JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (2): 26-31.doi: 10.6040/j.issn.1671-7554.0.2016.1451

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Feasibility of radioactive seed implantation in the treatment of lung cancer assisted by template combined with rib drilling technique

HUO Bin1, WANG Lei1, WANG Haitao1, HUO Xiaodong1, CAO Qiang1, WANG Lili1, ZANG Li1, WANG Jinhuan1, ZHENG Guanjun2, CHAI Shude2   

  1. 1. Department of Oncology;
    2. Department of Thoracic Surgery, Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Received:2016-11-23 Online:2017-02-10 Published:2017-02-10

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Abstract: Objective To assess the feasibility of using radioactive seeds implantation assisted by template combined with rib drilling technique under CT guidance in the treatment of lung cancer. Methods The study involved 21 patients with lung cancer who underwent radioactive seeds implantation in our hospital during Jan. 2015 and Jun. 2016. Dicom data were acquired by chest CT scan before implantation, brachytherapy radiation treatment planning system(BTPS)was introduced to carry out the plan, and the prescription dose was 120 Gy. In addition to the conventional needle design, the special design of penetrating rib was adopted in the dose cooling zone due to rib occlusion, rib drilling tech- 山 东 大 学 学 报 (医 学 版)55卷2期 -霍彬,等.模板联合肋骨钻孔技术辅助放射性粒子植入治疗肺癌的可行性 \=-nique was used to establish the real channel, and template was used to control implantation. The distribution of implanted needles and seeds were observed with CT scan. Dose verification was performed immediately after the operation. Intraoperative and postoperative complications were observed and recorded. Results All patients tolerated brachytherapy well. The mean gross tumor volume(GTV), seed number, needle number, D90, V100 and V200 in postoperative verification and preplan were 47.6 vs 46.4 cc, 33 vs 33, 10 vs 10, 12 765.1 vs 12 433.8 Gy, 92.6% vs 95.2% and 34.8% vs 28.8%, respectively(P=0.012, 0.930, 0.267, 0.179, 0.032, and 0.003). The satisfaction rate was 90.5% after operation. The incidence of pneumothorax, pulmonary hemorrhage, pleural cavity, bloody sputum and particle displacement were 19%, 9.5%, 4.7%, 19% and 9.5%. No massive hemoptysis or other complications occurred. Conclusion Template combined with rib drilling technique in radioactive seeds implantation is safe and feasible. The precise positioning can significantly improve the preoperative plan conformity and avoid the blindness of manual operation. It has important value for the standardization and quality control in the treatment of lung cancer.

Key words: Template, Rib drilling technique, Brachytherapy treatment planning system, Lung cancer, Radioactive seeds

CLC Number: 

  • R734.2
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