Annweiler H, Roth S L, Thesen N, Sack H
Strahlentherapie. 1985 May;161(5):286-92.
Since April 1983 patients with gynecologic tumors have been irradiated with the HDR afterloading method at the University Hospital of Cologne. The therapy scheme for the carcinoma of the cervix consists of a combination of intracavitary contact irradiation and external radiotherapy. Brachytherapy is preponderant in an early stage of tumor extension, whereas teletherapy contributes more to the total dose in advanced stages. At first, the pelvis is totally exposed to a homogenous irradiation, so the shrunken tumor can more easily be arrived by curietherapy. The therapy scheme is described for the different tumor stages with its dosages, fractionations, and treatment pauses. Besides the use of special multiple-way applicators, the risk organs are protected by collimating with a block the middle part of the external irradiation field as soon as the maximum permissible dose is reached. A special block shape minimizes the dose irregularities at the field borders. The total physical dose at point A is about 60 Gy. The high dose rate of HDR afterloading has to be considered when calculating the biologic efficient dose. Here the dose rate factor furnishes a rough relation to the established radium dosage.
自1983年4月起,科隆大学医院一直采用高剂量率后装治疗法对妇科肿瘤患者进行放射治疗。子宫颈癌的治疗方案包括腔内近距离照射和体外放射治疗相结合。近距离放射治疗在肿瘤早期扩展阶段占主导地位,而远距离放射治疗在晚期阶段对总剂量的贡献更大。首先,骨盆完全接受均匀照射,这样缩小后的肿瘤更易于接受镭疗。文中描述了针对不同肿瘤分期的治疗方案,包括剂量、分次照射和治疗间歇。除了使用特殊的多路施源器外,一旦达到最大允许剂量,通过用铅块遮挡体外照射野的中部来保护危险器官。一种特殊的铅块形状可使野边界处的剂量不均匀性降至最低。A点的总物理剂量约为60 Gy。在计算生物等效剂量时,必须考虑高剂量率后装治疗的剂量率。在此,剂量率因子提供了与既定镭剂量的大致关系。