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背景与目的:鼻咽腔内近距离放疗施源器(以下简称施源器)在鼻咽腔内近距离放疗中起重要作用,直接影响治疗的效果。我们研制了一种新型施源器。方法:新型施源器用医用乳胶材料制成,在距施源器前端15mm处置一气囊,气囊边缘与管轴相切,紧贴于管壁一侧,令充气时管轴反向拱形隆起贴近治疗部位。使用时经中鼻道达后壁,通过旋转施源器可调节施源器方向和位置,经注气孔注入空气并固定。治疗前需复核定位证实。结果:共治疗221例鼻咽癌,初治病例中鼻咽肿物消退率92.6%,复发病例鼻咽肿物全部消退,鼻咽前壁或后壁粘膜坏死5例,鼻甲水肿及后鼻道粘连8例。结论:本施源器具有安全可靠,操作方便,患者无痛苦,剂量分布理想,固定性较好等优点。在治疗中出现鼻咽粘膜坏死可能与初期使用时单次剂量过高有关。
BACKGROUND & OBJECTIVE: Nasopharyngeal brachytherapy (hereinafter referred to as “applicator”) plays an important role in the brachytherapy of the nasopharynx and has a direct impact on the therapeutic effect. We developed a new type of applicator. Methods: The new applicator was made of medical latex material. A balloon was disposed 15mm away from the front end of the applicator. The edge of the balloon was tangent to the tube axis and was close to the tube wall. When the tube was inflated, the reverse arched bulge was close Treatment site. When using the posterior wall of the middle nasal passages, the applicator can be rotated to adjust the direction and position of the applicator, air is injected through the air injecting holes and fixed. Need to review the positioning confirmed before treatment. Results: A total of 221 cases of nasopharyngeal carcinoma were treated. The regression rate of nasopharyngeal tumor in the initial treatment group was 92.6%. The nasopharyngeal tumor subsided in all cases, mucosal necrosis in anterior or posterior nasopharyngeal wall in 5 cases, nasal edema and posterior nasal passages Adhesion in 8 cases. Conclusion: The applicator has the advantages of safe, reliable, easy to operate, patient-free, ideal dose distribution and good fixity. In the treatment of nasopharyngeal mucosal necrosis may be associated with the initial use of a single dose is too high.