Multiple cobalt 60 sources for treatment of carcinoma of the body of the uterus.

Abstract

While a single intra-uterine tube, combined with vaginal sources, gives adequate irradiation to the cervix and the lower part of the body of the uterus, a different method is necessary if the upper part of the isodose curve is to be broadened so as to enclose the whole of the fundus. Many different techniques have been devised to produce this effect—the upper part of a single uterine tube may be loaded more heavily than the lower part (Tod and Morris, 1955), additional sources may be placed in each cornua (Hurdon, 1941), or special applicators may be constructed in which the radium is similarly arranged. The introduction of cobalt 60 has made possible the use of separate small sources without the need of added filtration, and Jones (1952) devised a special spring applicator loaded with such sources which after insertion through a cuff in the cervical canal expands to take the shape of the uterine cavity. All these techniques may prove unsatisfactory in advanced disease where the cavity of the uterus is distorted and the wall thickened and irregular, and in such cases a better distribution of radiation is obtained by the technique developed by Heyman (1947) (Figs. 4 and 5) in which the uterus is packed with a number of radium tubes enclosed in removable sleeves. A multiple source method similar to that of Heyman has been devised in which the uterus is packed with cobalt 60 sources mounted in Perspex beads (Fig. 1).