Therapeutic value of 3-D printing template-assisted ¹²⁵I-seed implantation in the treatment of malignant liver tumors

Figures & data

Table 1 General characteristics of the patients

Characteristic	Group A	Group B	P-value
Sex, n (%)			0.869
Male	8/15 (53.3)	14/25 (56)
Female	7/15 (46.7)	11/25 (44)
Age, years			0.334
Median (range)	61 (42–78)	57 (37–82)
KPS, n (%)			0.622
70	9 (60)	13 (52)
60	6 (40)	12 (48)
Diagnosis, n (%)			0.95
Primary hepatocellular carcinoma	6/15 (40)	10/25 (40)
Cholangiocarcinoma	2/15 (13.3)	5/25 (20)
Liver metastasis from rectal cancer	4/15 (26.7)	6/25 (24)
Liver metastasis from other cancers	3/15 (20)	4/25 (20)
Number of lesions, n (%)			0.908
One	3/15 (20)	5/25 (20)
Two	4/15 (26.7)	9/25 (36)
Three	3/15 (20)	5/25 (20)
More	5/15 (33.3)	6/25 (24)
Total lesions, n	47	66
Lesion size, n (%)			0.139
≤3 cm	14/47 (29.8)	27/66 (40.9)
3–8 cm	29/47 (61.7)	34/66 (51.5)
>8 cm	4/47 (8.5)	5/66 (7.6)
Location of lesions, n (%)			0.006
Right lobe of liver	19/47 (40.4)	20/66 (30.3)
Left lobe of liver	15/47 (31.9)	31/66 (46.9)
Caudate lobe of liver	11/47 (23.4)	13/66 (19.7)
Quadrate lobe of liver	2/47 (4.3)	23/66 (3.1)

Abbreviation: KPS, Karnofsky performance.

Figure 1 Use of TPS to design the needle-insert and seed-arrangement plane according to CT result for printing 3-D templates.

Abbreviations: TPS, treatment-planning system; CT, computed tomography.

Figure 2 Preoperative planning and postoperative quality authentication.

Table 2 Operation data

	Group A	Group B	t	P-value
Operation time (minutes)	42.5±19.3	67.6±37.2	2.4	0.01*
Number of operations	1.3±0.6	1.5±0.8	0.8	0.2
Hospital stay (days)	7.1±5.2	9.7±6.8	1.27	0.11
D90 (cGy)	12,426±2,324	10,985±3,656	1.37	0.18
D100 (cGy)	10,307±2,489	7,764±2,582	3.06	0.04*
V100 (%)	95.4±6.5	89.6±8.4	2.29	0.01*
V150 (%)	62.1±14.2	73.6±15.6	2.33	0.01*

Note:

* Statistically significant.

Table 3 Response (rate) results, n (%)

	Group A	Group B
CR	3 (20)	3 (12)
PR	10 (66.7)	18 (72)
NC	1 (6.7)	1 (4)
SD	1 (6.7)	3 (12)
Responsesa	13/15 (86.7)	21/25 (84)

Note:

a χ²=0.05, P=0.819 (not significant).

Abbreviations: CR, complete response; PR, partial response; NC, no change; SD, stable disease.

Table 4 Complications of permanent ¹²⁵I implantation

	Group A n (%)	Group B n (%)	χ^2	P-value
Pain	7 (46.7)	11 (44)	0.027	0.87
Fever	5 (33.3)	6 (24)	0.409	0.52
Massive bleeding	0	1 (4)	–	–
Pneumothorax	0	2 (8)	–	–
Seeds migration	2 (13.3)	1 (4)	1.177	0.28

Table 5 Patients suffering from varying degrees of complication

	Group A, n (%)	Group B, n (%)	χ^2	P-value
Grade 1	7 (46.7)	16 (36)	2.67	0.1
Grade 2	4 (28.5)	3 (12)	12	0.052
Grade 3	0 (0)	0 (0)	–	–
Grade 4	0 (0)	0 (0)	–	–
Grade 5	0 (0)	0 (0)	–	–

Note: Complications evaluated with CTCAE grading scale (version 4.03).

Abbreviation: CTCAE, Common Terminology Criteria for Adverse Events.