Pure Interstitial Brachytherapy Using 3D-Printed Vaginal Template for Improved Catheter Tracks in Treating Cervical Cancer

Li, Jianping; Meng, Xin; Dang, Yunzhi; Sun, Xiaohuan; Ying, Zhang; Wei, Lichun; Shi, Mingjun

doi:10.1166/jbt.2017.1591

Cited by 3 publications

(4 citation statements)

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“…Three-dimensional (3D) printed template-guided implantation is a newly emerging technology used in brachytherapy with the goal of individual therapy to achieve high doses and optimally sculpted isodose tailored to the target, as well as an enhanced therapeutic effect with minimal invasion. [10][11][12][13][14][15] Lindegaard et al 10 reported a case where a standard intracavitary applicator was applied combined with a 3D-printed individualized ring to treat a large target in the cervix uteri and resulted in preferable dose distribution compared to that in a patient treated with a standard Vienna applicator. Logar et al 13 demonstrated this further using a 3D-printed personalized applicator to implement IC/IS BT when they found that it was difficult to achieve ideal dose coverage for patients at stages IIIB and IVA treated with a standard applicator; their results showed an increase of 8-9 Gy in the HR CTV prescription.…”

Section: Introductionmentioning

confidence: 99%

“…Sekii et al 14 reported two cases where a polygon orthogonal projection method was utilized to create a 3D-printed template; this allowed better dose distribution and operation-time reduction, decreasing patient discomfort. Li et al 15 investigated the use of a 3D-printed template for the treatment of two patients at stage IVA with pure interstitial needles and found that the 3D-printed template was efficient and potentially valuable for use in clinical practice. Preplanning is always essential and crucial to obtain a personalized 3D guidance template that can achieve the geometric description of inserted needles as well as the anticipated dose distribution in the target volume and OARs.…”

Section: Introductionmentioning

confidence: 99%

“…Three‐dimensional (3D) printed template‐guided implantation is a newly emerging technology used in brachytherapy with the goal of individual therapy to achieve high doses and optimally sculpted isodose tailored to the target, as well as an enhanced therapeutic effect with minimal invasion 10–15 . Lindegaard et al 10 .…”

Section: Introductionmentioning

confidence: 99%

“…reported two cases where a polygon orthogonal projection method was utilized to create a 3D‐printed template; this allowed better dose distribution and operation‐time reduction, decreasing patient discomfort. Li et al 15 . investigated the use of a 3D‐printed template for the treatment of two patients at stage IVA with pure interstitial needles and found that the 3D‐printed template was efficient and potentially valuable for use in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of preplan‐based three‐dimensional individual template‐guided brachytherapy compared to freehand implantation

Zhang

Sun

et al. 2022

J Applied Clin Med Phys

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Image‐guided adaptive intracavitary/interstitial brachytherapy (IC/IS IGABT) has exhibited superior dosimetry advantage and local control for locally advanced cervical cancer (LACC). Our group designed a type of cylindrical three‐dimensional (3D) printed vaginal template combining an intracavitary applicator with straight and oblique interstitial needles according to the preplan on computed tomography images. This work aimed to research the consistency of the preplan with the treatment plan at every fraction to verify the practical guiding significance of the preplan. We also investigated the difference between 3D‐printed template‐guided implantation compared with freehand implantation for LACC. Twenty‐six patients were treated with 3D‐printed individual templates (3D template group), and 20 patients were treated by using freehand insertion (freehand group). Patients in the 3D template group would take a preplan one week before treatment to design and print the individual template, while the freehand group did not. All patients accepted volumetric rotational intensity‐modulated radiotherapy at a dose of 49.4 Gy in 26 fractions and subsequent brachytherapy at a dose of 26 Gy in four fractions. All analyses were performed by utilizing SPSS 26. The insertion depth was decreased in fractions 1 and 4 compared with the preplan. None of the dose volume histogram parameters of fractions 1–3, nor the D2cc of bladder and bowel at fraction 4 were barely changed compared with the preplan. The D90 and D98 of the high‐risk clinical target volume in the 3D template group were statistically higher than those in the freehand group (p < 0.01). The D2cc of the rectum, bladder, bowel, and sigmoid in the 3D template group were all lower than those in the freehand group (p < 0.01). The preplan in this research is consistent with treatment plans, which is important to ensure the feasibility of applying a 3D‐printed template in brachytherapy. The 3D‐printed individual guidance template was an effective method in brachytherapy for locally advanced cervical cancer.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Characteristics of preplan‐based three‐dimensional individual template‐guided brachytherapy compared to freehand implantation

Zhang

Sun

et al. 2022

J Applied Clin Med Phys

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Individual curved‐needle interstitial template created using three‐dimensional printing for brachytherapy for distal parauterine tumor recurrence

Zhang,

Luo,

Zhang

et al. 2024

Medical Physics

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BackgroundAchieving a clinically acceptable dose distribution with commercial vaginal applicators for brachytherapy of recurrent parauterine tumors is challenging. However, the application of three‐dimensional (3D) printing technology in brachytherapy has been widely acknowledged and can improve clinical treatment outcomes.PurposeThis study aimed to introduce an individual curved‐needle interstitial template (ICIT) created using 3D printing technology for high‐dose‐rate (HDR) brachytherapy with interstitial treatment to provide a clinically feasible approach to distal parauterine and vaginal cuff tumors. The entire workflow, including the design, optimization, and application, is presented.MethodsTen patients with pelvic cancer recurrence were examined at our center. The vaginal topography was filled with gauze strips soaked in developer solution, and images were obtained using computed tomography (CT) and magnetic resonance imaging (MRI). Curved needle paths were designed, and ICITs were 3D‐printed according to the high‐risk clinical target volume (HRCTV) and vaginal filling model. The dose and volume histogram parameters of the HRCTV (V100, V200, D90, and D98) and organs at risk (OARs) (D2cc) were recorded.ResultsAll patients completed interstitial brachytherapy treatment with the 3D‐printed ICIT. One patient experienced vaginal cuff tumor recurrence, and nine patients experienced parametrial tumor recurrence (four on the left and five on the right). We used two to five interstitial needles, and the maximum angle of the curved needle was 40°. No source obstruction events occurred during treatment of these 10 patients. The doses delivered to the targets and OARs of all patients were within the dose limits and based on clinical experience at our center.ConclusionThe ICIT is a treatment option for patients with distal parauterine tumor recurrence. This method addresses the limitations of vaginal intracavitary and standard interstitial applicators. The ICIT has the advantages of biocompatibility, personalization, and magnetic resonance imaging compatibility.

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3D printing in brachytherapy: A systematic review of gynecological applications

Fahimian¹,

Liu²,

Skinner³

et al. 2023

Brachytherapy

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Pure Interstitial Brachytherapy Using 3D-Printed Vaginal Template for Improved Catheter Tracks in Treating Cervical Cancer

Cited by 3 publications

References 0 publications

Characteristics of preplan‐based three‐dimensional individual template‐guided brachytherapy compared to freehand implantation

Characteristics of preplan‐based three‐dimensional individual template‐guided brachytherapy compared to freehand implantation

Individual curved‐needle interstitial template created using three‐dimensional printing for brachytherapy for distal parauterine tumor recurrence

3D printing in brachytherapy: A systematic review of gynecological applications

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