3D打印模具引导与徒手插植治疗宫颈癌剂量学比较  

Dosimetric comparison of three-dimensional printed template and free implantation in the treatment of cervical cancer

作　　者：张婷 邱凌平[1] 殷皓泽 李克[1] 袁磊 彭绿英 田秋红[1] Zhang Ting;Qiu Lingping;Yin Haoze;Li Ke;Yuan Lei;Peng Lvying;Tian Qiuhong(The First Affiliated Hospital of Nanchang University,Nanchang 310000)

机构地区：[1]南昌大学第一附属医院肿瘤医学中心,南昌310000

出　　处：《数理医药学杂志》2022年第11期1592-1594,共3页Journal of Mathematical Medicine

摘　　要：目的:比较研究3D打印模具引导与徒手插植近距离治疗宫颈癌术后阴道残端需要补量的患者剂量学差异,为宫颈癌术后残端患者提供一定的指导依据。方法:选取19例2020年11月-2022年8月在我院接受治疗的宫颈癌术后需补量的患者。其中9例徒手插植,10例借助3D打印模具插植,通过分析比较利用3D打印模具插植组和自由插植组高危临床靶区(High Risk CTV,HR-CTV)的D_(90cc)、D_(_(98cc))、D_(100cc)的参考剂量,以及膀胱、直肠等危及器官D_(2cc)、D_(1cc)、D_(0._(1cc))的剂量差异。结果:采用3D打印模具插值组的HR-CTV D_(90cc)、D_(_(98cc))、D_(100cc)分别为445.04±30.7 cGy、556.3±25.1 cGy、634.5±25.2 cGy;徒手插植组的HR-CTV D_(90cc)、D_(_(98cc))、D_(100cc)分别为407.1±43.2 cGy、548.7±44.6 cGy、631±43.2cGy;两组比较,3D打印治疗组的靶区剂量均高于徒手插植组,差异有统计学意义(P<0.05)。膀胱和直肠D_(0._(1cc))、D_(_(1cc))、D_(2cc)比较,发现3D打印组的剂量分布更加集中,其剂量都低于徒手插植组,剂量偏差也更小。结论:采用3D打印模具引导治疗宫颈癌其靶区适形性更好,直肠和膀胱的剂量更低,有一定的治疗优势。Objective: To study the dosemetric differences between 3D printing template and free-inserted brachytherapy in patients with postoperative vaginal stump requiring enhancement after cervical cancer surgery, and to provide some guidance for patients with postoperative vaginal stump after cervical cancer surgery. Methods: A total of19 patients who received brachytherapy in our hospital from November 2020 to August 2022. Among them, 9 patients were free implanted, 10 patients were implanted with the help of 3D printing molds, compared the reference doses of D_(90cc), D_(98cc), D_(100cc) of HR-CTV using 3D printing template insertion and free insertion, and compared the dose differences of D_(2cc), D_(1cc), and D_(0._(1cc)) for organs such as bladder and rectum. Results: The HR-CTV D_(100cc), D_(98cc),D_(90cc) in the 3D printed template interpolation were 445.04±30.7 cGy, 556.3±25.1 cGy, 634.5±25.2 cGy, respectively. the HR-CTV D_(100cc), D_(98cc), D_(90cc) in the free implantation group were 407.1±43.2 cGy, 548.7±44.6 cGy, 631±43.2 cGy,respectively;Compared with the two groups, the target dose of the 3D printing mold interpolation was higher than that in the free implantation group, and the difference was statistically significant (P<0.05). Comparing the bladder and rectum D_(0._(1cc)), D_(1cc) and D_(2cc), it was found that the dose distribution in the 3D printing group was more concentrated, and the doses in both the bladder and rectum were lower, and their dose deviations were smaller. Conclusion: The use of 3D printing mold to guide the treatment of patients who has better target conformity, lower rectum and bladder doses, which has certain therapeutic advantages.

关 键 词：宫颈癌 近距离治疗 3D打印 

分 类 号：R445.4[医药卫生—影像医学与核医学]