摘要
目的:探讨使用计算机辅助设计与快速成形技术制作上颌放射性粒子布源器进行恶性肿瘤腔内照射治疗的新方法,以弥补原方法的不足。方法:6例上颌区恶性肿瘤已侵及眶底和颅底的患者在手术切除肿瘤后,将患者的头部螺旋CT扫描数据输入电脑,经Mimics 8.11软件和Geomagic 7.0软件处理后,获得患者肿瘤术后缺损部位的三维影像,利用快速成型技术制作患者缺损部位的树脂模型,在此模型上制作患者缺损部位的高位弹性阻塞器,阻塞器戴入完成后,制定放疗计划,在组织内插植125I放射性粒子的同时,在阻塞器式布源器上对应靶区的部位埋入125I放射性粒子并计数,CT摄片检验放射性粒子稳定情况,并对患者随诊12个月。结果:全部患者的阻塞器固位、稳定良好,与设计的靶区组织贴合。阻塞器式布源器内的125I放射性粒子稳定性良好,6例患者阻塞器式布源器上植入的粒子数共计105粒,占总植入粒子数(189粒)的55.6%,阻塞器式布源器戴入后,照射患者靶区的放射性粒子数量比戴入前明显提高。随访12个月后,6例患者局部均未见肿瘤复发。结论:使用计算机辅助设计与快速成形技术制作上颌放射性粒子布源器,在其上植入放射性粒子对上颌恶性肿瘤术后的放疗靶区部位进行放射治疗,可有效地提高放射性粒子的放射治疗效果。
Objective：To test a new method to manufacture a maxillary applicator containing radioactive seeds for brachytherapy of malignant neoplasms based on computer aided design（CAD） and rapid prototyping（RP）.Methods： Six patients with maxillary malignancy which had eroded the inferior wall of orbit and skull base were included in this study.After excision of the tumors,head CT data of these patients were transmitted into the computer.Three-dimensional digital image of the patient＇s defected region was then obtained with special software processing based on Mimics 8.11 and Geomagic 7.0 and the resin cast of the defected region was manufactured by rapid prototyping.The elastic obturator was then made on this resin cast which can duplicate the undercut tissue of the defected region.After the obturator was completed,the radiotherapy plan was made.^125I radioactive seeds were implanted into the tissues,and they were also implanted into the target area of the obturator which was used as a maxillary applicator at the same time.The number of radioactive seeds was then counted and the stability of radioactive seeds was determined by CT examination.All these 6 patients were followed-up for 12 months.Results： All the obturators had good retention and stability and fitted the designed target tissue very well.^125I radioactive seeds in the form of the obturator applicator were stable.For all patients,the total number of radioactive seeds used was 189.Among them,105 seeds,55.6% of the total,were contained in obturator applicators.After the obturator applicators were used,the amount of radioactive seeds irradiating the target regions was significantly increased when compared with that of before.After follow-up of 12 months,there was no recurrence nor severe complications.Conclusion： ^125I radioactive seeds contained maxillary applicator made by computer aided design and rapid prototyping can effectively improve the brachytherapy of ^125I when it is used for the post-operation radiotherapy of maxillary malignant tumors.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2010年第1期63-66,共4页
Journal of Peking University:Health Sciences
基金
国家"十一五"科技支撑计划课题(2007BAI18B05)资助~~
关键词
计算机辅助设计
近距离放射疗法
颌面假体植入
颌肿瘤
Computer-aided design
Brachytherapy
Maxillofacial prosthesis implantation
Jaw neoplasms
