3D-Printed Coplanar Template-Assisted Iodine-125 Seed Implantation Therapy in Patients with Pancreatic Cancer: A Pilot Study

Rationale: To evaluate a 3D-printed coplanar template for iodine-125 seed implantation therapy in patients with pancreatic cancer. Methods: A retrospective analysis of our database was performed, and a total of 25 patients with pancreatic cancer who underwent iodine-125 seed implantation between January 2014 and November 2017 were analyzed. Of these, 12 implantations were assisted by a 3D-printed coplanar template (group A), and 13 implantations performed freehand were selected as the control group (group B). A 3D coplanar template was designed and printed according to a preoperative CT scan and treatment planning system. The iodine-125 seeds were then implanted using the template as a guide. Dosimetric verification was performed after implantation. Pre- and postoperative D90, V100, and V150 were calculated. The success rate of iodine-125 seed implantation, dosimetric parameters and complications were analyzed and compared between the two groups. Results: Iodine-125 seed implantation was successfully performed in both groups. In group A, the difference in pre- and post-operative D90 was minimal and not statistically significant (P>0.05). Postoperative V100 and V150 were 91.05±4.06% and 64.54±13.40%, respectively, which met the treatment requirement. A better dosimetric parameter was observed in group A than in group B, and the difference was statistically significant. Conclusion: A 3D-printed coplanar template appears to be a safe and effective iodine-125 seed implantation guidance tool to improve implantation accuracy and optimize dosimetric distribution. Funding: This research was supported by the Natural Science Foundation of China. Competing Interest Declaration: The content of this manuscript haven’t been influenced by any conflict of interest. Ethics Approval Statement: The study was approved by the institutional review board, and all subjects signed an informed consent form.