The Comparison of Treatment Plans Between Coplanar Versus Non-Coplanar Template-Assisted 125I Particle Implantation for Lung Cancer
Objective To design 125I particle implantation treatment plans for lung cancer patients based on 3D printed coplanar and non-coplanar templates,compare the dosimetric differences between the two plans,and provide a basis for clinical use.Methods With the seletion of 25 lung cancer patients who underwent 125I particle implantation treatment at Fujian Cancer Hospital from January 2018 to May 2023,the design of a close range radiation therapy planning system with 125I particle implantation assisted by coplanar and non-coplanar templates was adopted,requiring that the prescription dose of gross target volume(GTV)in both coplanar and non-coplanar plans cover more than 90%of GTV.Interpolating needle counts,particle counts,and GTV dosimetry parameters for both plans[including D90%and D100%with 90%and 100%GTV volume exposure doses,and V100,V150 and V200 with volume percentage of 100%,150%and 200%prescribed dose,the conformance index(CI),GTV external index(EI),and homogeneity index(HI)],the organ at risk(OAR)dosimetry parameters(V20 with percentage of volume receiving 20 Gy and mean dose Dmean,maximum spinal cord exposure dose Dmax)were compared.Results The interpolation needle number and particle number of coplanar plan were higher than those of non-coplanar plan,and the differences were statistically significant(P<0.05).There were no significant differences in D90%,D100%,V100,V200,EI and HI between the two plans(P>0.05);The V150 of coplanar plans was higher than that of non-coplanar plans,and the CI was lower than that of non-coplanar plans,with statistical significance(P<0.05).The V20 and Dmean of the affected lung and Dmax of the spinal cord in the coplanar plans were higher than those in the non-coplanar plans,but the differences were not statistically significant(P>0.05).Conclusion For lung cancer patients,both coplanar and non-coplanar template-assisted 125I particles implantation can meet the clinical target dose coverage requirements.The plan parameters such as the number of needles,the number of seeds and dose conformity of the non-coplanar plan are better than those of the coplanar plan,and the absorbed dose of important organs at risk is lower than that of the coplanar plan,but the price is more expensive,so the clinical selection needs to be made according to the specific situation.
125I particlesCoplanar templateNon-coplanar templateLung cancerTreatment plan
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