光学导航联合3D打印模板辅助^(125)I粒子植入治疗头颈复发癌的剂量评估  

Dosimetric evaluation of ^(125)I seed implantation assisted by an optical navigation system and a 3D-printing template in the treatment of recurrent head and neck cancers

作　　者：邓秀文 吉喆[1] 姜玉良[1] 孙海涛[1] 郭福新[1] 范京红[1] 李卫燕[1] 王俊杰[1] Deng Xiuwen;Ji Zhe;Jiang Yuliang;Sun Haitao;Guo Fuxin;Fan Jinghong;Li Weiyan;Wang Junjie(Department of Radiation Oncology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院肿瘤放疗科,100191

出　　处：《中华放射医学与防护杂志》2021年第1期3-8,共6页Chinese Journal of Radiological Medicine and Protection

基　　金：国家科技部重点研发项目(2019YFB1311300)。

摘　　要：目的通过对比治疗前后计划的物理剂量学参数,验证光学导航系统联合3D打印模板辅助CT引导放射性^(125)I粒子植入治疗头颈部复发癌的精确性与可行性。方法纳入2018年12月至2019年12月接受光学导航系统联合3D打印模板辅助CT引导放射性^(125)I粒子植入治疗的头颈部复发癌患者共12例。记录治疗前计划和治疗后计划实际植入针数及粒子数,比较治疗前后计划的90%靶区体积剂量(D90)、匹配周边剂量(MPD)、适形指数(CI)、均匀性指数(HI)、靶区外体积指数(EI)及100%、150%和200%处方剂量体积百分比(V100、V150和V200)。结果中位病灶体积31.2 cm^3,中位粒子数61.5颗,中位处方剂量130 Gy。治疗前计划的D90、MPD、V100、V150和V200均值分别为134.2、64.6、93.3、75.3和39.3 Gy,治疗后计划分别为146.7、68.94、97.47、80.40和48.30 Gy,差异无统计学意义(P>0.05)。治疗前后的植入针数、粒子数、CI、HI、EI差异均无统计学意义(P>0.05)。8例治疗后计划剂量质量评价为优(66.6%);4例为良(33.3%)。结论光学导航系统联合3D打印模板辅助下,粒子植入治疗计划完成质量良好,治疗后各项剂量参数均符合预计划的要求,有良好的应用前景。Objective To verify the accuracy and feasibility of radioactive ^(125)I seed implantation assisted by an optical navigation system and a 3D-printing non-coplanar template in the treatment of recurrent head and neck cancers.Methods A total of 12 patients with recurrent head and neck cancer treated with radioactive ^(125)I seed implantation assisted by an optical navigation system and 3D-printing non-coplanar template were enrolled from Dec 2018 to Dec 2019.The pre-plan and post-implant implantation needle number and implanted seed number were recorded.Meanwhile,their dosimetric parameters were compared,including D90,minimum peripheral dose(MPD),V100,V150,V200,conformity index(CI),external index(EI),and the homogeneity index(HI)of the target volume.Results The median lesion volume was 31.5 cm^3,the median number of seeds was 61.5,and the median prescription dose was 130 Gy.The means of the pre-plan D90,MPD,V100,V150 and V200 were 134.2,64.6,93.3,75.3 and 39.3 Gy,respectively,while those of post-implant D90,MPD,V100,V150,and V200 were 146.7,68.94,97.47,80.40 and 48.30 Gy,respectively,with no statistically significant difference(P>0.05).Meanwhile,there was no statistically significant difference between the pre-plan and post-implantation needle number,implanted seed number,CI,HI,and EI(P>0.05).In terms of postoperative dose quality assessment,eight cases were rated excellent(66.6%)and four cases were rated good(33.3%).Conclusions Radioactive ^(125)I seed implantation assisted by an optical navigation system and 3D-printing non-coplanar template can be accurately performed in the treatment of recurrent head and neck cancer,with good consistency between pre-plan and post-implant dosimetric parameters and thus of prospective potential in clinical application.

关 键 词：光学导航系统 3D打印非共面模板 放射性粒子植入 剂量学 头颈部复发癌 

分 类 号：R739.91[医药卫生—肿瘤]