Thesen N
Strahlentherapie. 1985 Aug;161(8):476-86.
The different techniques and radioisotopes for the intracavitary remote-controlled afterloading therapy of the carcinoma of the cervix are discussed. Single or multi-channel applicators including sector-shielding are characterized. A modified 3-channel-applicator offers beside the well known advantages, the possibility to irradiate a vaginal infiltration and the cervix simultaneously and guarantees a definite distance to rectum and bladder and allows an improved representation on localisation-films. Extended tumor-invasion requires beside the intracavitary therapy an additional percutaneous irradiation. Depending on the theoretical approach, intracavitary or percutaneous therapy is predominant. The complex 3-dimensional intracavitary isodose distribution and the locally different fractionation has to be considered by matching the intracavitary and percutaneous therapy. The biological effect of different fractionations arising from the abrupt intracavitary isodose decrease, enlarged penumbra regions behind wedge-filters or slow decreasing isodoses from moving-field irradiations have to be taken into consideration.
本文讨论了宫颈癌腔内遥控后装治疗的不同技术和放射性同位素。对包括扇形屏蔽在内的单通道或多通道施源器进行了特性描述。一种改良的三通道施源器除了具有众所周知的优点外,还能够同时对阴道浸润灶和宫颈进行照射,并确保与直肠和膀胱保持一定距离,且在定位片上能有更好的显示。对于广泛的肿瘤浸润,除腔内治疗外还需要进行额外的经皮照射。根据理论方法,腔内治疗或经皮治疗占主导地位。在匹配腔内和经皮治疗时,必须考虑复杂的三维腔内等剂量分布以及局部不同的分割方式。还必须考虑腔内等剂量突然降低、楔形滤过器后方半影区扩大或移动野照射导致等剂量缓慢降低所产生的不同分割方式的生物学效应。