868P - A clinical study on the application of 3D-printing minimally invasive-guided template in brachytherapy of patients with locally advanced cervical cancer

Background

To explore the clinical application of three-dimensional (3D)-printing minimally invasive-guided template in brachytherapy of patients with locally advanced cervical cancer.

Methods

From May 2016 to December 2018, 59 patients with locally advanced cervical cancer were admitted to Cangzhou Hospital of integrated Traditional Chinese and Western Medicine of Hebei Province. All patients were treated with radical radiotherapy with a radiation dose of 45 Gy in 25 fractions. The included patients were randomly divided into 2 groups. In the template group, 29 patients assisted by 3D-printing templates to place intrauterine tubes and implant for insertion of needles. In the free implantation group, 30 patients were assisted with freehand implanted intrauterine tubes and implant needles. All patients underwent Computed Tomography (CT) to adjust the position and depth of the insertion needle, and the final CT image was transmitted to the brachytherapy planning system, to outline the target area and perform treatment.

Results

A total of 283 times of combination of intracavitary and interstitial radiotherapy were undertaken. Complete Response (CR) rate in the template group (24/28;85.71%) was slightly higher than free transplantation group (22/28; 78.57%). There was no significant difference in short-term efficacy between the two groups (z=-0.692, P>0.05). Importantly, D₉₀ (90% of the target volume) of High-Risk Clinical Target Volume (HR-CTV) and Intermediate-Risk Clinical Target Volume (IR-CTV) in the template group were significantly higher than the free implantation group (t = 3.42, 2.13, P<0.05). D_2cm3 of bladder, rectum and sigmoid colon was significantly reduced (t = -2.59, -4.22, -2.01, P<0.05).

Conclusions

For large-block or eccentric cervical cancer, application of the 3D-printing minimally invasive-guided template in brachytherapy of patients with locally advanced cervical cancer can reflect its dose-based advantages, associating with a remarkable reduction of patients’ adverse reactions and a satisfactory therapeutic effect.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.