Side effect of radioactive 125 I seed implantation for recurrent malignant tumor of head and neck assisted by 3D-printing individual guide plate

Abstract

Objective To investigate the acute side effect of 3D printing individual non-coplanar template for 125I seed implantation in head and neck recurrent/ metastatic carcinoma. Methods Between January 2016 and December 2016, 42 patients of local recurrent malignant tumor of head and neck received 3D printing guide plate assist radioactive seeds implantations, and included in the study. The tumor volume ranged from 2.4 to 102.8 cm3 (median 28.6 cm3). The prescribed dose is 110-160 Gy, and the seeds activity were 0.34 to 0.70 mCi(1 Ci=3.7×1010Bq). All patients carried out preoperative planning design, individual guide plate production, seed implantation, postoperative dose assessment, and follow-up. The side effects of skin, mucous membrane, blood and spinal cord were statistically analyzed. Results All patients were operated successfully. The follow-up time was 4-14 months (median 8.5 months). There were no adverse reactions at grade three or above. Three patients had grade one skin reaction. One patient experienced grade one mucosal reaction, two experienced grade two mucosal reactions. The skin response was correlated with the dose of the skin (χ2=7.067, P=0.032). No hematologic toxicity or radiation myelopathy was observed and no seed displacement was found. Conclusions 3D-printing guide plate can provide good accuracy for positioning and direction. For local recurrent malignant tumor of head and neck, there were no obvious adverse reactions and the operation was simple and the dosage was accurate. Key words: 3D-printing non-coplanar template; Radioactive seed implantation; Side effect; Head and neck carcinoma