中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (5): 466-470.doi: 10.19438/j.cjoms.2022.05.009

• 论著 • 上一篇    下一篇

3D打印可分离式口腔支架在口腔癌放疗中的摆位准确性研究

樊文慧, 劳峥, 石慧烽, 毕帆, 涂文勇, 胡海生   

  1. 上海交通大学医学院附属第九人民医院 口腔颌面-头颈肿瘤科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011
  • 收稿日期:2021-09-15 修回日期:2022-01-10 出版日期:2022-09-20 发布日期:2022-09-20
  • 通讯作者: 胡海生,E-mail: huhaishen@sina.com
  • 作者简介:樊文慧（1991-）,女,硕士,放疗物理师,E-mail:281809270@qq.com
  • 基金资助:
    上海市黄浦区技术转移项目（XK2020012）

Accuracy of detachable 3D-printed stent placement in radiotherapy for oral cancer patients

FAN Wen-hui, LAO Zheng, SHI Hui-feng, BI Fan, TU Wen-yong, HU Hai-sheng   

  1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China
  • Received:2021-09-15 Revised:2022-01-10 Online:2022-09-20 Published:2022-09-20

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摘要： 目的: 为口腔恶性肿瘤放疗患者个性化定制可分离式3D打印口腔支架,评价其摆位精确度。方法: 选择20例口腔肿瘤术后患者,随机分为对照组和试验组,分别采用可分离式3D打印口腔支架和传统3D打印口腔支架进行固定,通过锥形束CT（CBCT） 获取患者治疗前（首次放疗）、中（第10次放疗）、后（第 20次放疗） X1、Y1、Z1 方向的平移和X2、Y2、Z2方向的旋转摆位误差,以及第三颈椎和下颌支的摆位误差,进行临床摆位误差评估。采用SPSS 23.0 软件包对数据进行统计学分析。结果: 对照组和试验组在X1、Y1、Z1 方向平均平移误差分别为（0.120±0.083）、（0.180±0.250）、（0.170±0.150）cm和（0.081±0.084）、（0.047±0.059）、（0.046±0.036）cm,在Y1(t=2.4, P<0.05)、Z1(t=3.64, P<0.05)方向上具有统计学差异;对照组和试验组在X2、Y2、Z2平均旋转摆位误差分别为 1.04°±0.62°、1.26°±1.30°、0.65°±0.55°和0.67°±0.73°、0.54°±0.24°、0.45°±0.37°,在Y2(t=2.53, P<0.05)方向上具有统计学差异; 对照组和试验组在第三颈椎的位移量为（0.130±0.080）和（0.074±0.090）cm,在下颌支中点的位移量为（0.240±0.180）和（0.095±0.065）cm,具有统计学差异(t=2.99, P<0.05)。结论: 可分离式3D打印口腔支架相比传统3D打印口腔支架,能有效提高摆位精度,具有良好的临床应用前景。

关键词: 3D打印, 可分离式, 固定热塑膜, 摆位误差, 口腔癌, 放射治疗

Abstract: PURPOSE: To customize a detachable 3D-printed oral stent for patients with oral cancer radiotherapy, the stent was connected with thermoplastic film to improve the positioning accuracy of patients. METHODS: Twenty patients with oral cancer were randomly divided into control group and experimental groups, patients in the experimental group used detachable 3D-printed stents placement while patients in the control group used traditional 3D-printed oral stents. X1, Y1, Z1 direction of translation and X2, Y2, Z2 direction of rotating beam position error were obtained by cone-beam CT (CBCT) in patients before (1st radiotherapy), during (10th radiotherapy), and after radiotherapy (20th radiotherapy). The positioning errors of the third cervical spine and the horizontal ramus of the mandible were evaluated for clinical positioning errors. SPSS 23.0 software package was used for data analysis. RESULTS: The mean translational errors in X1, Y1 and Z1 directions were (0.120±0.083), (0.180±0.250), (0.170±0.150) cm in the control group, and (0.081±0.084), (0.047±0.059) , (0.046±0.036) cm in the experimental group. The difference was statistically significant in the Y1(t=2.4, P<0.05) and Z1(t=3.64, P<0.05) direction. The mean rotational positioning errors of X2, Y2 and Z2 were 1.04°±0.62°, 1.26°±1.30°, 0.65°±0.55° in the control group and 0.67°±0.73°, 0.54°±0.24°, 0.45°±0.37° in the experimental group. The difference was statistically significant in the direction of Y2(t=2.53, P<0.05). The displacement of the third cervical vertebra in the control group and the experimental group was (0.130±0.080) and (0.074±0.090) cm. The displacement at the end point of the horizontal ramus of the mandible was (0.240±0.180) cm in the control group and (0.095±0.065) cm in the experimental group, which had significant difference (t=2.99, P<0.05). CONCLUSIONS: Compared with traditional 3D printed oral stent, the detachable 3D printed oral stent can effectively improve the positioning accuracy and has a good clinical application prospect.

Key words: 3D-printing, Separable type, Fixed thermoplastic film, Position error, Oral cancer, Radiation therapy

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