Tyrie L K, Hoskin P J
Mount Vernon Hospital, Northwood, UK.
Clin Oncol (R Coll Radiol). 1996;8(6):376-9. doi: 10.1016/s0936-6555(96)80083-5.
Using a standard three-channel Manchester-type tube and ovoid high dose rate applicator system, 46 consecutive patients have been treated for carcinoma of the cervix or endometrium. To facilitate fractionated treatments using high dose rate afterloading, a technique has been developed using an indwelling cervical sleeve inserted under an initial general anaesthetic. All patients received at least two insertions; in five patients we have delivered a total of six consecutive fractions on an outpatient basis without anaesthesia once the sleeve was in situ. Acute morbidity related to the procedure was some degree of uterine pain, which was relieved with nitrous oxide inhalation, and mild, but self-limiting, vaginal discharge. Complete late morbidity data are not yet available, but, in 30% of 25 evaluable patients, minor problems have been observed, particularly vaginal oedema and stenosis. Only one major late event has required surgery. Fractionated afterloading intrauterine brachytherapy can be delivered on an outpatient basis without anaesthesia using this cervical sleeve technique.
使用标准的三通道曼彻斯特型施源管和卵圆形高剂量率施源器系统，对46例宫颈癌或子宫内膜癌患者进行了连续治疗。为便于使用高剂量率后装进行分次治疗，已开发出一种技术，即在初次全身麻醉下插入留置宫颈套管。所有患者至少接受了两次插入治疗；有5例患者在套管就位后，在门诊无需麻醉的情况下连续进行了总共6次分次治疗。与该操作相关的急性并发症为一定程度的子宫疼痛，吸入氧化亚氮后可缓解，以及轻度但可自行缓解的阴道分泌物增多。完整的晚期并发症数据尚未获得，但在25例可评估患者中的30%观察到了轻微问题，尤其是阴道水肿和狭窄。仅1例严重晚期事件需要手术治疗。使用这种宫颈套管技术，分次后装子宫内近距离放疗可在门诊无需麻醉的情况下进行。
