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The efficacy and dosimetry analysis of CT-guided 125I seed implantation assisted with 3D-printing non-co-planar template in locally recurrent rectal cancer.


ABSTRACT: BACKGROUND:Locally recurrent rectal cancer (LRRC) after surgery or external beam radiotherapy (EBRT) is a serious challenge for which no standard treatment is defined. In the present study, we investigated the feasibility of computed tomography (CT)-guided radioactive 125I seed (RIS) implantation assisted with three-dimensional printing non-coplanar template (3D-PNCT) in LRRC patients who previously received surgery or EBRT. METHODS:Sixty-six patients with LRRC treated by CT-guided RIS implantation in our institute from December 2015 to May 2019 were included. The treatment procedure included: preoperative CT localization, planning design, the printing of 3D individualized template, CT-guided RIS implantation assisted with 3D-PNCT, and postoperative dose evaluation. Therapeutic outcomes including local control (LC) and overall survival (OS) were retrospectively evaluated, as well as side effects. RESULTS:All the patients had previously received surgery or EBRT. The median follow-up time was 12.2 (range, 2.5-35.9) months. The median radioactive activity of a single RIS was 0.6 (range, 0.43-0.72) mCi. The median number of RIS was 60, ranging from 10 to 175. The dosimetric parameters included D90 (140.7?±?33.1) Gy, D100 (90.3?±?138.6) Gy, and V100 (91.0?±?13.3) %. Pain relief was achieved in 85.1% (40/47) of patients. Besides, 9.1% (6/66) of patients had severe side effects (?grade 3), including perianal skin ulcer in 1 case, fistula, radiation proctitis, and intestinal obstruction each in two cases. Median OS time was 14.7 (95% confidence interval (CI): 13.0-16.3) months, and median LC time was 12.2 (95% CI: 9.1-15.2) months. Univariate analysis revealed that when D90?>?130?Gy or D100?>?55?Gy or V100?>?90%, the LC time was remarkably prolonged. However, none of the parameters significantly affected OS. CONCLUSIONS:CT-guided RIS implantation assisted with 3D-PNCT is an effective and safe salvage treatment strategy for patients with LRRC after EBRT or surgery. D90, D100, and V100 can be used as prognostic predictors. TRIAL REGISTRATION:NCT03890926 .

SUBMITTER: Wang L 

PROVIDER: S-EPMC7382046 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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The efficacy and dosimetry analysis of CT-guided <sup>125</sup>I seed implantation assisted with 3D-printing non-co-planar template in locally recurrent rectal cancer.

Wang Lu L   Wang Hao H   Jiang Yuliang Y   Ji Zhe Z   Guo Fuxin F   Jiang Ping P   Li Xuemin X   Chen Yi Y   Sun Haitao H   Fan Jinghong J   Li Weiyan W   Li Xu X   Wang Junjie J  

Radiation oncology (London, England) 20200725 1


<h4>Background</h4>Locally recurrent rectal cancer (LRRC) after surgery or external beam radiotherapy (EBRT) is a serious challenge for which no standard treatment is defined. In the present study, we investigated the feasibility of computed tomography (CT)-guided radioactive <sup>125</sup>I seed (RIS) implantation assisted with three-dimensional printing non-coplanar template (3D-PNCT) in LRRC patients who previously received surgery or EBRT.<h4>Methods</h4>Sixty-six patients with LRRC treated  ...[more]

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