3D打印个体化模具在宫颈癌近距离治疗中的应用

目的:通过3D打印个体化模具辅助插植,降低宫颈癌近距离治疗难度.方法:前瞻性研究2019年6月至2020年7月30例于重庆大学附属肿瘤医院行根治性放化疗宫颈鳞状细胞癌患者,随机分为15例3D打印组(试验组)和15例通用施源器组(对照组).评估两组治疗情况、靶区适形指数(coformity index,CI)、高危临床靶...

Application of three-dimensional printed individualized brachytherapy applicators for cervical cancer

  Objective  To reduce the difficulty in administering brachytherapy to patients with cervical cancer using three-dimensional (3D)printed individualized applicators.  Methods  This prospective study included 30 patients with cervical squamous cell carcinoma who visited the Chongqing University Cancer Hospital from June 2019 to July 2020 and received radical chemoradiotherapy. The patients were randomly assigned into a 3D printing group (clinical trial group) and a universal donor group (control group), each containing 15 participants. In both groups, treatment target was evaluated according to the conformity index (CI), fractional and total equivalent doses (equivalent dose in 2 Gy per fraction, EQD₂), high-risk clinical target area (HR-CTV), 90% of the lowest volume of absorbed dose (HR-CTV D₉₀), organs-at-risk (OARs) limits, and clinical treatment result.  Results  Uterine perforation was not observed in the clinical trial group; however, the rate of uterine perforation in the control group was 8.97% (7/78). The CI was 0.81±0.01 in the experimental group and 0.61±0.01 in the control group, and the difference was statistically significant (P < 0.05). HR-CTV D₉₀ and EQD₂ of the bladder were (6.65±0.06)/(91.84±1.35) and (3.75± 0.07)/(71.02±1.39), respectively, in the clinical trial group and (6.17±0.06)/(88.59±0.11) and (4.09±0.07)/(74.81±1.50), respectively, in the control group; the differences were statistically significant (P < 0.05). The rectum and sigmoid colon were also reduced in the clinical trial group, although the difference between both groups was not statistically significant (P > 0.05). The complete response (CR) rates were 93.33% (14/15) and 86.67% (13/15) in the clinical trial and control groups, respectively, 3 months after completing treatment, and the difference was statistically significant (P < 0.05).  Conclusions  3D printed has obvious advantages in assisting in treating cervical cancer with interstitial irradiation, and it is simple to operate and highly safe and conducive to promote intertissue implantation.