本研究旨在探讨3D打印非共面模板（3D-PNCT）辅助计算机断层扫描（CT）引导高剂量率间质近距离放射治疗（HDR-ISBT）用于盆腔复发宫颈癌术后再照射的有效性和安全性。外照射放射治疗。从2019年1月至2023年8月，45名符合条件的患者被纳入该前瞻性队列。所有患者均接受 3D-PNCT 辅助 CT 引导的 HDR-ISBT，处方剂量为 4-7 Gy/分次，分 3-8 分次到达高风险临床靶区 (HR-CTV)，用于治疗或姑息治疗目的。主要终点是局部无进展生存期（LPFS）和肿瘤缓解率（TRR）。次要结果指标包括总生存期 (OS)、毒性和症状缓解。45 名患者接受了 3D-PNCT 辅助 HDR-ISBT 的 261 部分治疗。 29 名患者有孤立的盆腔复发，16 名患者同时有盆腔外或远处复发。 TRR 为 66.7%。 2年和5年LPFS率分别为30.0%和25.7%。中位 OS 为 23.2 个月，2 年和 5 年 OS 率分别为 49.5% 和 34.0%。多因素分析显示鳞状细胞癌、根治性手术、无复发间隔≥12个月、肿瘤直径、盆腔复发类型、HR-CTV D90≥45 Gy是影响LPFS的独立因素（均p<0.05）。 D100≥21 Gy、V100≥83% 和 V150≥45% 与更好的 LPFS 相关（所有 p<0.05）。肿瘤直径和转移是 OS 的独立预测因素（所有 p<0.05）。疼痛缓解率为66.7%（10/15）。 20.0% 的患者发生 3-4 级毒性。3D-PNCT 辅助 HDR-ISBT 用于复发性宫颈癌的再放疗被证明是根治性手术的有效且安全的替代方案。© 2025。亚洲妇科肿瘤学会、韩国妇科肿瘤学会妇科肿瘤学和日本妇科肿瘤学会。

This study aimed to investigate the efficacy and safety of 3-dimensional printing noncoplanar template (3D-PNCT)-assisted computed tomography (CT)-guided high-dose-rate interstitial brachytherapy (HDR-ISBT) for reirradiation of pelvic recurrent cervical carcinoma after external beam radiotherapy.From January 2019 to August 2023, 45 eligible patients were enrolled in this prospective cohort. All patients underwent 3D-PNCT-assisted CT-guided HDR-ISBT with a prescribed dose of 4-7 Gy/fraction to the high-risk clinical target volume (HR-CTV) over 3-8 fractions, either for curative or palliative purposes. The primary endpoints were local progression-free survival (LPFS) and tumor response rate (TRR). The secondary outcome measures included overall survival (OS), toxicities, and symptom resolution.Forty-five patients received 261 fractions of 3D-PNCT-assisted HDR-ISBT. Twenty-nine patients had isolated pelvic recurrence, and 16 patients had simultaneous extra-pelvic or distant recurrences. The TRR was 66.7%. The 2- and 5-year LPFS rates were 30.0% and 25.7%, respectively. The median OS was 23.2 months, and 2- and 5-year OS rates were 49.5% and 34.0%, respectively. The multivariate analysis indicated that squamous cell carcinoma, radical surgery, recurrence-free interval≥12 months, tumor diameter, pelvic recurrence type, and HR-CTV D90≥45 Gy were independent factors influencing LPFS (all p<0.05). D100≥21 Gy, V100≥83%, and V150≥45% were associated with better LPFS (all p<0.05). Tumor diameter and metastasis were independent predictive factors for OS (all p<0.05). The pain relief rate was 66.7% (10/15). Grade 3-4 toxicities occurred in 20.0% of patients.3D-PNCT-assisted HDR-ISBT for reirradiation of recurrent cervical cancer proved to be an effective and safe alternative to radical surgery.© 2025. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.