Introduction
To investigate the accuracy of needle distribution and dosimetric parameter differences of 3D-printing non-coplanar template (3D-PNCT)-assisted computed tomography (CT)-guided iodine-125 seed ablative brachytherapy (125I-SAB) in gynecological cancer patients with non-central pelvic recurrence between pre-operative plan and post-operative plan.

Material and methods
Thirty-eight patients with forty-one non-central pelvic recurrent gynecological carcinomas after radiotherapy were enrolled in this study. All patients received 3D-PNCT-assisted CT-guided 125I-SAB from January 2016 to January 2019. The position, angle, and depth of seed needles were measured in both pre-operative plan and intra-operative real-time plan in brachytherapy treatment planning system (B-TPS). Dosimetric parameters of D90, D100, V100, V150, and V200 as well as quality parameters of conformal index (CI), external index (EI), and homogeneity index (HI) were compared between pre-operative plan and post-operative plan. Peri-operation complications and radiation-related toxicity were assessed.

Results
Median follow-up time was 12 months (range, 5-34 months). Prescribed dose was 100-170 Gy (median, 120 Gy). Radioactivity of 125I seed was 0.4-0.7 mCi (median, 0.55 mCi). Mean depth deviation for 499 needles was 0.8 ±1.0 cm. Mean angular deviation was 2.2 ±2.1 degrees. Mean tip distance deviation of needles was 0.4 ±0.3 cm. There were significant differences between pre-operative and post-operative plans in CI (p = 0.001) and EI (p = 0.005). No significant differences were shown in D90, D100, V100, V150, V200, and HI between pre-operative and post-operative plans. Only few patients suffered from ≤ grade 2 toxicities.

Conclusions
3D-PNCT-assisted CT-guided 125I-SAB is safe and feasible for non-central pelvic recurrence of gynecological cancer. All complications are tolerable and mild.



中文翻译：

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3D打印非共面模板辅助计算机断层扫描引导碘125粒子消融近距离治疗妇科癌盆腔外侧复发的准确性和剂量参数比较

 介绍

探讨 3D 打印非共面模板 (3D-PNCT) 辅助计算机断层扫描 (CT) 引导碘 125 粒子消融近距离放射治疗 (125I-SAB) 在妇科癌症患者中的针分布和剂量参数差异的准确性。 -术前计划和术后计划之间的中央盆腔复发。

 材料与方法

本研究纳入了 38 名放疗后患有 41 例非中央盆腔复发妇科癌的患者。所有患者于2016年1月至2019年1月接受3D-PNCT辅助CT引导的125I-SAB。近距离放射治疗的术前计划和术中实时计划均测量种针的位置、角度和深度。规划系统（B-TPS）。比较术前计划和术后计划的D90、D100、V100、V150和V200剂量学参数以及适形指数（CI）、外部指数（EI）和均匀性指数（HI）质量参数。评估围手术期并发症和放射相关毒性。

 结果

中位随访时间为 12 个月（范围：5-34 个月）。规定剂量为 100-170 Gy（中位剂量 120 Gy）。 125I 种子的放射性为 0.4-0.7 mCi（中位数，0.55 mCi）。 499 根针的平均深度偏差为 0.8 ±1.0 cm。平均角度偏差为2.2±2.1度。针尖距离的平均偏差为0.4±0.3cm。术前和术后计划的 CI (p = 0.001) 和 EI (p = 0.005) 存在显着差异。术前和术后计划的 D90、D100、V100、V150、V200 和 HI 没有显着差异。只有少数患者出现 ≤ 2 级毒性。

 结论

3D-PNCT辅助CT引导下125I-SAB治疗妇科癌症非中央盆腔复发是安全可行的。所有并发症都是可以忍受的且轻微。