Development of intracavitary irradiation system for carcinoma of the bladder

多种治疗膀胱癌的方法已被采用，包括放射性同位素注入、通过留置充气球囊导管插入中央封装辐射源、开放手术间质植入和术中电子束辐射。然而，在使用腔内照射时也存在一些明显的问题。在过去，这种方法不可避免地使医生、护士和其他人员暴露在辐射中，并且需要手术、长时间的照射和患者住院。为了避免这些问题，我们使用了一种远程控制的后加载照射系统来治疗膀胱肿瘤患者。有了这项技术，足够大剂量的辐射可以被送到膀胱肿瘤。我们开发了两种专门设计的膀胱镜，用于经膀胱镜腔内照射。一种是刚性膀胱镜，用于膀胱肿瘤的局部照射；另一种是柔性膀胱镜，其视角可远程控制，用于膀胱原位癌肿瘤的局部照射。此外，还报道了全膀胱粘膜照射技术预防膀胱肿瘤复发的研究。

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.