3D打印多通道施源器在宫颈癌术后患者近距离治疗中研究  

Study of 3D-printed multi-channel applicator in patients treated with brachytherapy after cervical cancer surgery

作　　者：唐成琼 刘江平[1] 古丽娜·库尔班[2] 刘浩[1] 曹耀峰[1] 张小芳 钟薇[2] Tang Chengqiong;Liu Jiangping;Gulina Kuerban;Liu Hao;Cao Yaofeng;Zhang Xiaofang;Zhong Wei(Department of radiation physics and technology,Affiliated Tumor Hospital of the Third Clinical Medical College of Xinjiang Medical University,Wulumuqi 830011,China;Department of Gynaecological Oncology Radiotherapy(Inpatient Area 1),The Affiliated Cancer Hospital of Xinjiang Medical University,Wulumuqi 830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院(第三临床医学院)放射物理技术科,乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院(第三临床医学院)妇科放疗一病区,乌鲁木齐830011

出　　处：《中华放射肿瘤学杂志》2022年第5期445-449,共5页Chinese Journal of Radiation Oncology

基　　金：新疆维吾尔自治区科技计划项目(2019D01C254)。

摘　　要：目的比较3D打印多通道施源器与常规阴道单通道施源器用于近距离治疗的剂量学差异,为宫颈癌术后患者的近距离治疗提供一定的指导依据。方法选取25例自2019年1月—2020年11月接受^(192)Ir高剂量率近距离治疗的宫颈癌术后合并阴道上皮内瘤变Ⅲ级的患者,每位患者均采用3D打印多通道施源器和常规阴道单通道施源器进行CT扫描定位,并制定相应计划及评估,运用逆向剂量优化算法计算后得出剂量体积直方图,比较两组施源器用于近距离治疗时的高危临床靶区、膀胱及直肠受照剂量的差异,选择最优计划实施治疗。结果采用3D打印个体化多通道施源设计计划的D_(90)%、D_(100)%、V_(100)%、V_(150)%与常规单通道施源器设计的计划相比,差异均无统计学意义(P>0.05);膀胱、直肠的D2cm3与常规相比均明显降低,差异有统计学意义(均为P<0.05)。结论采用3D打印技术制作的多通道个体化施源器靶区适形性好,可更好地保护膀胱和直肠,有一定的治疗优势。Objective To compare the dosimetric difference between 3D-printed multi-channel applicator and conventional vaginal single-channel applicator for brachytherapy,aiming to provide guidance for patients receiving brachytherapy after cervical cancer surgery.Methods From January 2019 to November 2020,25 cervical cancer patients complicated with VAIN Ⅲ receiving ^(192)Ir high-dose-rate brachytherapy after cervical cancer surgery were selected.Each patient was located by CT scanning with 3D-printed multi-channel applicator and conventional vaginal single-channel applicator,and corresponding plan and evaluation were carried out.The dose volume histogram(DVH)was obtained by inverse dose optimization algorithm.The dosimetric differences of high-risk clinical target volume(HRCTV),bladder and rectum during brachytherapy were compared with those of source applicators.The optimal treatment plan was selected.Results D_(90)%,D_(100)%,V_(100)% and V_(150)% of the plans designed by 3D-printed individual multi-channel applicator had no significant differences compared with those designed by conventional single-channel applicator(all P>0.05).The bladder and rectal D2cm^(3) designed by 3D-printed multi-channel applicator were significantly lower than those using conventional single-channel applicator,and the differences were statistically significant(both P<0.05).Conclusion The multi-channel individual applicator target made by 3D-printing technology has good conformal property,properly protects the bladder and rectum and possesses treatment advantages over conventional single-channel applicator.

关 键 词：3D打印 多通道施源器 近距离治疗 逆向剂量优化 

分 类 号：R737.33[医药卫生—肿瘤]