3D打印模具在宫颈癌近距离治疗中重复使用可行性研究

赵秀娟; 钟明松; 吴海燕; 陈杜可; 王冬

doi:10.16016/j.2097-0927.202204057

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3D打印模具在宫颈癌近距离治疗中重复使用可行性研究

临床医学 | 更新时间：2026-01-09

- 3D打印模具在宫颈癌近距离治疗中重复使用可行性研究
- Feasibility of repeated using 3D printed applicator in brachytherapy for cervical cancer
- 陆军军医大学学报 2022年44卷第18期页码：1874-1880
- 作者机构：
  
  1.400030 重庆，重庆大学附属肿瘤医院: 妇科肿瘤中心
  2.400030 重庆，重庆大学附属肿瘤医院: 肿瘤放射治疗中心
- 作者简介：
  
  [ 王冬，E-mail: cqwindow120@163.com WANG Dong, E-mail: cqwindow120@163.com
- 基金信息：
  
  重庆市科卫联合医学科研项目(2019ZDXM031);重庆市科卫联合医学科研项目(2021MSXM172)
- DOI：10.16016/j.2097-0927.202204057
  中图分类号： R319;R730.53;R737.33
- 收稿：2022-04-08，
  
  修回：2022-05-27，
  
  纸质出版：2022-09-30
- 稿件说明：
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赵秀娟, 钟明松, 吴海燕, 等. 3D打印模具在宫颈癌近距离治疗中重复使用可行性研究[J]. 陆军军医大学学报, 2022,44(18):1874-1880.

Xiujuan ZHAO, Mingsong ZHONG, Haiyan WU, et al. Feasibility of repeated using 3D printed applicator in brachytherapy for cervical cancer[J]. Journal of Army Medical University, 2022, 44(18): 1874-1880.
赵秀娟, 钟明松, 吴海燕, 等. 3D打印模具在宫颈癌近距离治疗中重复使用可行性研究[J]. 陆军军医大学学报, 2022,44(18):1874-1880. DOI： 10.16016/j.2097-0927.202204057.

Xiujuan ZHAO, Mingsong ZHONG, Haiyan WU, et al. Feasibility of repeated using 3D printed applicator in brachytherapy for cervical cancer[J]. Journal of Army Medical University, 2022, 44(18): 1874-1880. DOI： 10.16016/j.2097-0927.202204057.

摘要

目的

通过对比3D打印模具在宫颈癌近距离治疗中预计划与多次实际治疗计划的剂量学，探讨同一模具在同一患者治疗过程中重复使用的可行性。

方法

收集2019年11月至2020年7月本院收治的接受根治性放疗宫颈鳞癌患者10例，同步放化疗联合3D打印模具辅助近距离治疗。比较3D打印模具预计划与多次实际治疗计划参数: CT扫描次数，高危临床靶区(high risk clinical target area，HR-CTV)体积和D

剂量、靶区适形指数(conformity index，CI)，危及器官(organs at risk，OARs)2 cm

接收到的吸收剂量(D

2cc

)；分析患者近期疗效及2年局部控制率(local control rates

LCR)、无病生存率(disease free survival，DFS)、总生存率(overall survival，OS)。两种计划参数对比采用配对样本

检验，患者生存结局采用Kaplan-Meier生存分析。

结果

共设计3D打印模具10个、完成84次CT扫描、47次实际治疗；预计划与第1次实际治疗HR-CTV体积及CI差异无统计学意义(

0.05)，近距离治疗次数越多，HR-CTV体积越小，且靶区CI越好；HR-CTV D

及OARs均满足临床要求；中位随访23.5个月，2年的LCR、DFS、OS分别为100%、90%、80%。

结论

3D打印模具可重复用于同一宫颈癌患者近距离治疗，但伴随肿瘤退缩需根据CT定位调整进针深度。

Abstract

Objective

To explore the feasibility of repeated use of the same mold in the brachytherapy of cervical cancer by comparing the dosimetry of the 3D-printed vaginal applicator in the pre-plan and actual treatment plan in the brachytherapy of cervical cancer.

Methods

A total of 10 patients with cervical squamous cell carcinoma who received radical radiotherapy in our hospital from November 2019 to July 2020 were reruited in this study. All patients received concurrent radiotherapy and chemotherapy combined with 3D printed applicator assisted brachytherapy. Dosimetric parameters

including CT scan frequency

high risk clinical target area (HR-CTV) volume and D

dose

conformity index (CI)

Dose (D

2cc

the absorbed dose received by 2 cm

of OARs) variation in organs at risk (OARs)

and short-term efficacy and 2-year survival outcome of local control rates (LCR)

disease free survival (DFS) and overall survival (OS) were compared the parameters of 3D printed mold pre-planning and multiple actual treatment plans. Paired samples

test was used to compare the parameters of pre-planning and actual treatment plans. Kaplan-Meier survival analysis was applied to analyze the survival outcomes of the patients.

Results

Ten 3D printing applicators were designed

and a total of 84 CT scans and 47 practical treatments were completed. Only the target volume and CI of the first actual treatment plan were similar to those of the pre-plan

but the difference was not statistically significant (

0.05). The more times of close treatment

the smaller HR-CTV volume was and the better CI of target area was. Both HR-CTV D

dose and the OARs dose met clinical requirement. During the median follow-up of 23.5 months

the 2-year LCR

DFS and OS were 100%

90% and 80%

respectively.

Conclusion

The 3D-printed vaginal applicator can be used repeatedly for brachytherapy of the same cervical cancer patient

but the needle depth needs to be adjusted by CT positioning.

关键词

Keywords

references

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