A new applicator design for endocavitary brachytherapy of cancer in the nasopharynx.
BACKGROUND
In attempting to improve local tumor control by higher doses of radiation, there has been a resurgence of interest in the implementation of brachytherapy in the management of primary and recurrent cancers of the nasopharynx. Brachytherapy with its steep dose fall-off is of particular interest because of the proximity of critical dose limiting structures. Recent developments in brachytherapy, such as the introduction of pulsed-dose-rate and high-dose-rate computerized afterloaders, have encouraged further evolution of brachytherapy techniques.


METHODS
We have designed an inexpensive, re-usable and flexible silicone applicator, tailored to the shape of the soft tissues of the nasopharynx, which can be used with either low-dose-rate brachytherapy or high (pulsed)-dose-rate remote controlled afterloaders.


CONCLUSIONS
This Rotterdam nasopharynx applicator proved to be easy to introduce, patient friendly and can remain in situ for the duration of the treatment (2-6 days). The design, technique of application and the first consecutive 5 years of clinical experience in using this applicator are presented.
Levendag
P C
PC
Department of Radiation Oncology, Daniel den Hoed Cancer Center/Dijkzigt Hospital, University Hospital Rotterdam, The Netherlands.
Peters
R
R
Meeuwis
C A
CA
Visch
L L
LL
Sipkema
D
D
de Pan
C
C
Schmitz
P I
PI
D001918:Brachytherapy / Q000295:instrumentation* / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D004867:Equipment Design; D004869:Equipment Safety; D006801:Humans; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D016896:Treatment Outcome