您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (11): 44-50.doi: 10.6040/j.issn.1671-7554.0.2016.1157

• 临床医学 • 上一篇    下一篇

3D打印个体化模板联合CT引导125I粒子植入治疗恶性肿瘤质量评价

张颖,林琦,袁苑,戴建建,耿宝成,徐瑞彩,刘亚坤,韩明勇   

  1. 山东大学附属省立医院东院保健综合(肿瘤)科, 山东 济南 250014
  • 收稿日期:2016-09-13 出版日期:2016-11-10 发布日期:2016-11-10
  • 通讯作者: 韩明勇. E-mail:hangmingyong@sina.com E-mail:hangmingyong@sina.com
  • 基金资助:
    国家自然科学基金(81272351)

Feasibility of 3D print individual template combined with CT-guided 125I seed implantation for malignant tumors

ZHANG Ying, LIN Qi, YUAN Yuan, DAI Jianjian, GENG Baocheng, XU Ruicai, LIU Yakun, HAN Mingyong   

  1. Department of Health Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250014, Shandong, China
  • Received:2016-09-13 Online:2016-11-10 Published:2016-11-10

PDF (PC)

227

摘要： 目的 对3D打印个体化模板联合CT引导125I粒子植入术后验证的剂量学参数进行评价,探讨其治疗肿瘤的可行性。 方法 收集2015年12月至2016年7月住院患者30例,全部患者术前行CT模拟定位,设计并应用3D打印机打印个体化模板。手术时,将患者进行复位、模板与体表术区对合、按术前计划进针、植入粒子,术后即刻行CT扫描,进行剂量学验证。按照英国哥伦比亚癌症研究中心粒子植入质量评价标准对植入质量进行评价。 结果 30例患者均成功设计并打印个体化模板。28例技术成功,其中22例患者术后实际植入粒子数与术前计划一致,另外6例给予术中优化。术后验证评价结果,优:14例;良:10例;中:4例;差:0例。2例技术失败。 结论 3D 打印个体化模板联合CT引导粒子植入治疗恶性肿瘤能够保证粒子植入质量控制的实施,值得临床推广应用。

关键词: 个体化模板, 125I粒子, 3D打印, 恶性肿瘤

Abstract: Objective To evaluate the feasibility of 3D print individual template and CT-guided 125I seed implantation for malignant tumors. Methods A total of 30 patients were involved in this study. Before 125I seed implantation, the patients received CT simulation orientation as the predicted posture. The individual template was designed by the brachytherapy treatment planning system(BTPS), and printed by 3D print technique. Every patient received 125I seed implantation under the guidance of 3D print individual template and CT scan. After implantation, treatment quality was evaluated with CT and BTPS. Results The 3D print individual templates were successfully designed and manufactured. Of all 30 cases, 28 were successfully implanted with the 3D print templates, and 2 failed. Of the 28 successful cases, 22 had the same number of seeds implanted as scheduled before operation, and the other 6 cases optimized the number of seeds during operation. Postoperative evaluation indicated that 14(50.0%)cases had excellent implants, 10(35.7%)had good implants, 4(14.3%)had suboptimal implants, and no case had poor implants. Conclusion The 3D print individual template and CT-guided 125I seed implantation appears to be a feasible, safe and effective modality for the treatment of malignant tumors.

Key words: Malignancy, 3D print, Individual template, 125I seed

中图分类号: 

  • R730.55
[1] Stewart A, Parashar B, Patel M, et al. American brachytherapy society consensus guidelines for thoracic brachytherapy for lung cancer[J]. Brachytherapy, 2016, 15(1):1-11.
[2] Yao L, Jiang Y, Jiang P, et al. CT-guided permanent 125I seed interstitial brachytherapy for recurrent retroperitoneal lymph node metastases after external beam radiotherapy[J]. Brachytherapy, 2015, 14(5):662-669.
[3] Mutyala S, Stewart A, Khan AJ, et al. Permanent iodine-125 interstitial planar seed brachytherapy for close or positive margins for thoracic malignancies[J]. Int J Radiat Oncol Biol Phys, 2010, 76(4):1114-1120.
[4] Nath R, Anderson LL, Luxton G, et al. Dosimetry of interstitial brachytherapy sources: recommendations of the AAPM Radiation Therapy Committee Task Group No 43[J]. Med Phys, 1995, 22(2):209-234.
[5] Keyes M, Morris WJ, Spadinger I, et al. Radiation oncology and medical physicists quality assurance in British Columbia Cancer Agency Provincial Prostate Brachytherapy Program[J]. Brachytherapy, 2013, 12(4):343-355.
[6] Kovtun KA, Wolfsberger L, Niedermayr T, et al. Dosimetric quality and evolution of edema after low-dose-rate brachytherapy for small prostates: Implications for the use of newer isotopes[J]. Brachytherapy, 2014, 13(2):152-156.
[7] Marcu LG, Lawson JM, et al. Technical and dosimetric aspects of iodine-125 seed reimplantation in suboptimal prostate implants[J]. British Journal of Radiology, 2013, 86(1026):20130058. doi: 10.1259/bjr.20130058. Epub 2013 Mar 21.
[8] Kupelian PA, Ramsey C, Meeks SL, et al. Serial megavoltage CT imaging during external beam radiotherapy for non-small-cell lung cancer: Observations on tumor regression during treatment[J]. Int J Radiat Oncol Biol Phys, 2005, 63(4):1024-1028.
[9] Janusz S.Brachytherapy in the treatment of lung cancer- a valuable solution[J].J Contemp Brachytherapy, 2015, 7(4):297-311.
[10] Mandell L, Nori D, Anderson L, et al. The effects of permanent I-125 interstitial implantation on cortical bone[J]. Int J Radiat Oncol Biol Phys, 1985, 11(5):1029-1034.
[11] Feng S, Wang L, Xiao Z, et al. 125I Seed Implant Brachytherapy for Painful Bone Metastases After Failure of External Beam Radiation Therapy[J].Medicine, 2015, 94(31):e1253. doi: 10.1097/MD.0000000000001253.
[12] 杨瑞杰, 姜玉良,王俊杰,等.复发性直肠癌CT引导125I粒子植入的剂量学验证[J].中国肿瘤,2009,18(10):848-850. YANG Ruijie, JIANG Yuliang, WANG Junjie, et al.Dosimetric Verification of Ctguided 125I Seed Implantation in Recurrent Rectal Cancer[J].China Cancer, 2009, 18(10):848-850.
[13] Gao F, Li C, Gu Y, et al. CT-guided 125I brachytherapy for mediastinal metastatic lymph nodes recurrence from esophageal carcinoma: effectiveness and safety in 16 patients[J]. Eur J Radiol, 2013, 82(2):70-75.
[14] Taussky D, Austen L, Toi A, et al. Sequential evaluation of prostate edema after permanent seed prostate brachytherapy using CT-MRI fusion[J]. Int J Radiat Oncol Biol Phys, 2005, 62(4):974-980.
[15] Nasser NJ, Wang Y, Borg J, et al. Sector analysis of dosimetry of prostate cancer patients treated with low-dose-rate brachytherapy[J]. Brachytherapy, 2014, 13(4):369-374.
[16] Yamada Y, Potters L, Zaider M, et al. Impact of intraoperative edema during transperineal permanent prostate brachytherapy on computer optimized and preimplant planning techniques[J]. Am J Clin Oncol, 2003, 26(5):130-135.
[17] 张颖, 林琦, 韩明勇,等.3D打印个体化模板联合CT引导治疗胸壁肿瘤1例[J]. 山东大学学报(医学版), 2016,54(4):94-96.
[18] 张宏涛, 底学敏, 王娟,等. 3D打印模板引导125I粒子植入术前术后剂量对比[J]. 中华医学杂志, 2016,96(9):712-715. ZHANG Hongtao, DI Xuemin, WANG Juan, et al.Dose comparison between pre and post operation of 125I seed implantation guided by 3D print template[J]. National Medical Journal of China, 2016, 96(9):712-715.
[19] Huang MW, Liu SM, Zhang JG. A digital model individual template and CT-guided 125I seed implants for malignant tumors of the head and neck[J]. J Radiat Res, 2012, 53(6):973-977.
[20] Ikushima H. Radiation therapy: state of the art and the future[J].Journal of Medical Investigation, 2010, 57(1-2):1-11.
[1] 林琦,张颖,袁苑,戴建建,徐瑞彩,杨琦,耿宝成,韩明勇. 肾上腺转移瘤放射性125I粒子植入治疗后胃穿孔1例[J]. 山东大学学报（医学版）, 2017, 55(7): 124-129.
[2] 曹倩倩,姜玉华,李玉亮,杨瑞杰,刘路,张喜乐,王俊杰. 放射性125I粒子植入与外放疗治疗颈椎转移瘤剂量学对比分析[J]. 山东大学学报（医学版）, 2017, 55(7): 55-60.
[3] 戴建建,袁冰,张颖,林琦,袁苑,韩明勇. CT引导下125I粒子植入治疗Ⅲ期非小细胞肺癌疗效与并发症的临床观察[J]. 山东大学学报（医学版）, 2017, 55(2): 32-37.
[4] 林琦,张颖,戴建建,徐瑞彩,杨琦,耿宝成,韩明勇. CT引导放射性125I粒子植入治疗23例浅表淋巴结转移瘤[J]. 山东大学学报（医学版）, 2017, 55(2): 38-44.
[5] 许玉军,柳明,何祥萌,李成利. 1.0T开放型磁共振引导经皮穿刺125I放射性粒子植入治疗晚期胰腺癌[J]. 山东大学学报（医学版）, 2017, 55(2): 21-25.
[6] 张颖,林琦,袁苑,戴建建,耿宝成,徐瑞彩,刘亚坤,韩明勇. 3D打印个体化模板联合CT引导125I粒子植入治疗肿瘤术前术后剂量学比较[J]. 山东大学学报（医学版）, 2017, 55(2): 45-49.
[7] 李扬,何闯,陈玉潇,杨丽,李良山,李廷源,黄学全. 放射性125I粒子植入近距离治疗长骨转移瘤的临床疗效[J]. 山东大学学报（医学版）, 2017, 55(2): 50-54.
[8] 申文江. 放射性粒子植入的创新性临床研究[J]. 山东大学学报（医学版）, 2017, 55(2): 1-3.
[9] 袁苑,张颖,林琦,戴建建,李冉冉,徐瑞彩,杨琦,耿宝成,韩猛,韩明勇. 125I粒子植入术后应用透明质酸钠凝胶皮下注射保护皮肤1例[J]. 山东大学学报（医学版）, 2017, 55(11): 89-92.
[10] 王丽丽,霍彬,王磊,汪浩,侯定坤,霍小东,王金焕,臧立,曹强,柴树德,王海涛. 亚肺叶切除联合125I粒子植入治疗早期肺癌有效性的Meta分析与系统评价[J]. 山东大学学报（医学版）, 2017, 55(10): 76-83.
[11] 张颖,林琦,袁苑,戴建建,耿宝成,徐瑞彩,刘亚坤,韩明勇. 3D打印个体化模板联合CT引导125I粒子植入治疗胸壁转移瘤1例[J]. 山东大学学报（医学版）, 2016, 54(4): 94-96.
[12] 孔祥骞,王默,董典宁,种振岳,金星. 3D打印辅助开窗技术腔内修复治疗近肾动脉腹主动脉瘤[J]. 山东大学学报（医学版）, 2016, 54(3): 91-94.
[13] 房菲菲,张颖,林琦,袁苑,戴建建,徐瑞彩,耿宝成,韩明勇. CT引导放射性125I粒子植入治疗转移性肝癌的临床疗效[J]. 山东大学学报（医学版）, 2016, 54(12): 53-57.
[14] 于绍轶, 陈远银, 刘海韵, 曲淑娜, 徐颖, 王倩倩, 王茂波. 应用DALYs评价烟台市恶性肿瘤疾病负担[J]. 山东大学学报（医学版）, 2015, 53(8): 92-96.
[15] 倪忆媚, 叶丽. 舒适护理在妇产科恶性肿瘤患者中的应用效果[J]. 山东大学学报（医学版）, 2014, 52(Z2): 154-155.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发