3D打印非共面模板联合CT引导125I粒子植入治疗脊柱转移瘤剂量学分析

目的 对比分析3D打印非共面模板联合放射性粒子植入治疗脊柱转移瘤的术前、术后计划的剂量学参数,验证该技术指导放射性粒子治疗的精确性。方法 回顾分析2016-2018年于北京大学第三医院接受3D打印非共面模板联合 CT引导¹²⁵I粒子植入的脊柱转移瘤患者7例共9个病灶的治疗计划,比较术前、术后靶区适形指数(CI)、均匀性指数(HI)、靶区外体积指数(EI)、90%靶区体积剂量(D90)、匹配周边剂量(mPD)、V100、V150、V200及脊髓D2cm³。并且应用不列颠哥伦比亚癌症协会粒子植入质量评价标准评价粒子植入质量。结果 患者术前和术后验证的靶区D90、mPD、V100、V150、V200、CI、EI、HI及脊髓D2cm³剂量参数间差异均无统计学意义(P>0.05)。9个术后计划评价结果中优5个、良4个。结论 3D打印非共面模板联合 CT引导¹²⁵I粒子植入治疗脊柱转移瘤的术后剂量学参数与术前相比具有良好的一致性,术后计划评价为优或良,提示该技术治疗脊柱转移瘤准确性良好。

Dosimetric analysis of 3D-printing non-coplanar template combined with CT-guided125I seed implantation for the treatment of spinal metastasis

Objective To compare the preoperative and postoperative dosimetric parameters in the treatment of spinal metastasis, and to verifythe accuracy of 3D-printing non-coplanar template (3D-PNCT) combined with CT-guided ¹²⁵I seed implantation for the treatment of spinal metastasis.Methods The treatment plans of 7 patients with spinal metastasis (9 lesions)from 2016 to 2018receiving 3D-PNCT in combination with CT-guided ¹²⁵I seed implantation were retrospectively analyzed. The dosimetric parameters including homogeneity index (HI),conformal index (CI),external index (EI),dose of 90% target volume(D90),mPD, volume percent of 100%,150%,and 200% prescribed dose V100、V150、V200 and D2cm³ of spinal cord were compared before and afteroperation. The british columbia cancer ageny particle implantation quality evaluation standard was applied to evaluate the quality of implantation. Results The HI,EI and CI, D90,mPD,V100,V150,V200 and D2cm³ of spinal cord did not significantly differ before and after the plan (all P>0.05). Five were evaluated as excellent and 4 were assessed as good. Conclusion The postoperative dosimetric parameters of 3D-PNCT combined with CT guided ¹²⁵I seed implantation of spinal metastasis are basically consistent with preoperative dosimetric parameters. The postoperative plans are evaluated as excellent or good, suggesting that the technology has a good therapeutic accuracy in the treatment of spinal metastasis.