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Objective To compare the dosimetric data between preoperative plans and postoperative verification in computed tomography (CT)-guided and 3D-printing non-coplanar template-assisted 125I seed implantation for head and neck tumor,aiming to explore the safety,feasibility and accuracy of the individualized template design method.Methods A total of 42 patients with recurrent/metastatic malignant head and neck tumor admitted to Peking University Third Hospital from January to December 2016 were recruited in this study.A prescribed dose of l10-160Gy was adopted.3D-printing non-coplanar templates were designed for 42 cases.The dosimetric parameters including D90,minimum peripheral dose (mPD),V100,V150,V200,conformal index (CI),external index (EI) and homogeneity index (HI) were statistically compared before and after surgery.Results All templates were properly implanted intraoperatively.Compared with preoperative planning,postoperative D90,V100,CI,EI and HI did not significantly differ (P=0.490,0.407,0.893,0.143 and 0.079),whereas mPD,V150 and V200 significantly differed (P=0.036,0.007 and 0.000).Conclusion After postoperative verification,the main dosimetric parameters have high therapeutic accuracy and properly match with preoperative planning,which can meet clinical requirements.
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Objective@#To compare the dosimetric data between preoperative plans and postoperative verification in computed tomography (CT)-guided and 3D-printing non-coplanar template-assisted 125I seed implantation for head and neck tumor, aiming to explore the safety, feasibility and accuracy of the individualized template design method.@*Methods@#A total of 42 patients with recurrent/metastatic malignant head and neck tumor admitted to Peking University Third Hospital from January to December 2016 were recruited in this study. A prescribed dose of 110-160Gy was adopted.3D-printing non-coplanar templates were designed for 42 cases. The dosimetric parameters including D90, minimum peripheral dose (mPD), V100, V150, V200, conformal index (CI), external index (EI) and homogeneity index (HI) were statistically compared before and after surgery.@*Results@#All templates were properly implanted intraoperatively. Compared with preoperative planning, postoperative D90, V100, CI, EI and HI did not significantly differ (P=0.490, 0.407, 0.893, 0.143 and 0.079), whereas mPD, V150 and V200 significantly differed (P=0.036, 0.007 and 0.000).@*Conclusion@#After postoperative verification, the main dosimetric parameters have high therapeutic accuracy and properly match with preoperative planning, which can meet clinical requirements.
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Objective To evaluate the clinical efficacy and safety of CT-guided 125 I seed implantation in the treatment of recurrent head and neck tumors after radiotherapy. Methods Clinical data of 101 patients who received CT-guided radioactive 125 I seed implantation for recurrent head and neck cancer after radiotherapy from 2007 to 2015 were retrospectively analyzed. The median accumulated dose of external radiotherapy was 66 Gy and the median dose after seed implantation (D90) was 117 Gy. The local progression-free survival and overall survival were analyzed by Kaplan-Meier method. Univariate analysis was performed by log-rank test and multivariate analysis was conducted by using Cox regression model. Results The median follow-up time was 12. 2 months. The 5-year local progression-free survival rate was 26. 6％.The 5-year overall survival rate was 15. 5％. Univariate analysis demonstrated that age,pathological type,implantation site,lesion volume,D90 and short-term efficacy were correlated with local control,and KPS score,lesion volume ,D90,and short-term efficacy were associated with survival (all P<0. 05). Multivariate analysis revealed that pathological type,lesion volume ,D90 and short-term efficacy were independent factors related to local control (P= 0. 000, 0. 002,0. 003 and 0. 014).In terms of the adverse events,skin/ mucosal ulceration was observed in 25. 7％ and pain occurred in 13. 9％ of all patients. No correlation was noted between the adverse events and dose.Conclusions CT-guided radioactive 125 I seed implantation is an efficacious and safe treatment of recurrent head and neck tumors after radiotherapy. Non-squamous carcinoma,small lesion volume and high dose (D90) indicate excellent local control.