3D打印模板较单纯CT引导125I粒子植入头颈部复发转移癌优势研究

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摘要目的探究3D打印模板较单纯CT引导125I粒子植入头颈部复发转移癌优势。方法选择2015年4月至2019年2月河北省人民医院行125I粒子治疗头颈部复发转移癌99例患者（99个病灶），依据是否应用3D打印模板将患者分为3D打印模板组[A组，49例（49个病灶）]、单纯CT引导组[B组，50例（50个病灶）]。评价两组125I粒子植入治疗的质量及疗效；比较两组CT扫描次数、手术时间，单颗粒子植入所需时间；比较两组手术前后靶区体积、粒子数及剂量学参数（D90、V90、V100、V150）；观察两组并发症的发生情况。结果两组125I粒子植入治疗的质量比较，差异无统计学意义（P ＞ 0.05）。术后2个月，两组局部控制率及有效率比较，差异无统计学意义（P ＞ 0.05）。术后3个月，两组局部控制率比较，差异无统计学意义（P ＞ 0.05）；A组有效率高于B组，差异有统计学意义（P ＜ 0.05）。A组手术时间、单颗粒子植入所需时间短于B组，CT扫描次数少于B组，差异有统计学意义（P ＜ 0.05）。A组手术前后靶区体积、粒子数及各剂量学参数比较，差异无统计学意义（P ＞ 0.05）；B组手术前后靶区体积、粒子数、D90、V90比较，差异无统计学意义（P ＞ 0.05）；术后，B组V100小于术前，V150大于术前，差异有统计学意义（P ＜ 0.05）。术后，两组靶区体积、粒子数、D90、V90、V150比较，差异无统计学意义（P ＞ 0.05）；A组V100大于B组，差异有统计学意义（P ＜ 0.05）。A组穿刺疼痛发生率低于B组，差异有统计学意义（P ＜ 0.05）；两组声音嘶哑发生率比较，差异无统计学意义（P ＞ 0.05）。结论与单纯CT引导比较，3D打印模板缩短手术时间，减少扫描次数，并在一定程度上降低并发症的发生率、提高疗效。

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	王泽阳梁岩松张宏涛曹国辉刘泽洲高贞赵金鑫王娟

关键词 ： 3D打印, 125I粒子, 头颈部肿瘤, 对比研究

Abstract：Objective To investigate the advantages of 3D printing template compared with simple CT-guided 125I seeds implantation in recurrent and metastatic cancer of head and neck. Methods A total of 99 patients (99 lesions) with recurrent and metastatic cancer of head and neck treated with 125I seeds in Hebei General Hospital from April 2015 to February 2019 were selected, according to whether 3D printing template was applied, they were divided into 3D printing template group (group A, 49 cases [49 lesions]) and simple CT guided group (group B, 50 cases [50 lesions]). The quality and efficacy of 125I seeds implantation were evaluated between two groups; CT scan times, operation time and single seed implantation time were compared between two groups; the target volume, seeds number and dosimetric parameters (D90, V90, V100, V150) before and after operation were compared between two groups; the incidence of complications in two groups were observed. Results There was no significant difference in the quality of 125I seeds implantation between two groups (P > 0.05). Two months after operation, there were no significant differences in local control rate and effective rate between two groups (P > 0.05). Three months after operation, there was no significant difference in local control rate between two groups (P > 0.05); the effective rate of group A was higher than that of group B, and the difference was statistically significant (P < 0.05). The operation time and single seed implantation time of group A were shorter than those of group B, and CT scan times were less than those of group B, and the differences were statistically significant (P < 0.05). There were no significant differences in target volume, seeds number, and dosimetric parameters in group A before and after operation (P > 0.05). There were no significant differences in target volume, seeds number, D90, and V90 in group B before and after operation (P > 0.05); after operation, V100 in group B was lower than that before operation, and V150 was higher than that before operation, and the differences were statistically significant (P < 0.05). After operation, there were no significant differences in target volume, seeds number, D90, V90, and V150 between two groups (P > 0.05); V100 in group A was higher than that in group B, and the differences were statistically significant (P < 0.05). The incidence of puncture pain in group A was lower than that in group B, and the difference was statistically significant (P < 0.05); there was no significant difference in the incidence of hoarseness between two groups (P > 0.05). Conclusion Compared with simple CT guidance, 3D printing template can shorten the operation time, reduce the number of scans, reduce the incidence of complications, and improve the efficacy to a certain extent.

Key words： 3D printing 125I seeds Head and neck neoplasms Comparative study

基金资助:河北省医学科学研究重点课题计划项目（20170 378）。

通讯作者: 王娟（1958.5-），女，博士，主任医师，博士生导师，河北省粒子介入治疗学科主任；研究方向：放射性碘-125粒子治疗恶性肿瘤的基础及临床研究。

作者简介: 王泽阳（1984.7-），男，硕士；研究方向：放射性粒子植入与免疫及放射性损伤的相关性。

引用本文:

王泽阳梁岩松张宏涛曹国辉刘泽洲高贞赵金鑫王娟. 3D打印模板较单纯CT引导125I粒子植入头颈部复发转移癌优势研究[J]. 中国医药导报, 2021, 18(35): 105-109.
WANG Zeyang LIANG Yansong ZHANG Hongtao CAO Guohui LIU Zezhou GAO Zhen ZHAO Jinxin WANG Juan. Research on the advantages of 3D printing template compared with simple CT-guided 125I seeds implantation in recurrent and metastatic cancer of head and neck#br#. 中国医药导报, 2021, 18(35): 105-109.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2021/V18/I35/105

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