Weeks K J, Montana G S, Bentel G C
Division of Radiation Oncology, Duke University Medical Center, Durham, NC 27710.
Int J Radiat Oncol Biol Phys. 1991 Sep;21(4):1045-52. doi: 10.1016/0360-3016(91)90748-s.
A plastic intracavitary applicator system for the treatment of cancer of the uterine cervix is described. This applicator has a minicolpostat and a mechanism for affixing the tandem to the colpostats. Traditional afterloading refers only to the radioactive source. Both the source and the ovoid shield are afterloaded together in this applicator in contrast to traditional afterloading systems which afterload the source alone. A potential advantage of our applicator system is that it allows high quality CT localization because the sources and shields can be removed and the applicator is made of plastic. The advantages and disadvantages of this variation to the Fletcher system as well as other aspects of applicator design are discussed. An experimentally verified dose calculation method for shielded sources is applied to the design problems associated with this applicator. The dose distribution calculated for a source-shield configuration of the plastic applicator is compared to that obtained with a commercial Fletcher-Suit-Delclos (FSD) applicator. Significant shielding improvements can be achieved for the smallest diameter ovoid, that is, in the minicolpostat. The plastic minicolpostat dose distributions are similar to those produced by the conventional larger diameter colpostats. In particular, the colpostat shielding for rectum and bladder, which is reduced in the metal applicator's minicolpostat configuration, is maintained for the plastic minicolpostat. Further, it is shown that, if desired, relative to the FSD minicolpostat, the mucosa dose can be reduced by a suitable change of the minicolpostat source position.
