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Clinical evaluation of an interstitial remote afterloading device for multichannel intracavitary irradiation
P W Grigsby1, E D Slessinger, S P Teague
1Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.
Purpose:
The purpose of this report is to describe the clinical implementation and evaluation of an interstitial remote afterloading device for multichannel intracavitary brachytherapy.
Methods And Materials:
Two 15-channel low dose rate devices were adapted for use with Fletcher-Suit tandem and ovoids and Simon-Heyman capsules. The technical records for 103 intracavitary brachytherapy procedures performed from February 1989 through February 1991 were reviewed.
Results:
Isodose distributions from fixed source trains for Microselectron low dose rate gynecologic applicators closely approximate standard manual afterloading sources and applicators. Device malfunctions occurred in 51% (53 out of 103) of the procedures. Malfunctions by applicator type were 70% (51 out of 73) for tandem, ovoids, and capsules, 12% (2 out of 17) for tandem and ovoids, and none (0 out of 13) for ovoids only. The most common malfunction occurred during source transfer. Total implant time was prolonged 0 to 4% by malfunction and 10% by patient care interruptions, depending on applicator type.
Conclusion:
The adaptation of the Microselectron device for multichannel gynecologic intracavitary brachytherapy results in similar dose distributions as standard manual after loading sources and a decreased radiation exposure to nursing personnel. The system has a high rate of malfunctions but a low overall prolongation of implant time due to malfunction.