eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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1/2021
vol. 13
 
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abstract:
Original paper

Dosimetric comparison of computed tomography-guided iodine-125 seed implantation assisted with and without three-dimensional printing non-coplanar template in locally recurrent rectal cancer: a propensity score matching study

Lu Wang
1
,
Hao Wang
1
,
Yuliang Jiang
1
,
Zhe Ji
1
,
Fuxin Guo
1
,
Ping Jiang
1
,
Bin Qiu
1
,
Haitao Sun
1
,
Jinghong Fan
1
,
Weiyan Li
1
,
Junjie Wang
1

1.
Department of Radiation Oncology, Peking University Third Hospital, Beijing, People’s Republic of China
J Contemp Brachytherapy 2021; 13, 1: 18–23
Online publish date: 2021/02/18
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Introduction
To compare post-implant dosimetric parameters of computed tomography (CT)-guided radioactive iodine-125 (125I) seed (RIS) implantation assisted with and without three-dimensional printing non-coplanar template (3D-PNCT) in locally recurrent rectal cancer (LRRC).

Material and methods
One hundred and fifty-five LRRC patients treated by CT-guided RIS implantation assisted with or without 3D-PNCT from October 2003 to May 2019 were included in this study. Propensity score matching (PSM) method (1 : 1) was used to adjust for differences between the 3D-group (with 3D-PNCT) and the CT-group (without 3D-PNCT). After PSM, dosimetric parameters [D90 (dose that covered 90% of target volume), D100 (dose that covered 100% of target volume), V100 (percentage of gross tumor volume (GTV) receiving 100% of prescription dose), V150 (percentage of GTV receiving 150% of prescription dose), HI (homogeneity index), CI (conformity index), and EI (external index)] of the two groups were compared.

Results
After PSM, 45 pairs of matched cases were selected for analysis and differences in variables between the two groups were balanced. For the 3D-group, median values of D90, D100, V100, V150, EI, and HI were 142.6 Gy (73.7-218.2 Gy), 73.7 Gy (26.2-169.3 Gy), 94.1% (74.3-100%), 71.8% (35.4-98.3%), 0.7 (0.1-30.7), and 0.20 (0-0.60), respectively, and corresponding values were 119.9 Gy (39.8-159.3 Gy), 47.0 Gy (13.0-200.9 Gy), 89.9% (38.6-100%), 62.8% (14.8-100%), 0.39 (0-11.01), and 0.30 (0-0.95), respectively, for the CT-group. Parameters including D90, D100, V100, V150, and EI in the 3D-group were significantly higher than those in the CT-group (p < 0.001, p < 0.001, p < 0.001, p < 0.001, and p = 0.006, respectively).

Conclusions
3D-PNCT can improve the accuracy of radioactive seed implantation by increasing the dose delivered to the tumor and reducing the number of “cold” spots of dose.

keywords:

3D printing template, seed implantation, dosimetry, locally recurrent rectal cancer

 
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