The Clinical Research About The Single Tube Intracavitary Brachytherapy Applicator Contrasting With Fletcher Applicator For Cervical Carcinoma

Part I The Clinical Dose Distribution Research About the Single Tube Intracavitary Brachytherapy Applicator Contrasting with Fletcher Applicator For Cervical CarcinomaObjective:Underground of phantom experiment, to research whether the single tube intracavitary brachytherapy applicator for cervical carcinoma can attain identical clinical dose distribution with the fletcher applicator。Methods:20cervical carcinoma patients with different FIGO stages who need external irradiation and intracavitary brachytherapy were researched.These patients were randomly divided into external irradiation plus the single tube intracavitary brachytherapy applicator and external irradiation plus the fletcher intracavitary brachytherapy applicator by randbetween of WPS software. All patients were treated with a four-fields box technique or conventional two-fields technique,when external irradiation dose arrive at3000cGy,4cm lead blocks was beginning,while two-fields technique external irradiration continue until pelvic dose (B point) arriving in4800-5000cGy.After3000cGy, intracavitary brachytherapy were following with different applicators according different groups.192Ir was used as irradiation resource. A Point (the38th report of ICRU)dose was700cGy,dose of the bladder reference point and rectal reference point was measured with LiF TLD and contrasted.Results:The does of the bladder rectum reference point treated by the Fletcher intracavitary brachytherapy applicator are269.1±131.7cGy、358.5±187.1cGy respectively, The does of the bladder、rectum reference point treated by the single Tube Intracavitary Brachytherapy applicator are251.2±152.8cGy、381.5±117.6cGy respectively.The proportions that the average reference point’ doses to A point as to the Fletcher intracavitary brachytherapy applicator was38.4±18.8%and51.2±26.7%, while the proportions that the average doses to A point as to the single Tube Intracavitary Brachytherapy applicator was35.9±21.8%and54.5±16.8%.Comparing with the fletcher intracavitary brachytherapy applicator, the does of the bladder、rectum reference point treated by the single Tube Intracavitary Brachytherapy applicator showed no statistical significance.Conclusion:Giving A point same prescription dose,those reference points’dose didn’t show difference between the two applicators. PartⅡ The Clinical Outcome and Security About the Single Tube Intracavitary Brachytherapy Applicator Contrasting with Fletcher Applicator For Cervical CarcinomaObjective:Underground of phantom experiment and stage I clinical trial,to research whether the single tube intracavitary brachytherapy applicator for cervical carcinoma can attain identical clinical outcome and security with the fletcher applicator。Methods:49cervical carcinoma patients with different FIGO stages who need external irradiation and intracavitary brachytherapy were researched.These patients were randomly divided into external irradiation plus the single tube intracavitary brachytherapy applicator and external irradiation plus the fletcher intracavitary brachytherapy applicator by randbetween of WPS software. All patients were treated with a four-fields box technique or conventional two-fields technique,when external irradiation dose arrive at3000cGy,4cm lead blocks was beginning,while two-fields technique external irradiration continue until pelvic dose (B point) arriving in4800-5000cGy.After3000cGy, intracavitary brachytherapy were following with different applicators according different groups.192Ir was used as irradiation resource, once a week(stop a externa irradiation while intracavitary brachytherapy). A Point (the38th report of ICRU)dose was700cGy. Intracavitary brachytherapy was carried out6times (BED of A point: 8400-9200cGy).During irradiation,chemotherapy was used with cisplatin (40mg/m2), once a week.During treating,the short-term efficacy and security were observed.After treating,long-term efficacy and toxicity were followed up.Results:The short-term efficacy of25patients treated with the fl etcher intracavitary brachytherapy applicator were CR76%,PR20%,RR96%,at the same time,the short-term efficacy of24patients treated with the single Tube Intracavitary Brachytherapy applicator were CR83.3%,PR12.5%,RR95.8%. The rates of short-term efficacy are no statistical significance between Fletcher Intracavitary Brachytherapy applicator and single Tube Intracavitary Brachytherapy applicator. The gradeⅢ-Ⅳ acute radioactive rectum and bladder complications were0%and8%in the fletcher applicator,on the same time,they were0%and4.17%in the single tube intracavitary brachytherapy applicator.They showed no statistical signifiance. The grade Ⅰ-Ⅱ chronic radioactive rectum and bladder complications were52.4%and33.3%in the fletcher applicator, The grade Ⅰ-Ⅱ chronic radioactive rectum and bladder complications were26.3%and31.6%in the single tube intracavitary brachytherapy applicator.The chronic complications between the two applicators already showed no statistical signifiance.Conclusion:1,The initial clinical trial data indicated that the single tube Intracavitary Brachytherapy applicator have an identical cliniclal efficacy contrast with the fletcher applicator.2, The initial clinical trial data indicated that the single tube Intracavitary Brachytherapy applicator don’t increase patients’acute or chronic complications.