3D打印技术在妇科恶性肿瘤术后阴道腔内照射中的应用价值探究  

Application value of 3D printing technology in postoperative intravaginal irradiation for gynecologic malignancies

作　　者：许秀玲 XU Xiu-ling(Obstetrics and Gynecology Department,Shunde District Longjiang Hospital,Foshan 528318,China)

机构地区：[1]广东省佛山市顺德区龙江医院妇产科一区,528318

出　　处：《中国实用医药》2023年第1期70-73,共4页China Practical Medicine

摘　　要：目的 分析3D打印技术在妇科恶性肿瘤术后阴道腔内照射中的应用效果。方法 68例妇科恶性肿瘤患者,均接受术后阴道腔内照射治疗,用含稀释复方泛影葡萄胺溶液及柱状施源器填塞阴道,接受柱状施源器治疗或接受3D打印施源器治疗,并用CT做定位。比较子宫内膜癌术后、宫颈癌术后、阴道残端复发患者的空气间隙体积及分布状况,单通道柱状组、多通道柱状组、3D打印施源器组空气间隙后剂量差异,接受3D打印施源器治疗患者与接受柱状施源器治疗患者中上段阴道长度。结果 68例妇科恶性肿瘤患者中, 35例接受柱状施源器治疗(单通道柱状16例、多通道柱状19例),33例接受3D打印施源器治疗。阴道残端复发患者总空气间隙、顶端空气间隙、侧方空气间隙体积高于子宫内膜癌术后患者及宫颈癌术后患者,子宫内膜癌术后患者总空气间隙、顶端空气间隙、侧方空气间隙体积高于宫颈癌术后患者,差异均具有统计学意义(P<0.05)。单通道柱状组、多通道柱状组、3D打印施源器组CTV2-V100、CTV2-DNR、CTV2-OI比较,差异无统计学意义(P>0.05);3D打印施源器组CTV2-CI低于多通道柱状组低于单通道柱状组,差异有统计学意义(P<0.05);3D打印施源器组靶区中阴道表面平均量、小肠D2cc低于单通道柱状组低于多通道柱状组,差异有统计学意义(P<0.05);单通道柱状组膀胱D2cc、直肠D2cc高于3D打印施源器组高于多通道柱状组,差异有统计学意义(P<0.05);3D打印施源器组乙状结肠D2cc高于单通道柱状组高于多通道柱状组,差异有统计学意义(P<0.05)。33例接受3D打印施源器治疗患者中上段阴道长度(5.31±0.82)cm长于35例柱状施源器治疗患者的(4.94±0.51)cm,差异有统计学意义(P<0.05)。结论 妇科恶性肿瘤患者接受术后3D打印技术阴道腔内照射治疗,可降低顶端阴道折皱、空气间隙,提升靶区覆盖,避免低剂量冷点和高剂量Objective To analyze the application effect of 3D printing technology in postoperative intravaginal irradiation for gynecologic malignancies. Methods 68 patients with gynecologic malignancies were treated with postoperative intravaginal irradiation, and the vagina was filled with diluted compound meglumine diatrizoate solution and columnar applicators, then treated by columnar applicators or 3D printed applicators with CT localization. Comparison was made on air gap volume and distribution of patients with vaginal stump recurrence, endometrial cancer and cervical cancer was compared;the difference in post-air gap dose among the single-channel columnar group, the multi-channel columnar group, and the 3D printed applicator group;as well as the length of the upper and middle vagina in patients receiving 3D printed applicator versus those receiving columnar applicator treatment. Results Among 68 patients with gynecologic malignancies, 35 patients were treated with columnar applicator(16 cases with single-channel columnar, 19 cases with multi-channel columnar), and 33 patients were treated with 3D printed applicator. The total air gap volume, the apical air gap volume, and the lateral air gap volume in patients with vaginal stump recurrence were higher than those in patients with endometrial cancer and patients with cervical cancer;the differences were statistically significant(P<0.05). The CTV2-V100,CTV2-DNR and CTV2-OI were compared among the single-channel columnar group, multi-channel columnar group and 3D printed applicator group, and the differences were not statistically significant(P>0.05). The mean amount of vaginal surface and small intestinal D2cc in the target area of the 3D printed applicator group was lower than that of the single-channel columnar group, and the single-channel columnar group was lower than the multichannel columnar group, and the differences were statistically significant(P<0.05). The bladder D2cc and rectal D2cc in the single-channel columnar group were higher than those in 3D printed a

关 键 词：3D打印技术 妇科 恶性肿瘤 阴道腔内照射 

分 类 号：R737.3[医药卫生—肿瘤]