Clinical Study Of 3D Printing Individualized Template Assisted ¹²⁵Ⅰ Particles Implantation In The Therapy Of Head And Neck

ObjectiveThe traditional treatment method curative effect is limited for head and neck malignant tumors.However,radioactive seed implantation has shown a good effect in the treatment of head and neck tumors.Meanwhile,3D printed non-coplanar templates are also being used in particle implantation.This study is to evaluate the safety and efficacy of ¹²⁵Ⅰparticle implantation in the treatment of head and neck tumors.To explore the feasibility,advantages and application value of the 3D printed individualized template to assist ¹²⁵Ⅰparticle impla ntation in the treatment of head and neck cancer,and provide more evidence for the further application and promotion of this technology.MethodsRetrospective analysis 60 patients with head and neck malignant tumor who were treated by¹²⁵Ⅰ radioactive particles since December 2015 to December 2017 in the First Affiliated Hospital of Zhengzhou University imaging and nuclear medicine ward,which were divided into two groups:group A as the experimental group,including 28 patients,3 D printing individualized template+CT guided;Group B as the control group,including 32 patients and simple CT guided.The difference of dose parameters,particle consumption,scanning frequency and operation time of the two groups before and after operation were compared.Comparing two groups of different time points after treatment in patients with local efficacy（after 2、4、6months）,the degree of postoperative pain relief,Karnofsky score 2 months after operation,complications.ResultsThe experiment 60 patients were enrolled,experimental group（group A）including 28 patients and control group（group B）32 patients,two groups of patients were successfully completed as planned ¹2525 I radioactive particles implantation,no operative deaths,no serious complications occurred.The basic data of the two groups were analyzed without statistical difference.The average operation time of group A was shorter than group B,with fewer scanning times than group B.There was no statistically significant difference between the two groups on average operation time and scanning frequency for lesions with tumor size less than 3cm.For the lesion size of>3cm,the average scan frequency of group A was less than that of group B,and the average operation time was shorter than group B.There were all no statistical difference in group A,there were not statistically significant as for the number of particles,D90 and V100 in group B,while there was statistical difference as for V100.The local effective and local control rates of 2,4 and 6 months after treatment were not statistically significant between 2 groups.The results showed that the effective rate of pain control in both groups were 80.0%（16/20）and 81.0%（17/21）respectively,and the pain relief was obvious after treatment.Compared with the two groups of patients,as for the KPS score there was statistically significant between before the surgery and 2 months after surgery.There were no significant serious complications in the two groups,and the incidence of complications in group B was higher than that in group A.ConclusionThe ¹²⁵Ⅰ radioactive seed implantation is an effective method to treat the malignant tumor of head and neck,which has the characteristics of minimally invasive,high efficiency,safety,conformal and repeatability.Application of 3D printing individualized template auxiliary implanted ¹²⁵Ⅰ radioactive particles guided by CT can optimum dose science,reduce the operation difficulty and reduce complications,shorten the operation time,reduce The times of scanning and improve the operation safety and improve puncture accuracy,the advantages of the homogeneity of the surgery.