Abstract / Summary
Abstract Objective To evaluate the dosimetry, efficacy and safety of individualized 3-dimensional (3D)-printed applicator for interstitial brachytherapy (ISBT) compared to the freehand ISBT in locally advanced cervical cancer (LACC). Methods This retrospective study included 100 patients with LACC who underwent concurrent chemoradiotherapy at our institution between January 2020 and December 2024. Among them, 49 patients received ISBT using 3D-printed applicators, and 51 underwent freehand ISBT. The high-risk clinical target volume (HR-CTV) D90 and D2cc for organs at risks were compared between the two groups. The survival outcomes and treatment-related complications were assessed. Results The HR-CTV D90 was significantly higher in the 3D-printed group than in the freehand group (91.27 ± 1.76 Gy vs. 89.33 ± 1.72 Gy, P < 0.001), while bladder and rectum D2cc were significantly lower (83.77 ± 2.03 Gy vs. 85.37 ± 1.81 Gy, P < 0.001; 70.26 ± 1.87 Gy vs. 72.01 ± 1.53 Gy, P < 0.001). And a lower sigmoid D2cc trend was observed in the 3D-printed group (68.07 ± 2.07 Gy vs. 68.69 ± 1.50 Gy, P = 0.09). The incidence of treatment-related complications did not differ significantly between the two groups. The 3-year overall survival (71.5% vs. 69.8%; P = 0.79) and 3-year disease-free survival (71.7% vs. 67.0%; P = 0.80) rates were comparable between the 3D-printed and freehand groups. However, the 3D-printed group showed significantly improved 3-year local recurrence-free survival (86.5% vs. 67.0%; P = 0.04). Conclusion Compared to freehand ISBT, the 3D-printed ISBT provides superior dosimetric outcomes with a favorable safety. Clinical trial number Not applicable.