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Prostate cancer: An implant procedure
ASTR Poster Abstracts
1827
The most common sensation was of numbness and tingling in the vated through pathways in the treated areas. In each case, the applicator was at least three aperture ipsilateral arm when the chest was being treated. 90'; and the applicator was angled from widths from the axilla; the angle with the axilla was approximately 90-180 degrees to the affected arm. In each case, the sensation was only appreciated when the microwave There There was no correlation of sensation with temperature in the treatment volume. energy was present. The sensation would saturate at power densities was little correlation of sensation with power application. One patient reported such a severe "burning" sensation far below those used to achieve therapeutic heating. Only one patient in the arm at even the lowest measureable power that further treatment was discontinued. had a demonstrable motor deficit. These reports were patient specific and repeated from treatment to treatSensitive patients were sporadically distributed ment in at least two thirds of the treatment sessions. throughout the rest of the patient population.
C6 PROSTATE
AN IMPLANT
CANCER:
G. Ray Ridings, Southeast
M.D.,
Missouri
PROCEDURE
F,A.C.R.
Radiation
Oncology
Center
If the boost dose of irradiation given locally to the prostate is given with minimal attendant trauma, then, it can be expected that the overall treatment is better tolerated by the patient, This insertion technique emphasizes (a) almost atraumatic insertion with (b) control of seed distribution and of dose pattern, It is accomplished by transperineal implantation of gold or radon seeds, using a perineal template and fluoroscopic control. This program has been in use since January 1, 1978. Brachytherapy has been remarkably free of complications, Short-term clinical results have been encouraging.
c7 TREATMENT OF CARCINOMA DOSIMETRIC ANALYSIS Fang-Jen
Lin,
Department
M.D.,
OF CERVIX WITH 10 MeV OF COMPLICATIONS
Ph.D.
of Radiation
&
M.S.
Oncology,
Chen,
Chang
X-RAY
AND
HIGH
DOSE
RATE
INTRACAVITARY
RADIATION:
M.D.
Gung
Memorial
Hospital,
Taipei,
Taiwan
105,
R.O.C.
Approximately 150 patients with cervical cancer received radiation therapy in this Department each year. About Z/3 of them had primary curative radiation therapy, and l/3 included those who developed recurrent disease after initial treatment by radical hysterectomy, those who were scheduled for postoperative radiation due to tumor extension beyond surgical field or lymph node involvement, those who had incomplete or irregular radiation therapy at other hospitals. After staging workups, the patients were treated externally with 10 MeV X-ray, encompassing all pelvic nodes and entire vagina, and delivering 4400 to 4800 rads/22-24/5 weeks. In 2-3 weeks the patients were examined under anesthesia to evaluate the effect of external radiation and status of residual tumor and the afterloading applicators were placed after proper dilatation of cervix for the 1st intracavitary application. Thorough dosimetric planning for high dose rate intracavitary remote afterloading application with Co-60 sources was done for every single patient. Only one day of hospitalization was required in preparation for anesthesia and dilatation of cervix for first insertion of applicators. The subsequent applications were regularly performed on out patient basis. Analysis of 83 cases who were able to complete all planned treatment in the period of March 1980 to July 1981, 15 patients developed rectal bleeding and only three needed prolonged care and one required colostomy. Follow-up period was 12 - 30 months. Patients with rectal dose below 500 rads per application did not develop rectal bleeding. The volume of rectum in the region higher than 500 rads per application with rectal bleeders was larger than that non-
bleeders with statistical significance, The high dose rate intracavitary applications is recommended for, and only for, the institutions or radiation therapists experienced in low dose rate system with good dosimetry The main advantages are: good personnel protection, support. economic benefit of out patient care without anesthesia and the possibility of treating much more patients per working day in areas of high incidence of cervical cancers, as well as good control and complication rates comparable to conventional low dose rate application.
CS
PSYCHOSOCtAL Cynthia
SKILL TRAINING
Lee, M.S.W.,
The Tumor
Institute
M.P.H.,
FOR RADIATION Joanna
of The Swedish
THERAPY
Beckley, Hospital
TECHNOLOGISTS.
M.S.W., Medical
Donald Center,
Tesh, M.D. Seattle,
Wasllington
An educational program addressing the psychosocial aspects of cancer was incorporated into the curriculum Patient surveys given at the of the Swedish Hospital Tumor Institute Radiation Therapy Technology School.
1827
The most common sensation was of numbness and tingling in the vated through pathways in the treated areas. In each case, the applicator was at least three aperture ipsilateral arm when the chest was being treated. 90'; and the applicator was angled from widths from the axilla; the angle with the axilla was approximately 90-180 degrees to the affected arm. In each case, the sensation was only appreciated when the microwave There There was no correlation of sensation with temperature in the treatment volume. energy was present. The sensation would saturate at power densities was little correlation of sensation with power application. One patient reported such a severe "burning" sensation far below those used to achieve therapeutic heating. Only one patient in the arm at even the lowest measureable power that further treatment was discontinued. had a demonstrable motor deficit. These reports were patient specific and repeated from treatment to treatSensitive patients were sporadically distributed ment in at least two thirds of the treatment sessions. throughout the rest of the patient population.
C6 PROSTATE
AN IMPLANT
CANCER:
G. Ray Ridings, Southeast
M.D.,
Missouri
PROCEDURE
F,A.C.R.
Radiation
Oncology
Center
If the boost dose of irradiation given locally to the prostate is given with minimal attendant trauma, then, it can be expected that the overall treatment is better tolerated by the patient, This insertion technique emphasizes (a) almost atraumatic insertion with (b) control of seed distribution and of dose pattern, It is accomplished by transperineal implantation of gold or radon seeds, using a perineal template and fluoroscopic control. This program has been in use since January 1, 1978. Brachytherapy has been remarkably free of complications, Short-term clinical results have been encouraging.
c7 TREATMENT OF CARCINOMA DOSIMETRIC ANALYSIS Fang-Jen
Lin,
Department
M.D.,
OF CERVIX WITH 10 MeV OF COMPLICATIONS
Ph.D.
of Radiation
&
M.S.
Oncology,
Chen,
Chang
X-RAY
AND
HIGH
DOSE
RATE
INTRACAVITARY
RADIATION:
M.D.
Gung
Memorial
Hospital,
Taipei,
Taiwan
105,
R.O.C.
Approximately 150 patients with cervical cancer received radiation therapy in this Department each year. About Z/3 of them had primary curative radiation therapy, and l/3 included those who developed recurrent disease after initial treatment by radical hysterectomy, those who were scheduled for postoperative radiation due to tumor extension beyond surgical field or lymph node involvement, those who had incomplete or irregular radiation therapy at other hospitals. After staging workups, the patients were treated externally with 10 MeV X-ray, encompassing all pelvic nodes and entire vagina, and delivering 4400 to 4800 rads/22-24/5 weeks. In 2-3 weeks the patients were examined under anesthesia to evaluate the effect of external radiation and status of residual tumor and the afterloading applicators were placed after proper dilatation of cervix for the 1st intracavitary application. Thorough dosimetric planning for high dose rate intracavitary remote afterloading application with Co-60 sources was done for every single patient. Only one day of hospitalization was required in preparation for anesthesia and dilatation of cervix for first insertion of applicators. The subsequent applications were regularly performed on out patient basis. Analysis of 83 cases who were able to complete all planned treatment in the period of March 1980 to July 1981, 15 patients developed rectal bleeding and only three needed prolonged care and one required colostomy. Follow-up period was 12 - 30 months. Patients with rectal dose below 500 rads per application did not develop rectal bleeding. The volume of rectum in the region higher than 500 rads per application with rectal bleeders was larger than that non-
bleeders with statistical significance, The high dose rate intracavitary applications is recommended for, and only for, the institutions or radiation therapists experienced in low dose rate system with good dosimetry The main advantages are: good personnel protection, support. economic benefit of out patient care without anesthesia and the possibility of treating much more patients per working day in areas of high incidence of cervical cancers, as well as good control and complication rates comparable to conventional low dose rate application.
CS
PSYCHOSOCtAL Cynthia
SKILL TRAINING
Lee, M.S.W.,
The Tumor
Institute
M.P.H.,
FOR RADIATION Joanna
of The Swedish
THERAPY
Beckley, Hospital
TECHNOLOGISTS.
M.S.W., Medical
Donald Center,
Tesh, M.D. Seattle,
Wasllington
An educational program addressing the psychosocial aspects of cancer was incorporated into the curriculum Patient surveys given at the of the Swedish Hospital Tumor Institute Radiation Therapy Technology School.