Development of intracavitary irradiation system for carcinoma of the bladder

治疗膀胱癌的方法多种多样，包括放射性同位素注射、经留置充气球囊导管置入中心包裹式放射源、开放手术组织间植入和术中电子束照射等。然而，腔内照射也存在一些明显的问题，过去这种方法不可避免地使医生、护士等人受到辐射，而且需要手术，照射时间长，患者住院。为了避免这样的问题，我们使用遥控后置放射治疗系统来治疗膀胱肿瘤患者。有了这项技术，足够大剂量的辐射就可以投射到膀胱肿瘤。我们研制了两种特殊设计的膀胱镜，用于经膀胱镜腔内照射。一种是硬性膀胱镜，用于膀胱肿瘤的点状照射；另一种是可远程控制视角的可挠性膀胱镜，用于膀胱肿瘤合并原位癌的局部照射。此外，还报道了全膀胱粘膜照射预防膀胱癌复发的方法。

A variety of therapies have been used to treat bladder cancer, including instillation of radioisotopes, insertion of a central encapsulated radiation source through an indwelling inflatable balloon catheter, interstitial implantation by an open operation and intraoperative electron beam radiation. However, there also are some significant problens when intracavitary irradiation is used.In the past this method unavoidably exposed physicians, nurses and others to radiation, and required an operation, a long irradiation time and hospitalization of the patient. In an attempt to avoid such problems a remote controlled after-coading irradiation system was used to treat patients with bladder tumors. With this technique sufficient large doses of radiation can be delivered to the bladder tumor. We developed two kinfs of specially designed cystoscope for transcystoscopic intracavitary irradiation. One is rigid ctstoscope for spot irradiation of bladder tumor and the other is flexyble cystoscope of which viewing angle can be remotely controled for regional irradiation of bladder tumor with carcinom in situ. Furthermore, whole bladder mucosal irradiation technique for prophylaxis of the recurrence of bladder tumor was reported.