Svoboda V H, Kovarik J, Morris F
Department of Radiotherapy and Oncology, Saint Mary's Hospital, Portsmouth, UK.
Int J Radiat Oncol Biol Phys. 1995 Feb 15;31(4):967-72. doi: 10.1016/0360-3016(94)00485-4.
The feasibility of high dose rate iridium afterloaded molds in the treatment of skin tumors.
Expanded silicone rubber and bronchial applicator tubes were used in the construction of various molds. The number of tubes used and the separation between them depends on the size and area to be treated. Source dwell position and time are set to follow Paterson-Parker rules. Single plane expanded silicone rubber molds between 15 X 15 mm and 60 X 70 mm were used in 120 different sites, and of the others, seven were perspex double molds, two were cylindrical applicators, and one was a partially shielded intranasal applicator. One hundred and thirty lesions of various site and histology were treated in all. After exclusion of treatments that were combined with either external beam or chemotherapy, 106 lesions (76 patients) were evaluated.
Full response was obtained in all but four basal cell carcinomas. The acute reaction ranged from moist desquamation (27 sites) to erythema only. Follow-up at 5 or more months revealed no changes whatever in 47 sites; 53 showed an excellent cosmetic outcome, although slight changes in pigmentation or minimal atrophy was demonstrable and 6 sites became noticeably atrophic with patchy pigmentation. For 9.6 months of average follow-up time, no recurrences have been observed.
The high-dose-rate iridium-loaded skin applicators offer the possibility of improved therapeutic ratio in the treatment of superficial skin tumors. With the availability of a high-dose-rate afterloader this technique is simple and straightforward.
高剂量率铱后装模具治疗皮肤肿瘤的可行性。
使用膨胀硅橡胶和支气管施源管构建各种模具。所用施源管的数量及其间距取决于待治疗的大小和面积。源驻留位置和时间根据帕特森 - 帕克规则设置。15×15毫米至60×70毫米的单平面膨胀硅橡胶模具在120个不同部位使用，其他的有7个是有机玻璃双模具，2个是圆柱形施源器，1个是部分屏蔽的鼻内施源器。总共治疗了130个不同部位和组织学类型的病变。在排除与外照射或化疗联合的治疗后，对106个病变（76例患者）进行了评估。
除4例基底细胞癌外，其余均获得完全缓解。急性反应范围从湿性脱屑（27个部位）到仅出现红斑。5个月或更长时间的随访显示，47个部位无任何变化；53个部位美容效果极佳，尽管可观察到色素沉着有轻微变化或有轻微萎缩，6个部位出现明显萎缩并伴有片状色素沉着。平均随访9.6个月，未观察到复发。
高剂量率铱皮肤施源器为改善浅表皮肤肿瘤的治疗比提供了可能性。有了高剂量率后装治疗机，这项技术简单易行。
