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Cylindrical forms of isodoses in gynaecological afterloading therapy: an atlas using the Buchler afterloading machine al-mc

Radiotherapy Department, University of Göttingen, Robert-Koch-Straße 40, Federal Republic of Germany

This excerpt was created in the absence of an abstract.

Problems with intravaginal applicators and their solution have outlasted the changes from radium applicators to afterloading techniques. The question of interest is how intravaginal afterloading applicators have to be optimized to take account of unchanged clinical necessities and new technical concepts. According to the recommendations of ICRU 38, the rectal reference point is localized 5 mm behind the dorsal vaginal wall. The reference isodose surface defines the reference volume (ICRU, 1985). It is necessary for the isodoses used in combination with a defined applicator to be adapted to this applicator. While the concept of the "optimized applicator" uses applicators manufactured according to existing isodoses (Lambert, 1988), we progressed to the adaption of the isodoses to existing applicators.

In the radiotherapy department in Göttingen we use vaginal applicators which are cylindrical with a rounded, hemispherical top. From our point of view this form "unfolds" the vagina anatomically without the vaginal walls remaining in contact with each other. Figure 1 represents the attributes of our applicators. The Perspex applicator is cylindrical, available with diameters of 20, 25 and 30 mm. The cylinders are supplied with two copper rings at an interval of 2 cm. The surface of the copper rings is flush with the surface of the Perspex cylinder. From the X-ray film it is possible to identify exactly the applicator as well as the ratio of dimensions.

Received for publication September 1, 1989.