Hoskin P J, Cook M, Bouscale D, Cansdale J
Mount Vernon Centre for Cancer Treatment, Mount Vernon Hospital, Middlesex, UK.
Radiother Oncol. 1996 Jul;40(1):59-62. doi: 10.1016/0167-8140(96)01746-x.
The reproducibility of high dose rate gynaecological brachytherapy applicator position in the same patient at repeated treatments has been studied. Measurements on antero-posterior and lateral radiographs to detect relative positions of tube and ovoid to the bony pelvis, bladder and rectum were made. Major variations within the same patient in craniocaudal positioning of the applicators and in antero-posterior movement was seen. The position of the anterior rectal wall was found to move a median of 10.5 mm (range, 0-22) in relation to the ovoid source between first and second insertions. These changes can be accounted for in differences in technique between first and second insertion and in particular the use of posterior vaginal packing and exterior clamping. The importance of individual dosimetry for each high dose rate insertion is clear with major differences in dosimetry to critical normal structures having been found.
已对高剂量率妇科近距离放射治疗施源器在同一患者重复治疗时位置的可重复性进行了研究。通过前后位和侧位X线片测量，以检测施源管和卵形容器相对于骨盆、膀胱和直肠的相对位置。发现同一患者在施源器的头脚方向定位和前后移动方面存在较大差异。发现直肠前壁位置在第一次和第二次插入之间相对于卵形容器源平均移动10.5毫米（范围为0 - 22毫米）。这些变化可归因于第一次和第二次插入技术的差异，特别是阴道后填塞物的使用和外部夹紧。鉴于已发现对关键正常结构的剂量测定存在重大差异，每次高剂量率插入进行个体化剂量测定的重要性显而易见。
