Sherrah-Davies E
Clin Radiol. 1985 Mar;36(2):131-9. doi: 10.1016/s0009-9260(85)80095-7.
The Christie Hospital installed a Selectron afterloading machine in 1979. By early 1982 it became apparent that patients treated for carcinoma of the cervix using the Selectron had developed a high incidence of morbidity compared with patients treated by the standard Manchester radium technique. Initially, the majority opinion was that the patients had been overdosed, because little or no allowance had been made for the higher dose rate of 137Cs. The results of investigation suggest, however, that the main factor responsible for the morbidity was a change in technique, previously unrecognised, in that the rigid 137Cs applicators facilitate the use of a much higher proportion of long intrauterine tubes and larger vaginal components than used to be the case with radium. The evidence for this and the probable mechanism of the resulting damage are discussed.
1979年，克里斯蒂医院安装了一台Selectron后装治疗机。到1982年初，很明显，与采用标准曼彻斯特镭技术治疗的患者相比，使用Selectron治疗宫颈癌的患者出现了较高的发病率。最初，大多数人的看法是患者接受了过量照射，因为对于137铯较高的剂量率几乎没有或根本没有考虑在内。然而，调查结果表明，导致发病的主要因素是一种以前未被认识到的技术变化，即刚性的137铯施源器使得使用比以前镭治疗时比例高得多的长子宫内管和更大的阴道组件变得更容易。文中讨论了这方面的证据以及由此造成损伤的可能机制。
