Simplified afterloading and high voltage therapy in cervix carcinoma

In continuation of our long term afterloading method applied in the treatment of patients with inoperable cervix carcinomas, we have introduced the ring and pin applicator system into the short term afterloading proceeding. The benefit of a standardized treatment method is especially relevant in HDR afterload therapy. A time-consuming brachytherapy planning is not necessary because of the constant source distribution within the rigidly shaped ring and pin applicator and the unchanged dose to point A according to Manchester. Percutaneous radiotherapy planning is further facilitated by fixing a metal clip in the cervix at the first HDR insertion. With the aid of anterior-posterior localization radiography, the centre of the circular absorber used by us can be located on the metal clip. In case of an asymmetric position of the cervix, this allows to avoid a dose excess at one pelvis wall caused by superimposing target volumes of brachytherapie and percutaneous therapy as well as an insufficient dose at the opposite wall of the pelvis. (orig.)