Introduction/Background To explore the clinical application of 3D-printing minimally invasive-guided template in brachytherapy of patients with locally advanced cervical cancer.
Methodology From May 2016 to December 2018, 59 patients with locally advanced cervical cancer with clear pathological diagnosis and initial treatment. All patients were treated with radical radiotherapy, intensity-modulated radiotherapy was carried out with a radiation dose of 45 Gy in 25 fractions. The included patients were randomly divided into 2 groups. In the template group, 29 patients assisted by 3D-printing templates to place intrauterine tubes and implant for insertion of needles. In the free implantation group, 30 patients were assisted with freehand implanted intrauterine tubes and implant needles. All patients underwent CT to adjust the position and depth of the insertion needle, and the final CT image was transmitted to the Oncentra brachytherapy planning system, to outline the target area and organs at risk, make treatment plans, and perform treatment.
Results A total of 283 times of combination of intra-luminal and interstitial insertion radiotherapy were undertaken, including 141 times in template group and 142 times in free insertion radiotherapy. Importantly, D90 of HR-CTV and IR-CTV in the template group were significantly higher than those in the free implantation group (P<0.05). D2cm3 of bladder, rectum and sigmoid colon was significantly reduced (P<0.05). The incidence of radiation cystitis and radiation proctitis was 14.3%and 17.9%lower in the template group than in the free implantation group.Therefore, the incidence of grade 1, 2 and 3 acute radiation proctitis in the template group was noticeably lower than that in the free transplantation group (P<0.05).
Conclusion For large-block or eccentric cervical cancer, application of the 3D-printing template in brachytherapy of patients with locally advanced cervical cancer can reflect its dose-based advantages, associating with a remarkable reduction of patients’ adverse reactions and a satisfactory therapeutic effect.
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