{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:37:36Z","timestamp":1791581856501,"version":"4.3.4"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The prognosis of patients with non-central recurrent cervical cancer (NRCC) remains poor, and treatment options are limited. We aimed to explore the accuracy and safety of the 3D-printed non-coplanar template (3D-PNCT)-assisted <jats:sup>192<\/jats:sup>Ir interstitial brachytherapy (ISBT) in the treatment of NRCC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A total of 36 patients with NRCC who received 3D-PNCT-guided <jats:sup>192<\/jats:sup>Ir ISBT in the First Affiliated Hospital of Zhengzhou University from January 2021 to July 2022 were included in this study. There were 36 3D-PNCTs that were designed and printed. The prescribed dose was 30\u201336 Gy, divided into five to six times, once a week. To evaluate whether the actual parameters were consistent with the preoperative design, the dosimetric parameters of pre- and postoperative treatment plans were compared, including dose of 90% high-risk clinical target volume (HR-CTV D90), volume percentage of 100% and 150% prescribed dose V<jats:sub>100%<\/jats:sub> and V<jats:sub>150<\/jats:sub>%, homogeneity index (HI), conformal index (CI), external index (EI), and dose received by 2 cm<jats:sup>3<\/jats:sup> (D2cm<jats:sup>3<\/jats:sup>) of the rectum, colon, bladder, and ileum. The safety parameters including occurrence of bleeding, infection, pain, radiation enteritis, and radiation cystitis within 3 months after operation were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients successfully completed the treatment and achieved the goals of the preoperative plan. There was no significant difference in the accuracy (HRCTVD90, V<jats:sub>100%<\/jats:sub>, EI, CI, and HI) and safety (D2cm<jats:sup>3<\/jats:sup> of rectum, colon, bladder, and ileum) parameters of the postoperative plan compared with the preoperative plan (all <jats:italic>p<\/jats:italic>&amp;gt;0.05). Major side effects included bleeding at the puncture site (13.9%), postoperative pain (8.3%), acute radiation cystitis (13.9%), and radiation enteritis (19.4%). There were no serious perioperative complications and no grade 3\u20134 acute radiotherapy side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>3D-PNCT-assisted <jats:sup>192<\/jats:sup>Ir ISBT can be accurately and safely applied in the treatment of patients with NRCC.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1174470","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T13:54:57Z","timestamp":1698328497000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Dosimetric parameters and safety analysis of 3D-printing non-coplanar template-assisted interstitial brachytherapy for non-centrally recurrent cervical cancer"],"prefix":"10.3389","volume":"13","author":[{"given":"Cong","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yadong","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huirong","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32470-X","article-title":"Cervical cancer","volume":"393","author":"Cohen","year":"2019","journal-title":"Lancet (London England)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12050755","article-title":"Patterns of recurrent disease in cervical cancer","volume":"12","author":"Micco","year":"2022","journal-title":"J Pers Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.01265","article-title":"Efficacy and safety of pembrolizumab in previously treated advanced cervical cancer: results from the phase II KEYNOTE-158 study","volume":"37","author":"Chung","year":"2019","journal-title":"J Clin Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.critrevonc.2019.02.009","article-title":"Systemic therapy in cervical cancer: 30 years in review","volume":"137","author":"Liontos","year":"2019","journal-title":"Crit Rev Oncology\/Hematology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"100579","DOI":"10.1016\/j.esmoop.2022.100579","article-title":"Recurrent or primary metastatic cervical cancer: current and future treatments","volume":"7","author":"Gennigens","year":"2022","journal-title":"ESMO Open"},{"key":"B6","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.brachy.2021.11.004","article-title":"Efficacy and safety of a 3D-printed applicator for vaginal brachytherapy in patients with central pelvic-recurrent cervical cancer after primary hysterectomy","volume":"21","author":"Qin","year":"2022","journal-title":"Brachytherapy"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2020.07.013","article-title":"Multimaterial three-dimensional printing in brachytherapy: Prototyping teaching tools for interstitial and intracavitary procedures in cervical cancers","volume":"19","author":"Campelo","year":"2020","journal-title":"Brachytherapy"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2015.12.012","article-title":"Individualised 3D printed vaginal template for MRI guided brachytherapy in locally advanced cervical cancer","volume":"118","author":"Lindegaard","year":"2016","journal-title":"Radiotherapy Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S195829","article-title":"Dosimetry comparison between a 3D printed minimally invasive guidance template and free implantation in the brachytherapy treatment of postoperative recurrent cervical carcinoma","volume":"11","author":"Yuan","year":"2019","journal-title":"Cancer Manage Res"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2021.32.e15","article-title":"Safety and efficacy of 3D-printed templates assisted CT-guided radioactive iodine-125 seed implantation for the treatment of recurrent cervical carcinoma after external beam radiotherapy","volume":"32","author":"Liu","year":"2021","journal-title":"J gynecologic Oncol"},{"key":"B11","first-page":"197","article-title":"[Foreseeable dosimetry in the interstitial therapy using Iridium 192 wires (\"Paris system\"). 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