On September 21, 2022, the Department of Radiotherapy of Shanxi Medical University First Hospital successfully completed the very difficult post-loading and short-range implantation treatment for a head tumor patient and neck that had relapsed after surgery and radiotherapy. the first of its kind in the province.
How to overcome recurrent and metastatic head and neck tumors is a major clinical problem. The first choice recommended by medical guidelines is systemic treatment such as chemotherapy combined with targeted immunity. However, the efficiency is low and the average response time is only higher. 5 months. The Radiotherapy Department of Shanxi Medical University First Hospital introduced an internationally advanced three-dimensional therapy device in the second half of 2019. It shows remarkable effectiveness in radical radiotherapy of cervical cancer, with a high cure rate and few side effects. . It is very popular with patients and doctors. In order to deal with the recurrence and metastasis of head and neck tumors, with the support of Director Li Xianfeng, Deputy Chief Physician Hou Yanjie worked boldly and creatively closely with the team of physicists/ technicians/nurses to treat a patient with a recurrence after an operation. and radiotherapy on September 21. A patient with a head and neck tumor (pterygopalatine fossa area) who recurred twice after surgery completed difficult postoperative treatment and short-range implantation. Before surgery, an implantation plan was developed based on the patient’s CT images, and a custom 3D-printed multichannel non-coplanar model was also developed. Using the model, the surgical process went very smoothly and the set-up of. The implantation of 5 needles was completed in 30 minutes. The preoperative and postoperative radiotherapy plans were consistent, and a single radiotherapy dose of 30 Gy was administered to the patient to achieve the goal of precise brachytherapy.
△Pre-operative design of 3D printed non-coplanar models
△Tumor transplantation process
The patient underwent surgical treatment of a tumor in the pterygopalatine fossa region in the Department of Oral and Maxillofacial Surgery of the First Hospital of Shanxi Medical University in May 2021, and received adjuvant radiotherapy after operation in December of the same year. relapsed in the radiation field of the surgical area. The Oral and Maxillofacial Surgery Department of the entire hospital After consultation, a second resection of the tumor was carried out in cooperation with neurosurgery. However, due to the very high malignancy of the tumor, local. a recurrence occurred again 3 months after the operation and the tumor invaded the brain. Family members went to many hospitals in Beijing for medical treatment, but no effective solution was found. The Department of Radiotherapy of Shanxi Medical University First Hospital formulated a treatment plan of “re-radiotherapy, concomitant chemotherapy + short-range implantation”. After multi-stage treatment, the patient’s symptoms were significantly relieved and the tumor was in normal condition. continuous regression. It is expected that there will be better results after the implantation treatment.
△Perfect dose distribution
Resection of tumors in the pterygopalatine fossa region is a difficult operation, and secondary surgery and re-radiotherapy after postoperative radiotherapy better reflect the level and responsibility of a tertiary hospital. The treatment of this patient demonstrates the close cooperation between multiple disciplines in tumor treatment at the First Hospital of Shanxi Medical University, and the implantation and radiotherapy guided by the 3D printed non-coplanar model achieved the effect “icing on the cake”.
Director Li Xianfeng introduced that the First Hospital of Shanxi Medical University is the first unit in the province to practice three-dimensional brachytherapy, and it is also the first department to practice brachytherapy. He has carried out 13 cases of transplantation treatment, all of them. which achieved the expected therapeutic effect, and this patient implant radiotherapy, guided by a 3D printed non-coplanar model, has taken the essence of brachytherapy to the extreme. It was a perfect fusion of digital medicine, anatomy and dosimetry. no relevant reports on implant treatment in the country.
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