Preliminary exploration of 3D printed individualized applicator for 3D-image-guided intracavitary HDR-brachytherapy for nasopharyngeal carcinoma

中华放射肿瘤学杂志 Pub Date : 2020-03-15 DOI:10.3760/CMA.J.ISSN.1004-4221.2020.03.012

Yi-Qiang Tang, L. Zeng, Fan Ao, Yulu Liao, Min Huang, Shulan Chen, Xiaowei Rao, Jingao Li

{"title":"Preliminary exploration of 3D printed individualized applicator for 3D-image-guided intracavitary HDR-brachytherapy for nasopharyngeal carcinoma","authors":"Yi-Qiang Tang, L. Zeng, Fan Ao, Yulu Liao, Min Huang, Shulan Chen, Xiaowei Rao, Jingao Li","doi":"10.3760/CMA.J.ISSN.1004-4221.2020.03.012","DOIUrl":null,"url":null,"abstract":"Objective \nTo explore the feasibility of 3D printed individualized applicator for the intracavitary HDR-brachytherapy for nasopharyngeal carcinoma. \n \n \nMethods \nCT scan was performed in 1 case of recurrent rT1 nasopharyngeal carcinoma and 1 case of T2 residual nasopharyngeal carcinoma and the obtained images were transmitted to 3D image processing software. The geometric contour parameters of the nasopharyngeal cavity were obtained and a pipeline was designed to make it close to the recurrent gross tumor volume (rGTV). Individualized cavity applicators were created by using 3D printer. The applicator was inserted into the patient′s nasopharyngeal cavity through oral cavity. The source tube and false source were inserted into the preset pipe of the applicator. CT scan was performed again and the images were transmitted to the 3D brachytherapy planning system. After delineating the target volume and organ at risk, treatment plan was optimized. After completing the first treatment, the applicator was removed. Before second treatment in a few days, CT scan was reviewed to confirm whether the position was correct. \n \n \nResults \nWhen the applicator was inserted into the nasopharyngeal cavity, it could be fully aligned with the nasopharyngeal wall and self-fixed without additional fixation measures. Comparing the location of false source in multiple reviews of CT scan, the error was ≤1 mm. No significant discomfort was reported throughout the treatment. In optimized three-dimensional treatment, 100% prescription dose curve included the full rGTV, maximum dose of the brain stem and spinal cord was<30% prescription dose. Recurrent patients were given with a prescription dose of DT 40Gy/8 fractions/4 weeks and patients with residual tumors were given with 12Gy/2 fractions/1 week. No tumor recurrence was observed at postoperative 3 months in two cases. \n \n \nConclusions \nThe 3D printed individualized nasopharyngeal intracavitary applicator has the advantages of self-fixation, accurate location, good repeatability and good patient tolerance. The short-term outcome is effective, whereas its long-term clinical effect and adverse reactions need to be further observed. \n \n \nKey words: \n3D printed; Individualized applicator; Nasopharyngeal neoplasm/intracavitary radiotherapy","PeriodicalId":10288,"journal":{"name":"中华放射肿瘤学杂志","volume":"29 1","pages":"211-214"},"PeriodicalIF":0.0000,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华放射肿瘤学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.ISSN.1004-4221.2020.03.012","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Objective To explore the feasibility of 3D printed individualized applicator for the intracavitary HDR-brachytherapy for nasopharyngeal carcinoma. Methods CT scan was performed in 1 case of recurrent rT1 nasopharyngeal carcinoma and 1 case of T2 residual nasopharyngeal carcinoma and the obtained images were transmitted to 3D image processing software. The geometric contour parameters of the nasopharyngeal cavity were obtained and a pipeline was designed to make it close to the recurrent gross tumor volume (rGTV). Individualized cavity applicators were created by using 3D printer. The applicator was inserted into the patient′s nasopharyngeal cavity through oral cavity. The source tube and false source were inserted into the preset pipe of the applicator. CT scan was performed again and the images were transmitted to the 3D brachytherapy planning system. After delineating the target volume and organ at risk, treatment plan was optimized. After completing the first treatment, the applicator was removed. Before second treatment in a few days, CT scan was reviewed to confirm whether the position was correct. Results When the applicator was inserted into the nasopharyngeal cavity, it could be fully aligned with the nasopharyngeal wall and self-fixed without additional fixation measures. Comparing the location of false source in multiple reviews of CT scan, the error was ≤1 mm. No significant discomfort was reported throughout the treatment. In optimized three-dimensional treatment, 100% prescription dose curve included the full rGTV, maximum dose of the brain stem and spinal cord was<30% prescription dose. Recurrent patients were given with a prescription dose of DT 40Gy/8 fractions/4 weeks and patients with residual tumors were given with 12Gy/2 fractions/1 week. No tumor recurrence was observed at postoperative 3 months in two cases. Conclusions The 3D printed individualized nasopharyngeal intracavitary applicator has the advantages of self-fixation, accurate location, good repeatability and good patient tolerance. The short-term outcome is effective, whereas its long-term clinical effect and adverse reactions need to be further observed. Key words: 3D printed; Individualized applicator; Nasopharyngeal neoplasm/intracavitary radiotherapy

查看原文本刊更多论文

3D打印个性化应用器在三维图像引导下鼻咽癌腔内HDR近距离治疗中的初步探索

目的探讨3D打印个性化治疗器用于鼻咽癌腔内HDR近距离治疗的可行性。方法对1例复发性rT1鼻咽癌和1例T2残留鼻咽癌进行CT扫描，并将获得的图像传输到3D图像处理软件中。获得鼻咽腔的几何轮廓参数，并设计管道使其接近复发总肿瘤体积（rGTV）。使用3D打印机制作了个性化的空腔喷头。涂抹器通过口腔插入患者的鼻咽腔。将源管和假源插入涂抹器的预设管中。再次进行CT扫描，并将图像传输到3D近距离放射治疗计划系统。在划定目标体积和危险器官后，对治疗方案进行了优化。在完成第一次治疗后，移除施用器。在几天后进行第二次治疗之前，复查CT扫描以确认位置是否正确。结果将敷贴器插入鼻咽腔后，可与鼻咽壁完全对齐并自行固定，无需额外的固定措施。在CT扫描的多次复查中比较假源的位置，误差≤1mm。在整个治疗过程中没有明显的不适报告。在优化的三维治疗中，100%处方剂量曲线包括全rGTV，脑干和脊髓的最大剂量<30%处方剂量。复发患者给予DT 40Gy/8组分/4周的处方剂量，残留肿瘤患者给予12Gy/2组分/1周。两例术后3个月未发现肿瘤复发。结论3D打印个性化鼻咽腔内涂抹器具有自固定、定位准确、重复性好、患者耐受性好的优点。短期结果是有效的，但其长期临床效果和不良反应需要进一步观察。关键词：3D打印；个性化涂抹器；鼻咽肿瘤/腔内放射治疗

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

中华放射肿瘤学杂志

自引率

0.00%

发文量

6375

期刊介绍： The Chinese Journal of Radiation Oncology is a national academic journal sponsored by the Chinese Medical Association. It was founded in 1992 and the title was written by Chen Minzhang, the former Minister of Health. Its predecessor was the Chinese Journal of Radiation Oncology, which was founded in 1987. The journal is an authoritative journal in the field of radiation oncology in my country. It focuses on clinical tumor radiotherapy, tumor radiation physics, tumor radiation biology, and thermal therapy. Its main readers are middle and senior clinical doctors and scientific researchers. It is now a monthly journal with a large 16-page format and 80 pages of text. For many years, it has adhered to the principle of combining theory with practice and combining improvement with popularization. It now has columns such as monographs, head and neck tumors (monographs), chest tumors (monographs), abdominal tumors (monographs), physics, technology, biology (monographs), reviews, and investigations and research.