Koga K, Watanabe K, Kawano M, Kusumoto S, Nishikawa K, Kawano K, Kuroki T, Mori N
Int J Radiat Oncol Biol Phys. 1987 Apr;13(4):615-8. doi: 10.1016/0360-3016(87)90080-0.
Between January 1978 and June 1985 seventy-nine patients with carcinoma of the uterine cervix were treated by a remotely controlled afterloading system (RALS) with high-dose-rate irradiation following external beam therapy. It was given once a week with a dose per fraction of 6 Gy to point A, 3 to 6 times, using applicators equipped with 1 Ci 60Co bead in each ovoid and two 1 Ci 60Co beads in a tandem 1 cm apart. Five-year survival rates were 85, 68, and 51 percent in Stages I, II, and III, respectively. Recurrences were noted in 12 patients (20%) with a minimum follow-up of 2 years: 4 patients in the parametrium, 2 in the central area, 5 in both the parametrium and central areas, and 5 in the para-aortic lymph node. Complications were noted in 13 patients (22%): temporary rectal bleeding in 7, stenosis of the sigmoid in 2, recto-vaginal fistula in 1, ileo-sigmoidal fistula in 1, and perforation of the intestine in 2 patients. The treatment results of the high-dose-rate schedule for RALS appear to be comparable to those of conventional low-dose-rate systems reported by others. Therefore a fraction dose of 6 Gy to point A once a week by RALS should be considered to be practical, economical, and acceptable to patients.
1978年1月至1985年6月期间，79例子宫颈癌患者在体外照射后采用遥控后装系统（RALS）进行高剂量率照射治疗。每周进行一次，A点每次剂量为6 Gy，共3至6次，使用的施源器每个卵形容器内装有1居里60钴珠，串联中两个1居里60钴珠相距1厘米。I期、II期和III期患者的5年生存率分别为85%、68%和51%。12例患者（20%）出现复发，最短随访2年：4例宫旁复发，2例中心区域复发，5例宫旁和中心区域均复发，5例腹主动脉旁淋巴结复发。13例患者（22%）出现并发症：7例出现暂时性直肠出血，2例乙状结肠狭窄，1例直肠阴道瘘，1例回肠乙状结肠瘘，2例肠穿孔。RALS高剂量率治疗方案的治疗结果似乎与其他人报告的传统低剂量率系统相当。因此，RALS每周一次给A点6 Gy的分次剂量应被认为是实用、经济且患者可接受的。
