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Objective:To compare the dosimetric difference between 3D-printed multi-channel applicator and conventional vaginal single-channel applicator for brachytherapy, aiming to provide guidance for patients receiving brachytherapy after cervical cancer surgery.Methods:From January 2019 to November 2020, 25 cervical cancer patients complicated with VAIN Ⅲ receiving 192Ir high-dose-rate brachytherapy after cervical cancer surgery were selected. Each patient was located by CT scanning with 3D-printed multi-channel applicator and conventional vaginal single-channel applicator, and corresponding plan and evaluation were carried out. The dose volume histogram (DVH) was obtained by inverse dose optimization algorithm. The dosimetric differences of high-risk clinical target volume (HRCTV), bladder and rectum during brachytherapy were compared with those of source applicators. The optimal treatment plan was selected. Results:D 90%, D 100%, V 100% and V 150% of the plans designed by 3D-printed individual multi-channel applicator had no significant differences compared with those designed by conventional single-channel applicator (all P>0.05). The bladder and rectal D 2cm 3 designed by 3D-printed multi-channel applicator were significantly lower than those using conventional single-channel applicator, and the differences were statistically significant (both P<0.05). Conclusion:The multi-channel individual applicator target made by 3D-printing technology has good conformal property, properly protects the bladder and rectum and possesses treatment advantages over conventional single-channel applicator.
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Objective@#To explore the poor prognostic factors of patients with cervical stump carcinoma, aiming to provide certain reference for the clinical diagnosis and treatment.@*Methods@#Clinical data of 48 patients with cervical stump carcinoma admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 1, 2005 to December 1, 2016 were retrospectively analyzed. A total of 19 patients (40%) withⅠA-ⅡA stage cervical stump carcinoma were treated with surgery+ adjuvant therapy and 29 patients (60%) in ⅡB-Ⅳ stage received radiotherapy combined with chemotherapy. The median age of onset was 51 years old. Uterine fibroids were the main cause of subtotal hysterectomy. The average time interval from subtotal hysterectomy to definite diagnosis was 10.76 years.@*Results@#The 1-, 3-, 5-year survival rate was 98%, 83% and 74%, respectively. Univariate analysis demonstrated the time interval from subtotal hysterectomy (P=0.016), tumor diameter (P=0.016), clinical stage (P=0.036), histological grade (P=0.009), lymph node metastasis (P=0.044), parametrial invasion (P=0.046), myelosuppression (P=0.013) and radical surgery (P=0.019) were the poor prognostic factors of cervical stump carcinoma.@*Conclusions@#Poor prognosis of patients with cervical stump carcinoma is correlated with tumor diameter, clinical stage, histological grade, lymph node metastasis, parametrial invasion and myelosuppression. Histological grade is an independent risk factor.
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Objective Systematic pelvic lymph node ( SPLN) +abdominal paraaortic lymph node ( APLN) dissection re-mains controversial in the treatment of endometrial carcinoma , especially in the early stage of the tumor .This study aims to investigate the value and safety of APLN dissection in the treatment of early-stage endometrial carcinoma . Methods We retrospectively ana-lyzed the clinical data about 109 cases of early-stage endometrial adenocarcinoma , 56 treated by SPLN dissection ( group A ) and the other 53 by SPLN+APLN dissection ( group B ) .We compared the postoperative complications , recurrence and metastasis , and progno-sis-related factors between the two groups of patients . Results No statistically significant difference was found in the incidence rate of postoperative complications between groups A and B ( 19.64% vs26.41%, P>0.05).Recurrence and metastasis were found in 12 of the 109 patients, 10 in group A and 2 in group B (17.86%vs 3.77%, P=0.019).Multivariate logistic regression analysis showed that the independent factors of recurrence and metastasis includ -ed the differentiation degree (OR=7.385, 95%CI:1.877-29.062), pathologic stage (OR=5.444, 95%CI:1.673-17.720), range of lymph mode dissection (OR=19.171, 95%CI:2.242 -163.946), and range of lesion focus (OR=12.524, 95%CI:1.186-132.280), with the range of lymph mode dissection as the greatest influencing factor on prognosis . Conclusion SPLN+APLN dissection can reduce the recurrence and metastasis and improve the prognosis of early -stage endometrial adenocarcinoma , and therefore is safe and feasible for the treatment of the tumor .