle were consistent with that of planned (6.23 ± 0.24 vs. 6.21 ± 0.24 cm, p = 0.903; 83.14 ± 3.64 vs. 83.09 ± 3.66 degrees, p = 0.985, respectively). The mean deviation between the needle's planned and intraoperative depth and angle was 0.168 ± 0.024 cm and 1.56 ± 0.14 degrees, respectively. The postoperative dosimetry parameters, including D90, D100, V100, V150, V200, conformity index, external index, and homogeneity index, were all well-coordinated with planned dosimetry without significant difference (p = 0.515, 0.662, 0.958, 0.865, 0.872, 0.278, 0.456, and 0.989, respectively).
Within the limitation of this study, individualized 3D-PT assisted I RSI may be accurate in obtaining favorable postoperative dosimetry for patients with recurrent/metastatic head and neck cancer.
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评估个体化3D打印模板辅助碘放射性粒子植入术（3D-PT辅助IRS）治疗复发性/转移性头颈癌的准确性。
回顾性分析2017年2月至2020年1月在单一机构接受CT引导下个体化3D-PT辅助IRS治疗的41例复发性（48.8%）/转移性（51.2%）头颈癌患者的临床资料（平均年龄58.5±16.1岁；男性28例）。共插入430根粒子针[平均每例10.5根（范围3 - 17根）]。
所有粒子针均一次手动插入成功，技术成功率为100%，无严重围手术期并发症。针的平均进针偏差为0.090 cm（95%置信区间，0.081 - 0.098）。针的术中平均深度和角度与计划值一致（6.23±0.24 vs. 6.21±0.24 cm，p = 0.903；83.14±3.64 vs. 83.09±3.66度，p = 0.985）。针的计划深度和角度与术中深度和角度的平均偏差分别为0.168±0.024 cm和1.56±0.14度。术后剂量学参数，包括D90、D100、V100、V150、V200、适形指数、外轮廓指数和均匀性指数，均与计划剂量学良好协调，无显著差异（p分别为0.515、0.662、0.958、0.865、0.872、0.278、0.456和0.989）。
在本研究的局限性内，个体化3D-PT辅助IRS对于复发性/转移性头颈癌患者获得良好的术后剂量学可能是准确的。
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