Direct Measurements and Isodose Calculations in Radium Therapy of Carcinoma of the Cervix

Fletcher, Gilbert H.; Wall, John A.; Bloedorn, Fernando G.; Shalek, Robert J.; Wootton, P.

doi:10.1148/61.6.885

Cited by 23 publications

(5 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A coordinated effort should be made to determine by measured data the tolerance of the vault, rectum, and bladder; the amount of irradiation tolerable to the tissues which will control the greatest number of primary lesions and the range of doses, which would eventually control disease in the pelvic lymph nodes." (14,15) Fletcher was very determined to correlate radiation distribution with patient anatomy (15). With the vaginal and intrauterine radium in place and the patient opened at laparotomy, direct in vivo measurements with a scintillation probe at selected points within the pelvis such as the bladder and rectum and along the regional lymph nodes were obtained (14,16).…”

Section: Dosage Systemsmentioning

confidence: 99%

“…and "An exaggerated emphasis on figures and a complacent regard for well filled forms where γ roentgens appear cannot compensate for the inexperience of the therapist." (15) Fletcher felt the dose gradient around Point A was too steep to use it as a point of dose calculation and stated, "Determining dosage at a point in the paracervical area with reference to the radium system is an illusory and damaging practice." (22) Because of his experience with intraoperative dose measurements, Fletcher had an underlying distrust of normal tissue point doses stating, "The base of the bladder is not a 'point' but a 'surface' with an average length of 6-7 cm.…”

Section: Dosage Systemsmentioning

confidence: 99%

“…(15) Fletcher found no correlation between Point A and B doses and rectal and bladder and complications and wisely stated, "The severity of damage is not only a function of the dose but also of the surface irradiated." (15) The direct measurements, the dose finder calculations, and the calculations based on radiographs were factored into treatment duration and a table was devised listing maximum Mg-hrs and or maximum time which determined implant duration. A set of maxima of Mg-hrs was established for combination with external beam (22).…”

Section: Dosage Systemsmentioning

confidence: 99%

See 2 more Smart Citations

The sculpted pear: An unfinished brachytherapy tale

Erickson

2003

Brachytherapy

View full text Add to dashboard Cite

Section: Dosage Systemsmentioning

confidence: 99%

Section: Dosage Systemsmentioning

confidence: 99%

Section: Dosage Systemsmentioning

confidence: 99%

See 1 more Smart Citation

The sculpted pear: An unfinished brachytherapy tale

Erickson

2003

Brachytherapy

View full text Add to dashboard Cite

“…He also considered the importance of dose to OAR and stressed the need for dose measurement in the bladder and rectum. He further emphasized the importance of dose measurements in the para-cervical triangle and the regional nodes to compensate for underdosing with EBRT [12].…”

Section: The Birth Of Dosimetric Systemsmentioning

confidence: 99%

Evolution of Intracavitary Brachytherapy in the Treatment of Cervical Cancer

Rajasooriyar¹,

Hoskin²

2021

Act Sci wom hea

View full text Add to dashboard Cite

The evolution of intracavitary brachytherapy in the treatment of cervical cancer spans over 120 years. The purpose of this review is to understand how the discovery of radium paved the way to the current standard of care; the image-guided adaptive brachytherapy. Materials and Methods:A literature search was done to identify the important milestones in the evolution. The terminologies used for the search were "history", "brachytherapy", "radium", "dosimetric systems" and "image-guided adaptive brachytherapy" (IGABT).The information gathered was organized in chronological order and the key milestones were identified. Results:The origin of brachytherapy can be tracked down to the discovery of radioactivity by Sir Henry Becquerel, followed by the invention of radium by the Curies' in the late 19 th century. In the early 20 th century, various dosimetric systems evolved. Among these systems, the Manchester system prescribing to point A became popular and was widely in practice for many decades. The deficiencies of the point A prescription model were brought to light with the advances in soft tissue imaging in the late 20 th century. Imaging helped in prescribing to the actual tumor volume and to generate dose-volume histograms to achieve better target coverage while reducing the dose to the organs at risk. The IGABT started with computed tomography and was further enhanced by magnetic resonance imaging (MRI) due to better anatomical delineation of the pelvis anatomy. Hence MRI based adaptive brachytherapy became the gold standard and has been proven to be safe and effective while significantly reduced toxicity. As cervix cancer is most prevalent in low resource regions, ultrasound scanning has been identified as a reasonable substitute for MRI. Conclusion:Intracavitary brachytherapy in the treatment of cervical cancer has developed over the last 120 years and has made tremendous advances in the last 20 years.

show abstract

“…(9) and by Kottmeier (11) by direct in vivo measurements at selected points within the pelvis and along the regional lymph nodes at laparotomy performed with vaginal and intra-uterine radium in place.…”

mentioning

confidence: 99%