[en] In advanced carcinoma of the cervix the associated obliteration of the fornices or contracture of the vagina may interfere with accurate placement of conventional intracavitary applicators. Poorly placed applicators fail to irradiate the pelvis homogeneously. Waterman (and others) solved this dilemma by transvaginal radium implants many years ago; however, despite good survival figures, this technique has not gained popularity, presumably because of excessive exposure to personnel. In this paper, we describe a technique which largely eliminates the exposure problem and at the same time improves the homogeneity of pelvic endoradiotherapy. We locate what is in essence a pair of paravaginal interstitial colpostats in both parametria in combination with the usual intrauterine tandem. This helps to distribute the dose laterally, with relative sparing of bladder and rectum. The technique employs a template to guide the insertion into the parametria of a group of 18 gauge hollow steel needles transperineally. Afterloading with ¹⁹²Ir is accomplished when the patient has returned to her room (after orthogonal radiography and computer dosimetry). Doses to point B compare very favorably to those at point A

No abstract available

[en] Consideration of radiation dose rate effects emphasizes advantages of the template method for lateral distribution of multiple sources in treatment of laterally infiltrating gynecologic cancer, when compared to a conventional technique with colpostats. Biological doses in time dose fractionation (TDF), ret and reu units are calculated for the two treatment methods. With the template method the lateral dose (point B) is raised without significantly increasing the doses to the rectum and bladder, that is, relatively, the calculated biological doses at point A and B are more nearly equivalent and the doses to the rectum and bladder are significantly lower than the dose to point B