Intracavitary applicator in relation to complications of pelvic radiation: the Ernst system
Case studies were reviewed for 100 consecutive patients with carcinoma of the cervix, Stages I to III, who were treated prior to 1968 at a large municipal hospital in New York City. Treatments consisted of orthovoltage therapy prior to or following intracavitary radium. A 250 kV x-ray unit delivered a 3000 rad tumor dose in 3 weeks through four oblique fields. Intracavitary radium delivered 6000 to 7200 mg hr using the Ernst applicator. The 9% incidence of fistulae was 4-fold higher than that found in subsequent years using /sup 60/Co teletherapy and the afterloading Fletcher-Suit applicator. A review of the dosimetry relating to the use of the Ernst applicator demonstrates inherent structural characteristics which lend themselves to such complications. Where less than an ideal application is possible, this rigid applicator compacts itself in accordion-like fashion, producing a so-called short-system. Coupled with a reduced source to applicator-surface distance, such applications result in unacceptable dose anisotropy and excessive radiation of critical structures where a predetermined dose is to be delivered to anatomic Point A. Information gleaned from this study can be extrapolated to other rigid unprotected short-surface distance intra-vaginal applicators that have proliferated in recent years.
- Research Organization:
- New York Medical Coll., NY
- OSTI ID:
- 6776415
- Journal Information:
- Int. J. Radiat. Oncol., Biol. Phys.; (United States), Vol. 4:11/12
- Country of Publication:
- United States
- Language:
- English
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560151* - Radiation Effects on Animals- Man