[en] This brief note describes a modification of the Selectron (Nucleon Trading, Leersum, The Netherlands) afterloading treatment unit used at the Western Infirmary, Glasgow, as a standard post-operative treatment for corpus carcinoma. Gauze packing previously employed is in effect replaced by 5 mm of nylon and the dose to the surface of the recto-vaginal septum is accurately predetermined. Use of the modification offers the advantage of eliminating a general anaesthetic, with its attendant risks and higher theatre costs. (U.K.)

[en] The authors describe an afterloading brachytherapy to treat oral cavity carcinomas. Catheters for arterial/venous catheterization are inserted percutaneously in the target volume. The internal needles are then removed and replaced with iridium wires inside tubes to form wire loops. This technique has proven to be simple, quick and safe. (author). 4 refs.; 1 fig

[en] With HDR (high dose rate) afterloading treatment, a very critical dependence of normal tissue reaction (rate of side effects of organs at risk) on dosage was demonstrated compared with the effect of low dose rate application. Furthermore, a stronger dependence of normal tissue reaction (steeper curves) on application of a single HDR afterloading fraction compared with that on total dose application over several weeks was observed. All these observations require exact dosage of HDR afterloading application to all points of organs at risk concerned in order to compensate the radiobiologically critical dosage of HDR. On the other hand, a threshold of 7 to 7.5 Gy per single fraction at organs at risk should not be exceeded. Therefore, HDR afterloading treatment requires optimization of source arrangement or source movement in order to receive good results. Since 1976, computer optimization of the movement of a highly active Ir-192 source is used, since 1987, an IBM PC AT is used for this calculation. The computer optimization programme, its data output and isodose calculation parts, is briefly discussed. 3 refs.; 5 figs

[en] The authors describe and have used a new afterloading applicator in six patients for primary radiation therapy of endometrial cancer. The first introduction of the applicator was done under general anaesthesia. Dilating the cervical canal to Heger 9 made insertion easier. Prior to application it is advisable to probe the lumen of the uterine cavity with a tube or curette to estimate how far the applicator must be spread open. For brachytherapy it is advantageous to remove necrotic tumour portions. This requires experienced hands to avoid perforation of the uterus. The new afterloading applicator is easy to use, and permits direct contact between the six tubes and the tumour. In conjunction with careful planning with the help of MRI, it provides an optimal system for the treatment of endometrial cancer. (Author)

[en] The experience of the Christie Hospital in Manchester in treating cancer of the cervix, (with particular reference to intracavitary radiation and after loading systems, and treatment complications) is described, together with consideration of cancer of the uterine corpus, vulva and ovaries. (U.K.)

[en] A high-dose-rate Microselectron has been under clinical evaluation at the Christie Hospital and Holt Radium Institute since April 1988. This remote afterloading machine uses a single 370 GBq (10 Ci) iridium source of 1.1 mm external diameter. Consequently, the applicator may be much narrower and treatment times much shorter. To date, 25 patients with oesophageal tumours have been successfully treated without major technical problems using a simplified intraluminal palliative technique, which is described in this paper. (author)

[en] The Dijon clinical and endoscopic staging system for intracavitary radiotherapy of rectal cancer takes into account the size and the depth of penetration of the rectal wall. Its prognostic value was evaluated in a series of 72 patients with rectal adenocarcinoma treated at the Centre de Lutte Contre le Cancer G.F. Leclerc in Dijon: 30 presented with a cilincal stage (CS) T_1A (purely exophytic tumors of less than 3 cm). The 5-year local relapse-free actuarial survival (LRFS) was 97%. Fourteen patients with CS T_1B (infiltrative component and less than 3 cm diameter) has a LRFS of 77%. Nine patients with CS R_2A tumors (with larger exophytic tumors) had a LRFS of 65%. Nineteen CS T_2B cases (larger than 3 cm with an infiltrative component) presented a LRFS of 60%. The size of the tumor and the clinical estimate of the infiltration of the rectal wall both have a significant prognostic value: adenocarcinoma of less than 3 cm (n= 44) has a LRFS of 93% versus 59% in larger ones (n = 39; p = < 0.02). Free mobile lesions (n = 39) did better (n = 33; LRFS = 86%) than infiltrated tumors (n = 39, LRFS 66%; p = 0.01). In conclusion, the Dijon clinical staging system can identify tumors, which can be safely treated with intracavitary contact therapy alone (CS) T_1A from lesions which more often require the combination of intracavitary and interstitial therapy (CS) T_2A), CS T_1B and at last, from clinical situations in which intracavitary radiotherapy techniques cannot be used alone; in these T_2B cases, our present approach consists of external irradiation first, followed by either surgery or intracavitary techniques according to the response to external irradiation. This clinical staging system is also suitable for non-radiotherapeutic intrarectal treatment techniques and should also allow the study of the correlations between clinical parameters and pathology specimens in surgically resected tumors. (author). 55 refs.; 4 figs.; 2 tabs

No abstract available

[en] We have developed a new interstitial HDR brachytherapy technique for the treatment of prostate cancer using CT based 3D planning after transrectal implantation of four non-parallel needles. CT based needle reconstruction, target definition, evaluation and documentation, including DVHs and 3D imaging, is a feasible, safe and well tolerated treatment concept. (author.)

[en] 'Afterloading' refers to the contact irradiation of malignant tumors with radioactive sources which can be inserted into an unloaded applicator which is positioned prior to loading. (AJ)