Qiu Lingyun, Wu Rong, Chen Yinan, Xiang Haixin, Zhan Wenming, Zhang Yinghao, Li Qiang, Liu Huaxin, Ding Jieni, Li Yucheng, Bi Aihong, Luo Limin, Jia Yongshi, Chen Weijun, Shao Kainan
Cancer Center, Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Department of Breast Surgery, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
PLoS One. 2025 Aug 14;20(8):e0330271. doi: 10.1371/journal.pone.0330271. eCollection 2025.
Recurrent and metastatic tumors of the head and neck pose significant treatment challenges due to their proximity to critical structures and prior radiation exposure. This study aimed to evaluate the consistency between preoperative and postoperative dosimetric parameters in CT-guided 3D-printed noncoplanar template (3DPNCT)-assisted radioactive iodine-125 seed implantation (RISI).
Twenty-six patients with recurrent or metastatic head and neck cancer were retrospectively analyzed. Gross tumor volume (GTV) coverage and dosimetric parameters such as D90 (dose covering 90% of the GTV), conformity index (CI), and homogeneity index (HI) were compared before and after implantation. The Shapiro-Wilk test was used to assess data normality.
There were no significant differences between pre- and postoperative D90, V100, V150, or CI values (P > 0.05). Bland-Altman analysis showed high agreement for key metrics.
3DPNCT-assisted RISI demonstrated accurate dose delivery and high reproducibility. This approach may enhance local control while minimizing radiation to organs at risk in complex head and neck anatomies. These results suggest that this technique has promising clinical applicability in complex head and neck cases; however, further validation through larger prospective studies is warranted to confirm long-term efficacy and safety.
头颈部复发和转移性肿瘤因其靠近关键结构以及既往接受过放疗，给治疗带来了重大挑战。本研究旨在评估在CT引导下的三维打印非共面模板（3DPNCT）辅助放射性碘-125粒子植入术（RISI）中术前和术后剂量学参数的一致性。
回顾性分析26例头颈部复发或转移性癌患者。比较植入前后的大体肿瘤体积（GTV）覆盖情况以及剂量学参数，如D90（覆盖90% GTV的剂量）、适形指数（CI）和均匀性指数（HI）。采用Shapiro-Wilk检验评估数据正态性。
术前和术后的D90、V100、V150或CI值之间无显著差异（P > 0.05）。Bland-Altman分析显示关键指标具有高度一致性。
3DPNCT辅助RISI显示出精确的剂量传递和高重复性。这种方法可能会增强局部控制，同时将对复杂头颈部解剖结构中危险器官的辐射降至最低。这些结果表明该技术在复杂头颈部病例中具有良好的临床应用前景；然而，需要通过更大规模的前瞻性研究进行进一步验证，以确认其长期疗效和安全性。
