Physical Aspects of Intracavitary Radium Treatment of Carcinoma of the Cervix Uteri. Part III—A New Applicator

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Abstract
A new applicator for the treatment of carcinoma of the cervix uteri is described, the design of which is based on the author's analysis of intracavitary techniques (Neary 1943). Without exceeding the local doses normally arising in conventional techniques, a more than two-fold improvement in the dose at the pelvic wall (5000 r) is achieved. Further, the predetermined radiation field cannot change during treatment and it is maintained in correct relationship to the bony pelvis. The radium sources consist of 70 mg. in the uterus and two units of 140 mg. each in the vagina on the midline. The treatment time is seventy-two hours leading to a total of 25,000 mg. hr. Drastic modification of the distribution of radiation is brought about by massive platinum screens. The design of this applicator is not regarded as necessarily final or universally applicable. It is one possible embodiment of the principles previously elucidated, permitting a clinical trial. [Already, it has been found desirable to modify the uterine tube.] The wider importance of the principle of screening for obtaining special dose distributions is stressed, and it is pointed out that its application will be greatly simplified when powerful sources of radio-elements giving radiation in the X-ray region become available.

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