B超或CT引导下3D打印个体化非共面模板近距离放射治疗局部控制不佳的复发性头颈部鳞状细胞癌。
B-ultrasound or CT-guided 3D-printing individualized non-coplanar template brachytherapy for the treatment of locally uncontrolled recurrent head and neck squamous cell carcinoma.
作者信息
Han Pengbing, Li Fengju, Zhang Yanping, Gao Liying, Zhang Guiqiong, Guo Qing, Zhu Yuxia, Su Qun
机构信息
Department of Radiotherapy, Gansu Provincial Cancer Hospital, Lanzhou, China.
出版信息
Postepy Dermatol Alergol. 2024 Feb;41(1):41-48. doi: 10.5114/ada.2024.136252. Epub 2024 Feb 28.
INTRODUCTION
It is worth to explore a more effective treatment method to minimize the damage for patients during the treatment process.
AIM
To explore the method, feasibility and efficacy of B-ultrasound or computed tomography (CT)-guided 3D printing individualized non-coplanar template brachytherapy in the treatment of locally uncontrolled recurrent head and neck squamous cell carcinoma.
MATERIAL AND METHODS
Ten patients with locally uncontrolled recurrent head and neck squamous cell carcinoma who were treated in our department from August 2021 to February 2023 were collected and treated by 3D printing individualized non-coplanar template brachytherapy under the guidance of B-ultrasound or CT, using the 192Ir high-dose rate afterloading treatment machine of NUCLETRON Technologies GmbH. The radiation source was 192Ir, with a diameter of 0.5 mm, a length of 3.5 mm, a total dose of 10-24 Gy, 5-8 Gy/time, once a week.
RESULTS
According to the efficacy evaluation criteria, CT scan was performed after 1-6 months, followed up for 24 months, including CR 40% (4/10), PR 50% (5/10), NC 10% (5/10), PD 0 (0). The total effective rate of CR + PR was 90% (9/10), the 6-month local control rate was 90%, the 12-month local control rate was 80%, the 18-month local control rate was 70%, and the 24-month local control rate was 70%. The overall survival rate at 24 months was 100%.
CONCLUSIONS
Safe and effective interpolation is used to guide the 3D printing of a single non-coplanar template with B-ultrasound or CT in the radiotherapy of local and uncontrolled recurrent head and neck squamous cell carcinoma. According to the guidance of B-ultrasound or CT, the 3D printing individualized non-coplanar template has an obvious healing effect especially in the brachytherapy, and can also protect the functional organs well, with less side effects and fewer complications. Therefore, this method is the most effective for the treatment of locally uncontrolled recurrent head and neck squamous cell carcinoma.
引言
探索一种更有效的治疗方法，以在治疗过程中尽量减少对患者的损害是值得的。
目的
探讨B超或计算机断层扫描（CT）引导下3D打印个体化非共面模板近距离放射治疗局部控制不佳的复发性头颈部鳞状细胞癌的方法、可行性及疗效。
材料与方法
收集2021年8月至2023年2月在我科治疗的10例局部控制不佳的复发性头颈部鳞状细胞癌患者，在B超或CT引导下采用3D打印个体化非共面模板近距离放射治疗，使用NUCLETRON Technologies GmbH的192Ir高剂量率后装治疗机。放射源为192Ir，直径0.5mm，长度3.5mm，总剂量10 - 24Gy，每次5 - 8Gy，每周1次。
结果
按照疗效评价标准，1 - 6个月后行CT扫描，随访24个月，其中完全缓解（CR）40%（4/10），部分缓解（PR）50%（5/10），病情稳定（NC）10%（1/10），疾病进展（PD）0（0）。CR + PR的总有效率为90%（9/10），6个月局部控制率为90%，12个月局部控制率为80%，18个月局部控制率为70%，24个月局部控制率为70%。24个月总生存率为100%。
结论
在局部控制不佳的复发性头颈部鳞状细胞癌放疗中，采用安全有效的插值法在B超或CT引导下进行3D打印单非共面模板。在B超或CT引导下，3D打印个体化非共面模板在近距离放射治疗中尤其具有明显的治愈效果，还能很好地保护功能器官，副作用少，并发症少。因此，该方法是治疗局部控制不佳的复发性头颈部鳞状细胞癌最有效的方法。
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