2nd Jul 2019
2nd Jul 2019
Curated by Flávia Oliveira
Scientists have developed a way to reduce toxicity and side effects of brachytherapy for women with cervical cancer by using 3D-printed applicators. The promising results strengthen the argument for the wider use of the treatment.
In 10 seconds? Researchers have been using 3D-printed templates that are personalised to individual patient anatomy to ensure that a high-dose, but localised cervical cancer treatment, brachytherapy can be administered with even more precision. (Read the science)
What did they do exactly? Using CT and MRI scans, researchers 3D-printed personalised cylinders and needle guides. This ensured that the devices inserted into the patients' vaginas matched their anatomies and their tumours' topographies. The needles in the device could be pointed at optimal angles delivering high-dose radiation in a more precise way, without harming surrounding healthy tissues. Commercially available applicators are not always optimal and due to their generic shape, the treatment can lead to side effects impacting patients’ quality of life. (Read a recent paper)
And does this work in practice? Yes. According to studies, patients treated via 3D-printed personalised templates, as opposed to generic-shaped ones benefited from a ‘minimally invasive’ method and better clinical results. Implantation time was shorter, the treatment could be repeated more easily and resulted in excellent dose distribution to the tumour. Additionally, no life-threatening level of toxicity was detected during the course of the therapy and damage to adjacent organs, such as the bladder, rectum and bowel was avoided. (Find out more)
OK, how are the templates made? The customised applicators were printed based on the MRI scans of patients taking part in the study. They contained multiple curved channels for intracavitary and guided interstitial needle placement. The printer used for production was a digital light processing (DLP) 3D printer using a photopolymer resin that can solidify under a specific type of light source. (Read more)
So, what role does brachytherapy play in cervical cancer treatment? It is often part of the regimen and studies argue for the expansion of its use. Surprisingly, its use has been declining worldwide. According to a study, 55-88% of patients with locally advanced cervical cancer benefit from it, despite that it is proven to enhance both progression-free and overall survival. Even in the US, only 75% of women treated for cervical cancer receive it. Women on low incomes and/or belonging to certain minority groups are less likely to receive the treatment at the recommended time. (Read more)
And does the new research advance the use of brachytherapy? Well, it strengthens the argument for its use. Researchers already describe the method, with its internal radiation source, as a radiotherapy technique with an unparalleled therapeutic index. So, any development that makes it more effective and safe will boost its case, especially given that currently, far fewer women receive the therapy compared to the number who stand to benefit. (Read more)
How 3D printing is gaining traction in healthcare?
A 3D printer for medical use can cost thousands of dollars but buying the kit might not always be necessary.
There are now companies that offer cloud-based solutions to labs and clinicians to meet their 3D printing needs with 48-hour delivery.
Top hospitals tend to establish their own in-house 3D printing units to support their radiology, orthopaedics, cardiac and neurology departments.
Although 3D printing is currently used mostly for surgical planning and visualisation, it is also possible to 'bioprint' to create scaffolds or even directly with living cells to create tissues, and more - read a Digest about 4D printing!