MSOR12 演讲时间：下午 5:55

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2024-10-25 DOI:10.1016/j.brachy.2024.08.046

Felipe Castro Canovas MD, DRCPSC, Carlos Herrera Castillo MSc, Eduardo Carrasco Solis MSc, Yesenia Miranda Tunque MD, Luis Gamarra Delgado MD, Indranit Revilla Coz MD, Gustavo Lasteros Ayma MD, Juan Manuel Trejo Mena MD, Herbert Cardenas Del Carpio MD, Paola Fuentes-Rivera Carmelo MD, Alberto Lachos Davila MD, Adela Heredia Zelaya MD, Karinthia Ballon Cervantes MD

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引用次数: 0

摘要

目的在中低收入国家，CT 模拟或专用表面扫描仪非常稀缺，我们利用许多现成的智能手机中的几何图形映射技术替代其他设计方法，将所需的 CT 模拟次数从两次减少到一次，让更多患者获得了定制涂抹器。材料与方法在选定的有皮肤近距离放射治疗或 EBRT 适应症的同意患者中，使用智能手机前置摄像头系统（如配备 TrueDepth 摄像头的苹果 iPhone X 或更新机型），通过捕捉软件（苹果 iOS - Marek Simonik 的 Heges 3D 扫描仪）捕捉皮肤表面，然后导出到计算机辅助设计软件，绘制涂抹器蓝图（苹果 MacOS 或微软 Windows 上的 Meshmixer 和 Fusion 360 Autodesk）。然后使用内部的熔融沉积建模打印机（Flashforge Adventure 3）和聚乳酸（PLA）材料对涂抹器进行三维打印。敷贴器完成了质量保证检查，然后安装到患者身上，进行单次 CT 模拟规划 (SagiPlan®)、质量保证和使用 Cobalt - 60 后装载器 (SagiNova®) 进行治疗。按照标准机构协议进行随访，并使用《不良事件通用术语标准 5.0 版》（CTCAE）报告毒性。结果从2023年7月到2024年1月，共扫描了05名患者，4名患者接受了3D打印定制的EBRT栓剂，1名患者接受了定制的HDR皮肤近距离放射治疗定制涂抹器，报告的1名接受HDR近距离放射治疗的患者患有鼻基底细胞癌，处方剂量为40Gy，每天分10次给药，100%等剂量线包裹PTV，限制表面剂量<150%。治疗结束时出现急性 1 级皮肤毒性，3 个月后完全消退。结论这种新型工作流程的早期小规模经验似乎是可面对的、安全的，有可能减少 CT Sim 的拥堵，让更多中低收入国家的患者获得定制的 3D 打印配件。还需要更多患者和更长时间的随访，有关 3D EBRT 栓剂结果的报告将在随后公布。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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MSOR12 Presentation Time: 5:55 PM

Purpose

This single-institution proof of concept and early experience on an innovative workflow for the creation of custom applicators for high dose rate (HDR) skin brachytherapy and skin bolus in low to middle-income countries, where access to CT simulation or dedicated surface scanners is sparse, we utilized geometry mapping technology found in many readily available smartphones as an alternative to other design methods, reducing the number of CT-simulations needed from two to one, improving access to custom applicators for more patients. We now report our skin brachytherapy early experience.

Materials and Methods

In selected consenting patients with indication for skin brachytherapy or EBRT, a smartphone front camera system (e.g. Apple iPhone X or newer with TrueDepth camera) was used to capture the skin surface with capturing software (Apple iOS - Heges 3D Scanner by Marek Simonik), then exported to a computer-aided design software to blueprint the applicator (Meshmixer and Fusion 360 Autodesk on Apple MacOS or Microsoft Windows). The applicator was then 3D printed in-house using a fused deposition modeling printer (Flashforge Adventure 3) with polylactic Acid (PLA) material. The applicator completed a quality assurance examination and then fitted to the patient for a single CT simulation for planning (SagiPlan®), quality assurance and treatment delivery with a Cobalt - 60 after loader (SagiNova®). Follow-up was conducted per standard institutional protocol, and Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE) was used to report toxicities.

Results

From July 2023 to January 2024, 05 patients were scanned, 4 patients received a 3D printed custom bolus for EBRT, and 1 patient received a custom HDR skin brachytherapy custom applicator, the one patient treated with HDR brachytherapy is reported, had basal cell carcinoma of the nose, the prescription dose was 40Gy in 10 fractions delivered daily, 100% isodose line encapsulated the PTV, limiting surface dose <150%. Acute grade 1 skin toxicity was observed at the end of treatment, it completely resolved at 3 months. No late toxicity or recurrence was observed at 6 months.

Conclusions

This small, early-reported experience with a novel workflow seems faceable and safe, potentially allowing less congestion at the CT Sim, improving access for more patients in low to middle-income countries to custom 3D printed accessories. A larger number of patients and longer follow-ups are needed, report on 3D EBRT bolus results to follow.

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.