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Treatment of extensive carcinoma of the cervix with the transperineal parametrial butterfly. [Dosimetry efficiency and complications of afterloaded /sup 192/Ir implants]

Journal Article · · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

In advanced carcinoma of the cervix the associated obliteration of the fornices or contracture of the vagina may interfere with accurate placement of conventional intracavitary applicators. Poorly placed applicators fail to irradiate the pelvis homogeneously. Waterman (and others) solved this dilemma by transvaginal radium implants many years ago; however, despite good survival figures, this technique has not gained popularity, presumably because of excessive exposure to personnel. In this paper, we describe a technique which largely eliminates the exposure problem and at the same time improves the homogeneity of pelvic endoradiotherapy. We locate what is in essence a pair of paravaginal interstitial colpostats in both parametria in combination with the usual intrauterine tandem. This helps to distribute the dose laterally, with relative sparing of bladder and rectum. The technique employs a template to guide the insertion into the parametria of a group of 18 gauge hollow steel needles transperineally. Afterloading with /sup 192/Ir is accomplished when the patient has returned to her room (after orthogonal radiography and computer dosimetry). Doses to point B compare very favorably to those at point A.

Research Organization:
Univ. of Southern California, Los Angeles
OSTI ID:
6801116
Journal Information:
Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 4:7-8; ISSN IOBPD
Country of Publication:
United States
Language:
English

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