Hetzel H, Fritsch E, Url M, Frommhold H, Dapunt O
Universitätsklinik für Frauenheilkunde und Geburtshilfe, Innsbruck.
Strahlenther Onkol. 1987 Dec;163(12):774-81.
In continuation of our long-term afterloading method applied in the treatment of patients with inoperable cervix carcinomas, we have introduced the ring and pin applicator system into the short term afterloading proceeding. The benefit of a standardized treatment method is especially relevant in HDR afterloading therapy. A time-consuming brachytherapy planning is not necessary because of the constant source distribution within the rigidly shaped ring and pin applicator and the unchanged dose to point A according to Manchester. Percutaneous radiotherapy planning is further facilitated by fixing a metal clip in the cervix at the first HDR insertion. With the aid of anterior-posterior localization radiography, the centre of the circular absorber used by us can be located on the metal clip. In case of an asymmetric position of the cervix, this allows to avoid a dose excess at one pelvis wall caused by superimposing target volumes of brachytherapy and percutaneous therapy as well as an insufficient dose at the opposite wall of the pelvis.
在我们将长期后装方法应用于不可手术宫颈癌患者治疗的基础上,我们已将环形和针形施源器系统引入短期后装治疗过程。标准化治疗方法的益处尤其体现在高剂量率后装治疗中。由于刚性形状的环形和针形施源器内源分布恒定,且根据曼彻斯特法对A点的剂量不变,因此无需耗时的近距离放疗计划。在首次高剂量率植入时在宫颈处固定一个金属夹,进一步简化了经皮放疗计划。借助前后位定位射线照相,我们使用的圆形吸收器的中心可定位在金属夹上。在宫颈位置不对称的情况下,这可以避免因近距离放疗和经皮治疗的靶体积叠加而导致一侧骨盆壁剂量过量以及骨盆对侧壁剂量不足的情况。