Radiotherapy Clinical Trial
Official title:
3D-printing Template-assisted CT-guided I125 Seed Implantation and Stereotactic Radiotherapy for Locally Advanced Pancreatic Cancer:A Prospective Multicenter Cohort Study
Data of 100 patients with locally advanced pancreatic cancer who received stereotactic radiotherapy or ct-guided radioactive 125I seed implantation in the multicenter of the research group from July 2019 to June 2021 were collected, as well as follow-up data.To evaluate the clinical efficacy of stereotactic radiotherapy and ct-guided 125I seed therapy with 3D printing template in pancreatic cancer;In addition, the local control rate and side effects of ct-guided radioactive 125I particles in the treatment of pancreatic cancer lesions were explored, and the efficacy and safety of different doses of stereotactic radiotherapy were determined.
1. Radiation: Stereotactic Radiotherapy 1.1 Equipment: Accuray VSI Cyberknife stereotactic
radiotherapy platform, simulated positioning CT machine, MR, positron emission computed
tomography PET-CT, vacuum pad.
1.2 Radiotherapy localization: CT, MRI and PETCT were used to simulate localization.
1.3 Relevant Definitions of Tumor Targets CT, MRI, PET-CT fusion, combined with MRI
location and PET-CT location image for sketching.
To delineate target areas and organs at risk. GTV: Combining localization and fusion
images to delineate the tumors seen PTV = GTV + 0-10mm Dangerous organs: The stomach,
duodenum, jejunum, ileum, colon, spinal cord and esophagus were delineated on the base
sequence of CT plain scan.
The target area should be approved by at least one physician in charge or by a physician
in charge.
1.4 Target volume radiation dose: According to the volume, location, organ function and
other factors, the dosage of radiotherapy was determined. The range of BED value of
radiotherapy was 80-100 when the distance between the tumor and gastrointestinal tract
was more than 5 mm (alpha/beta=10) and 60-80 when the distance between the tumor and
gastrointestinal tract was less than 5 mm (alpha/beta=10).
1.5 Normal Tissue Limit: Reference to TG101 Report
2. CT-guided radioactive 125I seeds therapy with 3D printing template for pancreatic cancer
2.1 Preoperative planning 2.2 Design and fabrication of 3D-PNCT 2.3 125I seeds
implantation: 3D-PNCT was placed on the surface of the patient's treatment area, and
positioned with the help of the patient's outline features, laser lines, body surface
positioning lines and template alignment reference lines.
The location of the template and the tumor is well repeated. If there are errors, the
template should be adjusted in time. The insertion needle was percutaneously punctured to a
predetermined depth through a template guide hole. During the puncture process, the puncture
path was monitored by CT scanning and fine-tuned if necessary to avoid injuring nerves and
blood vessels. Seeds implantation and CT scan were performed according to the preoperative
plan to understand the distribution of seeds. During the operation, the implant needle should
be added or reduced when necessary to ensure that the whole target area is adequately
irradiated and the surrounding normal tissues are protected.
2.4 Postoperative dose assessment: CT scan was performed after operation, and the image was
transmitted to BTPS for dose verification (Figure 3-4). The dosimetric parameters included
tumor volume, D90, mPD, V100, V150 and V200.
After these treatments,to evaluate the clinical efficacy of stereotactic radiotherapy and
ct-guided 125I seed therapy with 3D printing template in pancreatic cancer;In addition, the
local control rate and side effects of ct-guided radioactive 125I particles in the treatment
of pancreatic cancer lesions were explored, and the efficacy and safety of different doses of
stereotactic radiotherapy were determined.
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