Wang Lu, Wang Hao, Jiang Yuliang, Ji Zhe, Guo Fuxin, Jiang Ping, Qiu Bin, Sun Haitao, Fan Jinghong, Li Weiyan, Wang Junjie
Department of Radiation Oncology, Peking University Third Hospital, Beijing, People's Republic of China.
J Contemp Brachytherapy. 2021 Feb;13(1):18-23. doi: 10.5114/jcb.2021.103582. Epub 2021 Feb 18.
To compare post-implant dosimetric parameters of computed tomography (CT)-guided radioactive iodine-125 (I) seed (RIS) implantation assisted with and without three-dimensional printing non-coplanar template (3D-PNCT) in locally recurrent rectal cancer (LRRC).
One hundred and fifty-five LRRC patients treated by CT-guided RIS implantation assisted with or without 3D-PNCT from October 2003 to May 2019 were included in this study. Propensity score matching (PSM) method (1 : 1) was used to adjust for differences between the 3D-group (with 3D-PNCT) and the CT-group (without 3D-PNCT). After PSM, dosimetric parameters [D (dose that covered 90% of target volume), D (dose that covered 100% of target volume), V (percentage of gross tumor volume (GTV) receiving 100% of prescription dose), V (percentage of GTV receiving 150% of prescription dose), HI (homogeneity index), CI (conformity index), and EI (external index)] of the two groups were compared.
After PSM, 45 pairs of matched cases were selected for analysis and differences in variables between the two groups were balanced. For the 3D-group, median values of D, D, V, V, EI, and HI were 142.6 Gy (73.7-218.2 Gy), 73.7 Gy (26.2-169.3 Gy), 94.1% (74.3-100%), 71.8% (35.4-98.3%), 0.7 (0.1-30.7), and 0.20 (0-0.60), respectively, and corresponding values were 119.9 Gy (39.8-159.3 Gy), 47.0 Gy (13.0-200.9 Gy), 89.9% (38.6-100%), 62.8% (14.8-100%), 0.39 (0-11.01), and 0.30 (0-0.95), respectively, for the CT-group. Parameters including D, D, V, V, and EI in the 3D-group were significantly higher than those in the CT-group ( < 0.001, < 0.001, < 0.001, < 0.001, and = 0.006, respectively).
3D-PNCT can improve the accuracy of radioactive seed implantation by increasing the dose delivered to the tumor and reducing the number of "cold" spots of dose.
比较在局部复发性直肠癌（LRRC）中，计算机断层扫描（CT）引导下放射性碘-125（I）粒子植入术（RIS）在有和没有三维打印非共面模板（3D-PNCT）辅助情况下的植入后剂量学参数。
本研究纳入了2003年10月至2019年5月期间接受CT引导下有或没有3D-PNCT辅助的RIS植入术治疗的155例LRRC患者。采用倾向得分匹配（PSM）方法（1:1）来调整3D组（有3D-PNCT）和CT组（没有3D-PNCT）之间的差异。PSM后，比较两组的剂量学参数[D（覆盖90%靶体积的剂量）、D（覆盖100%靶体积的剂量）、V（接受100%处方剂量的大体肿瘤体积（GTV）百分比）、V（接受150%处方剂量的GTV百分比）、HI（均匀性指数）、CI（适形指数）和EI（外扩指数）]。
PSM后，选择45对匹配病例进行分析，两组间变量差异得到平衡。对于3D组，D、D、V、V、EI和HI的中位数分别为142.6 Gy（73.7 - 218.2 Gy）、73.7 Gy（26.2 - 169.3 Gy）、94.1%（74.3 - 100%）、71.8%（35.4 - 98.3%）、0.7（0.1 - 30.7）和0.20（0 - 0.60），而CT组的相应值分别为119.9 Gy（39.8 - 159.3 Gy）、47.0 Gy（13.0 - 200.9 Gy）、89.9%（38.6 - 100%）、62.8%（14.8 - 100%）、0.39（0 - 11.01）和0.30（0 - 0.95）。3D组的D、D、V、V和EI等参数显著高于CT组（分别为<0.001、<0.001、<0.001、<0.001和=0.006）。
3D-PNCT可通过增加肿瘤接受的剂量并减少剂量“冷”点数量来提高放射性粒子植入术准确性。
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