3D打印模板辅助CT引导放射性125I粒子植入治疗肿瘤专家共识  

Expert consensus on 3D-printing template assisted CT-guided radioactive 125I seed implantation brachytherapy

作　　者：王俊杰[1] 柴树德[2] 郑广钧[2] 廖安燕[1] 江萍[1] 姜玉良[1] 吉喆[1] 申文江[3] 张红志[4] 高献书[3] 张福泉[5] Wang JJ Liao AY Jiang P Jiang YL Ji Z Chai SD Zheng G J Shen W J Gao XS Zhang HZ Zhang FQ(Peking University Third Hospital,Beijing 100191, China The Second Hospital of Tianjin Medical University, Tianjin 300211 , China Peking University First Hospital, Beifing 100034, China Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Bering 100021, China Peking Union Medical College Hospital, Chinese Academy of Medical Science, Bering 100730, China)

机构地区：[1]北京大学第三医院,100191 [2]天津医科大学第二医院,300211 [3]北京大学第一医院,100034 [4]北京协和医学院中国医学科学院肿瘤医院,100021 [5]北京协和医学院中国医学科学院北京协和医院,100730

出　　处：《中华放射医学与防护杂志》2017年第3期161-170,共10页Chinese Journal of Radiological Medicine and Protection

摘　　要：放射性粒子组织间永久植入治疗（简称粒子植入）肿瘤属于近距离范畴，它具有局部剂量高和周围正常组织损伤小的特点，已成为早期前列腺癌标准治疗手段之一。粒子植入借助超声、CT、MRI影像引导将放射性粒子送人到肿瘤靶区，因此，放射性粒子治疗兼具外科和介入治疗的特点。而粒子植入治疗的剂量学评估、危及器官剂量控制又隶属放射治疗范畴，因此，粒子治疗是跨学科、跨专业的技术。建立一支多学科合作团队，才有可能实现精准的粒子植入治疗。目前前列腺癌粒子植入技术已经非常成熟，而其他部位肿瘤粒子植入技术流程、标准尚处于研究阶段。本文主要基于3D打印模板技术建立起的规范和共识，内容包括：粒子物理学、剂量学、技术流程、适应证、不良反应。粒子治疗是非常有效的局部治疗手段，但是鉴于目前尚缺少大规模循证医学证据，还需要多中心的前瞻性、随机Ⅲ期临床研究，以及发表高水平文章，提高循证医学等级，确立粒子植入治疗在肿瘤综合治疗中的地位和作用。As an interstitial brachytherapy, radioactive seed implantation could provide high doses in the local site and minimal doses at surrounding normal tissues. It has become one of the best choice for early stage prostate carcinoma. Radioactive seeds were implanted under the guidance by ultrasound, CT and MRI, featured with surgical and interventiona] treatment. Based on dosimetry for target and organs at risk, radioactive seed implantation is multiple disciplinary. In order to acquire the accurate and high quality seed implantation, it is necessary to set up a team including surgeons, radiation oncologists, interventional doctors and nuclear medicine doctors. The content of the consensus is as follows： radiation physics and dosimetry, indications, side-effects and 3D-printing template work-follow. Despite the benefit of radioactive seed implantation for solid carcinoma, there still a compelling need for prospective randomized and stage Ⅲ clinical trials from multiple centers, so as to upgrade the evidencebased level, above all confirm the role of radioactive seed implantation in the comprehensive treatment of tumors.

关 键 词：3D打印模板 CT引导 125I 植入治疗 肿瘤 

分 类 号：R730.55[医药卫生—肿瘤] TP391.73[医药卫生—临床医学]