Ping Jiang
Peking University Third Hospital, China
Title: Clinical Application of 3D-printing individual template assisted HDR 192Ir interstitial brachytherapy for central recurrence of GYN after pelvic EBRT.
Biography
Biography: Ping Jiang
Abstract
Purpose: To evaluate the feasibility of 3D-printing individual template assisted interstitial brachytherapy for recurrence of
GYN aft er pelvic external beam irradiation.
Materials & Methods: 11 patients in our center from Aug 9, 2016 to Dec 1, 2017 diagnosed with central recurrence of GYN
aft er pelvic adjuvant EBRT or radical chemoradiotherapy, they all received 192Ir HDR interstitial brachytherapy under CT
guidance with 3D-printing template assisted. Th ey all fi rstly, undertook CT simulation with lithotomy position. Secondly,
preplan with virtual needle insertion and template with needle passage were designed 3D template would be printed and
verifi ed by both physicist and physician. Th irdly, the patients accept 192Ir HDR interstitial brachytherapy under anesthesia.
Among them, 5 cases under local anesthesia with 3D-printing vaginal insertion template and 6 cases under epidural anesthesia
with 3D-printing combined vaginal and perineal insertion template. GTV prescription doses are 5-6 Gy/f, 2-6 f, 1-2 f/W totally
45 fraction treatment of 11 patients. Dosimetry parameters of GTV V100, D100 and D90, organ at risk D2cc of rectum, bladder
and intestine were recorded and analyzed. Complications and early toxicities were analyzed.
Results: Totally 229 needles were inserted for 45 applications, median 6 (3-9) needles per fraction, mean inserting depth
was 8.3±3.4 cm (2-13.7 cm), mean CT scan 3 (1-5) times, during CT guidance procedure. Actual dosimetry parameters of
median V100,D100 and D90 were 83±4.5% 3.0±1.3 Gy and 5±1.7 Gy respectively per fraction; median D2cc of rectum and bladder
was 3.4±1.0 Gy and 3.55±2.15 Gy respectively per fraction. Th ere were no acute puncture side eff ects such as hemorrhea,
perforation of bowel and hematuria recorded. Early side eff ect of grade I/II urethritis were found in 45% patients and relieved
aft er symptomatic treatment.
Conclusion: 3D-printing individual template assisted interstitial brachytherapy for recurrence of GYN aft er pelvic external
beam irradiations under CT guidance have good dosimetry parameters. It is clinically feasible and high effi ciency with low
complications. However long-term clinical outcomes should be further investigated.