JP2004202253A - Therapeutic device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a therapeutic device which performs thermotherapy and radiotherapy in a body cavity at the same time to enhance a therapeutic effect on a lesion and highly accurately and concentratedly irradiates the lesion locally existing only in a part in the circumferential direction in the body cavity of a patient with a radiation emitted from a radiation source so as to effectively apply combined use of the thermotherapy and radiotherapy. <P>SOLUTION: The outer circumferential direction of a catheter path 64 for RI in which the radiation source for radiotherapy is inserted is covered with a high-frequency electrode 61 for thermotherapy formed by materials which have low transmittance of the radiation. A balloon 26 is arranged to cover the high-frequency electrode 61 for the thermotherapy. The radiation from the radiation source can be emitted through an opening 62 for emitting the radiation in the high-frequency electrode 61. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

  The present invention relates to a treatment apparatus for performing a heating treatment on a tumor-causing site in a body cavity of a patient.

  2. Description of the Related Art In general, a hyperthermia applicator for heating treatment disclosed in Patent Literature 1 is known as a device for heating treatment of a tumor occurrence site or the like in a body cavity of a patient. This is because the applicator body is provided with a high-frequency electrode for intracavity, and a balloon is provided so as to cover it. A high frequency (RF) dielectric heating applicator structure.

Patent Document 2 discloses a configuration in which a radiation radiation source for radiation treatment is further provided on an applicator body having an optimal structure for heating the cavity, and radiation can be applied to a body cavity by the radiation radiation source. There are also things.
Japanese Patent Publication No. 2-41971 Japanese Utility Model Publication No. 64-46056

  However, in the prior art of Patent Document 2, since the radiation radiation source disposed inside the applicator main body is disposed at an eccentric position deviated from the axial center position of the applicator main body, the applicator is placed inside the body cavity of the patient. After inserting the main body, when the balloon is inflated and the applicator main body is fixed at the site near the affected part in the patient's body cavity, it is necessary to make sure where the radiation source of the radiation is inserted in the cavity. There is a problem that cannot be confirmed.

  Here, the affected part formed in the body cavity of the patient is one that has spread all over the entire inner peripheral surface in the body cavity, or locally exists only in a part of the inner peripheral surface in the body cavity in the circumferential direction. In some cases. Therefore, when the applicator body is inserted into a patient's body cavity, such as an applicator that uses the above-described prior art intracavitary heating treatment and intracavity radiation irradiation treatment, the radiation source of the radiation is located at any position in the cavity. If it is not possible to reliably confirm whether or not it has been inserted, the radiation radiated from the radiation source can be intensively concentrated on the affected area that exists locally only in a part of the patient's body cavity in the circumferential direction. Since it is difficult to irradiate, if the radiation radiated from the radiation radiation source is radiated to a part outside the affected part, the radiation treatment effect of the affected part may be reduced.

  In the case of radiation therapy using a radiation source, it has been confirmed that there is a correlation between the distance from the radiation source to the irradiation site such as the affected area, and the radiation dose at the irradiation site. In fact, it is demanded that the distance between the radiation source and the affected area be shorter than the distance between the radiation source and the normal tissue to improve the therapeutic effect of the affected area. .

  The present invention has been made in view of the above circumstances, and an object of the present invention is to simultaneously perform a thermal treatment and a radiotherapy in a patient's body cavity, and to enhance a therapeutic effect on an affected part, and to improve a patient's body cavity. It is possible to irradiate the radiation radiated from the radiation radiation source intensively with high precision to the affected area that exists only in a part of the inner circumferential direction, and it is effective to use both heat treatment and radiation treatment It is an object of the present invention to provide a treatment device that can be applied to a patient.

The invention according to claim 1 is a radiation source for radiotherapy, a high-frequency electrode part for heating treatment, which is formed of a material having low radiation permeability and covers the outer periphery of the radiation source, and a high-frequency electrode part for heating treatment. And a balloon provided so as to allow radiation from the radiation source to be radiated, and a balloon disposed so as to surround the high-frequency electrode unit for warming treatment.
According to the first aspect of the present invention, a radiation source insertion hole for inserting a radiation source for radiation therapy is opened in the center axis of the shaft of the applicator, and a high-frequency electrode for warming therapy and a balloon are arranged so as to surround the distal end. By providing a high-frequency electrode for heating treatment with a material having low radiation permeability outside the radiation source, and further providing an opening for radiation transmission in the electrode, it is very suitable for intracavitary heating. In addition to having a structure, it is possible to perform directional irradiation on a part of the affected area in the cavity in radiation therapy, and it is possible to perform heating treatment and radiation irradiation treatment at the same time. It was made.

  According to the present invention, the high-frequency electrode for warming treatment is provided on the outside of the radiation source with a material having low permeability to radiation, and further, by providing an opening for radiation transmission in the electrode, radiation is transmitted from the opening of the electrode Only the outside is irradiated. Therefore, by directing the opening to the place where radiation is to be applied, it has a structure that is very suitable for intracavitary heating, and has directivity to a part of the affected area in the cavity during radiation treatment. Irradiation can be performed, and the heating treatment and the radiation irradiation treatment can be performed simultaneously.

  Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 3 shows a schematic configuration of a situation where the treatment apparatus 1 is used at the time of combined therapy of thermal treatment and radiation treatment. In FIG. 3, reference numeral 2 denotes an intracavity applicator of the treatment apparatus 1 used in a room (treatment room) 3 which is radiation shielded by the radiation shield wall 3a.

  The intracavity applicator 2 has an insertion portion 6 to be inserted into the body of a patient 5 on a bed 4 in a treatment room 3, and a proximal end 7 connected to a base end of the insertion portion 6. Has been.

  In addition, the treatment apparatus 1 is provided with an extracorporeal applicator 8, which is attached to the outside of the patient 5, a hyperthermia apparatus main body 9 for thermal treatment, and a brachytherapy apparatus main body 10 for radiation treatment. Here, the hyperthermia apparatus main body 9 and the brachytherapy apparatus main body 10 are installed in the treatment room 3.

  Further, the intracavity applicator 2 and the extracorporeal applicator 8 are connected to the hyperthermia apparatus main body 9 via a hyperthermia cable and tubes 11, respectively. Further, the intraluminal applicator 2 is connected to the brachytherapy device main body 10 via a brachytherapy guide tube 12, and a brachytherapy controller 13 disposed outside the treatment room 3 includes a brachytherapy controller 13. It is connected.

  FIG. 1 shows a schematic configuration of a main part of the intracavity applicator 2. The body of the applicator 2 is provided with a flexible shaft portion 15 forming the insertion portion 6.

The shaft portion 15 has a multi-lumen cross-sectional structure in which five parallel lumens 16 to 20 are formed as shown in FIG. Here, the shaft portion 15 together with brachytherapy insertion hole 16 at a position deviated from the axial center position O ₁ is located, the four lumens 17-20 is disposed on the outer peripheral surface of the shaft portion 15 I have. Further, the four lumens other than the small wire source insertion hole 16 are used as a cooling water supply channel 17, a drain channel 18, a temperature sensor insertion channel 19, and an electrode cable insertion channel 20, respectively.

The lumens 17 to 20 other than the small beam source insertion hole 16 need not necessarily be arranged at the locations shown in FIG. It suffices that communication is established between the lumens 17 to 20 on the proximal end portion 7 side and the respective lumens 17 to 20 in the shaft portion 15. Further, it is not always necessary to arrange the small-ray source insertion hole 16 at this cross-sectional position at a portion other than the distal end of the shaft portion 15. It is correctly positioned outside a central axial position O ₁ of 15.

  In addition, at the proximal end 7 of the applicator 2, respective openings 16 a to 20 a on the proximal side of the five lumens 16 to 20 of the shaft portion 15 are formed. The distal end of the water supply tube 21 is connected to the proximal opening 17 a of the water supply passage 17, and the distal end of the drain tube 22 is connected to the proximal opening 18 a of the drainage passage 18.

  Further, the temperature sensor cable 23 is provided in the proximal opening 19a of the temperature sensor insertion path 19, the electrode cable 24 is provided in the proximal opening 20a of the electrode cable insertion path 20, and the proximal opening 16a of the small wire source insertion hole 16 is provided. The small-ray source guide tubes 12 are respectively introduced.

  As shown in FIG. 1, a coil-shaped high-frequency electrode 25 for heating treatment is wound on the outer peripheral surface of the distal end portion of the shaft portion 15, and an inflatable balloon 26 is attached so as to surround the high-frequency electrode 25. Has been. In the present embodiment, the heating treatment high-frequency electrode 25 has a coil shape wound around the shaft portion 15. However, the present invention is not limited to this. For example, a mesh heating treatment high-frequency electrode, A plate-like high-frequency electrode for heating treatment may be used.

  The balloon 26 is formed of a ring-shaped elastic sheet. The front end of the elastic sheet is fixed to the outer peripheral surface of the distal end of the shaft section 15 at a position in front of the high-frequency electrode 25. The rear end is fixed to the outer peripheral surface of the front end of the shaft 15 at a position behind the high-frequency electrode 25.

  Further, on the outer peripheral surface of the distal end of the shaft portion 15, the distal opening 17 b of the cooling water supply channel 17, the distal opening 18 b of the drainage channel 18, the distal opening 19 b of the temperature sensor insertion channel 19, and the distal end of the electrode cable insertion channel 20. Openings 20b are respectively formed. Here, the distal opening 17 b of the water supply channel 17, the distal opening 18 b of the drainage channel 18, and the distal opening 20 b of the electrode cable insertion channel 20 are arranged inside the balloon 26. The cooling water is supplied to the inside of the balloon 26 through the cooling water supply passage 17 and the drain passage 18 of the shaft portion 15, and drainage can be performed. The cooling water is circulated inside the balloon 26. It has become.

  An electrode cable 24 is disposed inside the electrode cable insertion path 20. The distal end of the electrode cable 24 is taken out of the distal end opening 20b of the electrode cable insertion path 20 into the balloon 26 and connected to the high-frequency electrode 25 for warming treatment.

  The distal end opening 19 b of the temperature sensor insertion path 19 is disposed outside the balloon 26. A temperature sensor cable 23 is provided inside the temperature sensor insertion path 19. A temperature sensor 27 is connected to a distal end of the temperature sensor cable 23. The distal end of the temperature sensor cable 23 is taken out of the shaft portion 15 from the distal end opening 19b of the temperature sensor insertion path 19 before the balloon 26, and the temperature sensor 27 is attached to the surface of the balloon 26. The temperature sensor 27 includes, for example, a thermocouple, a platinum element temperature sensor, an optical fiber temperature sensor, a thermistor, etc., and any of them may be used.

  The small-ray source guide tube 12 is inserted into the small-ray source insertion hole 16 of the shaft portion 15. A small ray source 28 which is a radiation radiation source for radiation therapy is inserted into the small ray guide tube 12. In this case, as shown in FIG. 1, the brachytherapy source 28 is disposed so as to overlap a substantially central portion in the axial direction of a heating section formed by the heating treatment high-frequency electrode 25.

Note that the small-beam source insertion hole 16 of the shaft portion 15 does not necessarily need to penetrate to the tip end surface of the shaft portion 15 as shown in FIG. For example, the distal end side of the small-ray source insertion hole 16 of the shaft portion 15 is drilled to a part necessary for inserting the small-ray source 28 to an internal position corresponding to the balloon 26. The configuration may be such that the portion is closed. When the small-ray source guide tube 12 is inserted into the small-ray source insertion hole 16, the distal end of the small-ray source guide tube 12 is brought into contact with the distal-end closing portion of the small-ray source insertion hole 16, so that the small wire is inserted. The source 28 is positioned in the axial direction of the source insertion hole 16 so that the source 28 is correctly positioned at the center of the balloon 26. In this case, brachytherapy insertion hole 16 is disposed reliably off-axis position O ₁ of the shaft portion 15 located in the distal portion of the shaft portion 15, the radiation direction of the radiation emitted from brachytherapy 28 A directivity imparting means for adjusting the direction of the shaft portion 15 to have a directivity in the circumferential direction of the shaft portion 15 is configured.

  Next, the operation of the above configuration will be described. The treatment apparatus 1 is used in a radiation-shielded treatment room 3 as shown in FIG. Then, during actual use of the treatment apparatus 1, first, the air supply / drainage pipe system is evacuated, and then the cooling water in the balloon 26 of the intraluminal applicator 2 is sucked to deflate the balloon 26.

  In this state, the insertion section 6 of the intracavity applicator 2 is inserted into the body cavity of the patient 5. The source guide tube 12 may be inserted into the source insertion hole 16 of the applicator 2 before the insertion part 6 of the applicator 2 is inserted into the patient 5, or the insertion part 6 of the applicator 2 may be inserted into the patient 5. After the insertion into 5, the source guide tube 12 may be inserted into the source insertion hole 16 of the applicator 2.

  After inserting the applicator 2 into the body cavity of the patient 5, the cooling water is circulated again in the balloon 26, and the balloon 26 is inflated. As a result, the surface of the balloon 26 comes into close contact with the inner peripheral surface of the body cavity, and the distal end portion of the applicator 2 is fixed in the body cavity.

Incidentally, FIG. 4 (A) an applicator 2 is inserted from the mouth _{H 1} of the patient into the esophagus _{H 2,} a fixed state, Fig. 4 (B) rectal _H 4 the applicator 2 from the anus _{H 3,} S-shaped colon H _5, inserted into the colon _{H 6,} fixed state, Fig. 4 (C) inserts the applicator 2 in the bile duct _{H 8} in the vicinity of the liver _{H 7,} fixed state, Fig. 4 (D) applicator 2 Is inserted into the trachea H ₉ or the bronchus H ₁₁ near the lung H ₁₀ , and is fixed. FIG. 4E shows that the applicator 2 is inserted from the urethra H ₁₂ into the bladder H ₁₃ and the prostate H ₁₄ in the foreground. FIG. 5 shows a state in which the applicator is inserted into the vagina H ₁₅ , the uterus H _{16 and the} like, and is fixed.

  Further, after the insertion section 6 of the intracavity applicator 2 is inserted into a target treatment site in the body cavity of the patient 5 and fixed, the treatment site is subjected to heating treatment and radiation treatment. The actual procedure of the treatment differs depending on the protocol of the doctor using the treatment device 1.

  Here, as an example of the treatment procedure, the simultaneous use of high-dose irradiation treatment of radiation and hyperthermia will be described. First, a high-frequency current is supplied to the high-temperature electrode 25 for hyperthermia to start hyperthermia. When the heating temperature in the hyperthermia heating treatment is stabilized, the operator goes out of the treatment room 3 which is a shield room.

  In this case, the hyperthermia apparatus main body 9 needs to have an automatic heating temperature control function. With the above function, even if the operator is outside the treatment room 3, the hyperthermia heating treatment can be correctly continued. It is desirable that the temperature condition and the like at the time of the heating treatment by the hyperthermia be displayed on a monitor or the like outside the treatment room 3. This may be, for example, such that the display panel portion of the hyperthermia device main body 9 faces only in a direction that can be seen from outside the treatment room 3.

Subsequently, the operator performs radiation treatment outside the treatment room 3 in the shield room. During this operation, the brachytherapy device controller 13 located outside the treatment room 3 is used to feed the brachytherapy source 28 from the brachytherapy device main body 10 into the body cavity of the patient 5 via the brachytherapy guide tube 12. . Since brachytherapy guide tube 12 is inserted into brachytherapy insertion holes 16 arranged at a position deviated from the axis position O ₁ of the shaft portion 15 of the applicator 2, brachytherapy as a result 28 is disposed at a position deviated from the axis position O ₁ of the distal end portion of the shaft portion 15 of the applicator 2, as shown in FIG.

  In this state, radiation is emitted from the brachytherapy source 28, and intracavity irradiation is performed on the treatment target site in the body cavity for a predetermined time. Thereafter, the brachytherapy source 28 is collected by the brachytherapy device main body 10. The heating of the treatment site by the hyperthermia apparatus main body 9 is continued even after the irradiation of the radiation from the small-ray source 28 is completed, and the heating is automatically ended when a predetermined heating time has elapsed.

  Further, when the irradiation of the radiation from the brachytherapy source 28 is a low-dose irradiation, the irradiation time of the radiation to the treatment target is long. Hyperthermia and radiation therapy are simultaneously used in a protocol in which the heating by is started and terminated. Alternatively, the heating by the hyperthermia device main body 9 can be started during the irradiation time of the radiation by the brachytherapy device main body 10.

  In addition, the hyperthermia device main body 9 does not simultaneously heat the treatment target portion with the hyperthermia device main body 9 and irradiates the radiation with the brachytherapy device main body 10, and the hyperthermia device main body 9 irradiates the radiation with the brachytherapy device main body 10. A protocol for heating the treatment site or a protocol for irradiating the radiation by the brachytherapy device body 10 after the treatment site is heated by the hyperthermia device body 9 also uses the intracavity applicator 2 of the treatment device 1. Done.

  Therefore, the above configuration has the following effects. That is, it is possible to simultaneously use the hyperthermia device main body 9 to heat the treatment site and the brachytherapy device main body 10 to irradiate the radiation, so that the therapeutic effect on the affected part such as cancer treatment in the body cavity of the patient can be improved. Can be increased.

The radiation source is a brachytherapy 28 for radiation therapy is disposed at a position deviated from the axis position O ₁ of the shaft portion 15 of the applicator 2, the radiation direction of radiation emitted from brachytherapy 28 Since the directivity providing means for adjusting the state of having directivity in the circumferential direction of the shaft portion 15 is configured, an eccentric diseased part locally existing only in a part of the body cavity of the patient in the circumferential direction. Therefore, the radiation radiated from the small-ray source 28 can be intensively irradiated with high accuracy, and the combined use of the thermal treatment and the radiation treatment can be effectively performed.

  Further, since the main body of the applicator 2 is provided with the high-frequency electrode 25 for warming treatment and the small-ray source 28 as a radiation radiation source for radiation treatment, there is little systemic side effect in cancer treatment in the body cavity of the patient. When performing the combined therapy of the radiation source brachytherapy and the intracavitary hyperthermia, the number of operations of inserting the applicator 2 into the patient 5 is one, which is simple and easy.

  Further, since the brachytherapy source 28 is disposed inside the high-frequency electrode 25 for warming therapy, the heating distribution of the treatment target site by the hyperthermia warming therapy is not distorted due to the brachytherapy source 28.

  In addition, when the distal end portion of the brachytherapy source insertion hole 16 of the shaft portion 15 is closed, when the insertion portion 6 of the applicator 2 is inserted into the body cavity of the patient, the brachytherapy source insertion hole 16 holds the patient 5. There is no risk of contamination with bacteria.

  In addition, when the small beam source insertion hole 16 of the shaft portion 15 is open to the front end, the manufacture of the shaft portion 15 of the applicator 2 is easier than when the front end portion of the small beam source insertion hole 16 is closed. The small-ray source insertion hole 16 can be used for purposes other than insertion of the small-ray source 28, such as insertion of a guide wire, insertion of an endoscope, and ventilation holes.

  FIGS. 6A and 6B show a second embodiment of the present invention. This is a modification of the configuration of the intraluminal applicator 2 of the treatment device 1 as shown in FIG.

That is, in the lumen applicator 2 of the present embodiment FIG. 6 (A), the with brachytherapy insertion hole 16 is disposed in a central axial position O ₁ of the shaft portion 15 (B), the this Four lumens 17 to 20 are arranged around the small beam source insertion hole 16.

Further, an eccentric balloon 31 is mounted on the outer peripheral surface of the distal end portion of the shaft portion 15. The central axis O ₂ of the eccentric balloon 31 is disposed at an eccentric position with respect to the central axis (axis position) O ₁ of the shaft portion 15. Incidentally, brachytherapy insertion holes 16 are not necessarily disposed in a central axial position O ₁ of the shaft portion 15, also the brachytherapy insertion hole 16 is offset from the center axis O ₁ of the shaft portion 15, the small The position of the central axis of the source insertion hole 16 does not have to be on the central axis O ₂ of the eccentric balloon 31. The other parts are the same as those of the first embodiment.

Therefore, the configuration described above to place the brachytherapy insertion hole 16 in a central axial position O ₁ of the shaft portion 15, so mounting the eccentric balloon 31 to the distal end outer peripheral surface of the shaft portion 15, brachytherapy among sources inserting the eccentric direction of the center axis O ₂ of the eccentric balloon 31 radiation emitted from brachytherapy 28 inserted into bore 16 with respect to the center axis O ₁ of the shaft portion 15 and the opposite direction (FIG. 6 (B) It can be emitted with directivity (downward). For this reason, even in the present embodiment, similarly to the first embodiment, the small-ray source 28 radiates an eccentric diseased part locally existing only in a part of the body cavity of the patient in the circumferential direction. The radiation to be applied can be intensively irradiated with high precision, and the combined use of thermal treatment and radiation treatment can be effectively performed.

Further, in this embodiment in particular, brachytherapy insertion hole 16 is not necessarily must be placed in a central axial position O ₁ of the shaft portion 15, the brachytherapy insertion hole 16 from the center axis O ₁ of the shaft portion 15 be shifted, since the position of the center axis of the brachytherapy insertion hole 16 may be present on the central axis O ₂ of the eccentric balloon 31, brachytherapy insertion hole is disposed inside the shaft section 15 16 and various arrangement paths can be freely devised. Therefore, it is easy to make the shaft portion 15 thinner, and it is easy to manufacture the entire intraluminal applicator 2.

  FIGS. 7A and 7B show a third embodiment of the present invention. In the present embodiment, a notch 41 is provided in a portion inside the balloon 26 on the outer peripheral surface of the distal end portion of the shaft portion 15 of the applicator 2 of the first embodiment, and a small wire source is inserted into a portion corresponding to the notch 41. The hole 16 is arranged, and the other four lumens 17 to 20 in the shaft portion 15 are arranged in portions other than the cutout portion 41, respectively. Therefore, the small-diameter source insertion hole 16 is opened on both front and rear end surfaces of the notch 41 of the shaft portion 15.

  Further, a connection tube 42 is provided in the notch 41 of the shaft portion 15 between the front and rear openings of the small beam source insertion hole 16. Then, the positioning of the small-ray source guide tube 12 inserted into the small-ray source insertion hole 16 in the balloon 26 is performed by the connection tube 42.

  However, the tube 42 is not necessarily provided, and even when the tube 42 is not provided, the positioning of the small-ray-source guide tube 12 is possible to some extent.

  The opening at the front end of the notch 41 of the shaft 15 may be closed, or the tip of the small-ray source guide tube 12 is positioned on the wall at the front end of the notch 41 of the shaft 15. A simple recess may be provided.

Therefore, in the above configuration, a notch 41 is provided in a portion inside the balloon 26 on the outer peripheral surface of the distal end portion of the shaft portion 15 of the applicator 2, and a small wire insertion hole 16 is provided in a portion corresponding to the notch 41. having arranged, with respect to the center axis O ₁ of the shaft portion 15 of the radiation emitted from a small source 28 inserted into brachytherapy insertion hole 16, the direction in which the notch portion 41 is disposed (FIG. 7 ( It can be radiated in a state where directivity is given in (B) downward direction). For this reason, even in the present embodiment, similarly to the first embodiment, the small-ray source 28 radiates an eccentric diseased part locally existing only in a part of the body cavity of the patient in the circumferential direction. The radiation to be applied can be intensively irradiated with high precision, and the combined use of thermal treatment and radiation treatment can be effectively performed.

  Furthermore, in the present embodiment, particularly, since the high-frequency electrode 25 for warming treatment is arranged inside the brachytherapy source 28, radiation emitted from the brachytherapy source 28 is disturbed by the high-frequency electrode 25 for warming therapy. Therefore, it is possible to prevent the dose distribution of the radiation radiated from the beam source 28 from being disturbed.

  In addition, since the connecting tube 42 is provided between the front and rear openings of the small wire source insertion hole 16 in the cutout portion 41 of the shaft portion 15, the positioning of the small wire source 28 can be more reliably performed. If the connection tube 42 is not connected, the entire applicator 2 can be easily assembled and the cost can be reduced.

  FIG. 8 shows a fourth embodiment of the present invention. In the applicator 2 according to each of the first to third embodiments, a coating layer 51 provided with a lubricating coating such as Teflon coating is provided on the inner peripheral surface of the small ray insertion hole 16 of the shaft portion 15 in the applicator 2 of each of the first to third embodiments. .

  Therefore, in the above-described configuration, the friction on the inner peripheral surface of the small-source insertion hole 16 can be reduced by the coating layer 51 on the inner peripheral surface of the small-source insertion hole 16 of the shaft portion 15 to improve the lubricity. Therefore, even if the length of the shaft portion 15 in the axial direction is long, the insertability of the small-source guide tube 12 into the small-source insertion hole 16 can be improved. For this reason, in the present embodiment, the inner peripheral surface of the small-beam source insertion hole 16 is formed of a surface such as silicon, and the small-beam-source insertion hole 16 is formed as in the case where the friction of the inner peripheral surface of the small-beam source insertion hole 16 is large. When the length in the axial direction becomes longer, it is possible to prevent the difficulty in inserting the small-ray source guide tube 12 to the distal end side of the shaft portion 15 even when the inner diameter of the small-ray source insertion hole 16 is increased. In addition, the insertability of the small-ray source guide tube 12 into the small-ray source insertion hole 16 can be maintained in a favorable state.

  In the present embodiment, the case where the coating layer 51 is provided on the inner peripheral surface of the small-ray source insertion hole 16 of the shaft portion 15 is shown, but the inside of the small-ray source insertion hole 16 of the shaft portion 15 is provided with a Teflon tube or the like. A configuration may be adopted in which a lubricating tube having a small friction on the peripheral surface is inserted, and the small-ray source guide tube 12 is inserted inside the lubricating tube.

FIGS. 9A and 9B show a fifth embodiment of the present invention. This is because a radiopaque tungsten high-frequency electrode 61 made of tungsten is provided at the tip of the shaft portion 15 in the intracavity applicator 2 of the first embodiment, and the center of the high-frequency electrode 61 is An opening 62 for radiation emission having a size of 1 cm ² is provided in the portion. Further, temperature sensors 63 composed of thermocouples are mounted at two places on the outer peripheral surface of the balloon 26. Further, the shaft portion 15 is made of silicon, and the RI catheter passage 64 penetrates in the middle.

  A water supply connector 65 connected to the water supply passage 17 of the shaft portion 15, a drainage connector 66 connected to the drainage passage 18, and a temperature sensor insertion passage 19 are provided at the proximal end 7 of the applicator 2. A sensor connector 67 connected to the temperature sensor cable 23 of the temperature sensor 63, an electrode cable connector 68 connected to the electrode cable 24 disposed in the electrode cable insertion path 20, and an RI catheter (not shown) in the RI catheter passage 64. Are connected to each other.

  When performing treatment using the applicator 2 having the above-described configuration, the applicator 2 is first inserted into the body cavity of the patient with the balloon 26 deflated. Subsequently, the balloon 26 is inflated by supplying cooling water from the water supply connector 65 through the water supply passage 17 to fix the applicator 2 in the body cavity of the patient.

  Here, the cooling water is of a circulation type. That is, the cooling water discharged from the drain connector 66 through the drain passage 18 from inside the balloon 26 is supplied again from the water supply connector 65 through the water supply passage 17.

  In addition, during the heating treatment of the affected part in the body cavity of the patient, an extracorporeal electrode (not shown) attached to the extracorporeal applicator 8 as shown in FIG. This is performed by dielectric warming.

  Further, when performing radiation treatment, an unillustrated RI catheter as a radiation radiation source for radiation treatment was inserted into the RI catheter passage 64 from the RI catheter introduction base 69 at the proximal end portion 7 of the applicator 2. Set to state. In this state, radiation is emitted from the RI catheter, and radiation treatment of the affected part is performed. At this time, the radiation radiated from the RI catheter is radiated to the outside only from the radiation emission opening 62 of the electrode 61, and the other parts are shielded by the electrode 61.

Therefore, in the above configuration, since the high-frequency electrode 61 of the intraluminal applicator 2 is made of tungsten, the radiation radiation source for radiation treatment contained in the RI catheter inserted into the RI catheter passage 64 is used as the electrode 61. When placed inside, the radiation is emitted only from the opening 62 of the electrode 61. Therefore, by radiation to the location desired to be irradiated to direct the opening 62, the radiation emitted from the RI catheter with respect to the center axis O ₁ of the shaft portion 15, to have a directivity in a direction in which the opening 62 is located It can be radiated in the state.

  Therefore, even in the present embodiment, similarly to the first embodiment, the RI catheter emits radiation to an eccentric diseased part locally existing only in a part of the body cavity of the patient in the circumferential direction. Radiation can be intensively irradiated with high precision, and combined use of thermal treatment and radiation treatment can be effectively performed.

  FIGS. 10 and 11 show a sixth embodiment of the present invention. This is a modification of the configuration of the distal end portion of the shaft portion 15 of the applicator 2 according to the fifth embodiment. That is, in the present embodiment, a sheet-like high-frequency electrode 71 for heating treatment made of conductive rubber and a balloon 72 are provided so as to cover the electrode 71 only on one side of the outer peripheral surface of the distal end portion of the shaft portion 15. It is. In this case, one temperature sensor 63 composed of a thermocouple mounted on the balloon 72 is also provided.

  Further, a radiopaque member 73 made of tungsten is provided on a portion of the distal end portion of the shaft portion 15 where the balloon 72 is not mounted, and this portion is covered with a coating material 74 made of Teflon. The other parts are the same as those of the fifth embodiment.

  Therefore, in the above configuration, when the cooling water is supplied from the water supply connector 65 through the water supply passage 17, the balloon 72 is inflated to only one side of the outer peripheral surface of the distal end portion of the shaft portion 15. In this case, since the radiopaque member 73 is attached to a portion other than the attachment portion of the balloon 72 on the outer peripheral surface of the distal end portion of the shaft portion 15, the radiation source in the RI catheter inserted into the RI catheter passage 64 The emitted radiation can pass only in the mounting direction of the balloon 72, that is, only in the direction of the electrode 71.

Therefore, it is possible to irradiate only one side of the outer peripheral surface of the distal end portion of the shaft portion 15, and by directing the balloon 72 in the direction in which the radiation is desired to be irradiated, the radiation radiated from the RI catheter is transmitted to the central axis of the shaft portion 15. O ₁ can be radiated with directivity in the direction in which the balloon 72 is arranged. Therefore, even in the present embodiment, similarly to the first embodiment, the RI catheter emits radiation to an eccentric diseased part locally existing only in a part of the body cavity of the patient in the circumferential direction. Radiation can be intensively irradiated with high precision, and combined use of thermal treatment and radiation treatment can be effectively performed.

  Furthermore, in this embodiment, in particular, since the high-frequency electrode 71 for warming treatment is provided only on one side of the outer peripheral surface of the distal end of the shaft portion 15, the outer peripheral portion of the distal end of the shaft portion 15 is also used during the warming treatment. Only one side of the surface can be used, and only one side of the outer peripheral surface of the distal end of the shaft portion 15 can be reliably subjected to simultaneous treatment with thermal treatment and radiation treatment, and it is possible to selectively treat only the affected part to be treated It becomes.

  FIGS. 12A and 12B show a seventh embodiment of the present invention. In the present embodiment, a coil-shaped high-frequency electrode 81 is provided at the distal end portion of the shaft portion 15 in the intraluminal applicator 2 of the fifth embodiment, and the outer peripheral surface of a balloon 82 covering around the electrode 81 is shown in FIG. As shown in (B), two temperature sensors 83 each composed of a thermocouple and one RI insertion passage 84 are mounted.

  Here, the RI insertion passage 84 is formed of a silicon tube, and an RI catheter 85 as a radiation radiation source for radiation treatment can be inserted into the RI insertion passage 84. Further, the distal end of the tube of the RI insertion passage 84 is closed, and when the RI catheter 85 is inserted into the RI insertion passage 84, the distal end of the RI catheter 85 is attached to the closed portion of the RI insertion passage 84. It can be positioned by hitting.

Therefore, in the above configuration, the RI insertion passage 84 is mounted on the outer peripheral surface of the balloon 82 of the intraluminal applicator 2, and the RI catheter 85 is inserted into the RI insertion passage 84. by the place to be irradiated directing RI insertion path 84 on the balloon 82, directing the radiation emitted from the RI catheter 85 relative to the center axis O ₁ of the shaft portion 15, in the direction RI insertion path 84 is arranged It can be radiated in a state where it has properties.

  Therefore, even in the present embodiment, similarly to the first embodiment, the RI catheter 85 radiates an eccentric diseased part locally existing only in a part of the body cavity of the patient in the circumferential direction. The radiation to be applied can be intensively irradiated with high precision, and the combined use of thermal treatment and radiation treatment can be effectively performed.

  Furthermore, in this embodiment, in particular, since the RI catheter 85 can be mounted on the outer peripheral surface of the balloon 82, the radiation radiated from the RI catheter 85 may be disturbed by the radiofrequency electrode 81 for warming treatment and the balloon 82. Therefore, it is possible to prevent the dose distribution of the radiation emitted from the RI catheter 85 from being disturbed.

  The distal end of the tube of the RI insertion passage 84 is closed, and when the RI catheter 85 is inserted into the RI insertion passage 84, the distal end of the RI catheter 85 is applied to the closed portion of the RI insertion passage 84. Therefore, the positioning of the RI catheter 85 when the RI catheter 85 is inserted into the RI insertion passage 84 can be easily performed.

  Furthermore, since the RI insertion passage 84 is provided on the outer peripheral surface of the balloon 82, the close contact between the RI catheter 85 and the inner peripheral surface of the body cavity in the patient's body cavity is good. Therefore, the distance from the mucous membrane is easy to measure, which is convenient for determining the radiation distribution of the radiation radiated from the RI catheter 85, and facilitates the concentrated irradiation of the radiation radiated from the RI catheter 85 to the affected part. Become.

  FIG. 13 shows an eighth embodiment of the present invention. This is because an RI catheter insertion tube 91 made of a fluororesin material such as Teflon is disposed along the shaft portion 15 on the outer peripheral surface of the shaft portion 15 in the intraluminal applicator 2 of the seventh embodiment. Things.

  The distal end of the RI catheter insertion tube 91 extends toward the distal end of the shaft portion 15 and is provided on the outer peripheral surface of the balloon 82. The distal end of the RI catheter insertion tube 91 is closed. Further, the proximal end of the RI catheter insertion tube 91 extends toward the proximal end 7 of the applicator 2 and is connected to the RI catheter introduction mouthpiece 92. Then, the RI catheter 85 can be inserted into the RI catheter insertion tube 91 from the RI catheter introduction base 92. In this case, by inserting the RI catheter 85 into the RI catheter insertion tube 91 in a state where the balloon 82 is deflated or inflated, the distal end of the RI catheter 85 is fixed on the balloon 82. I have.

Therefore, in the above configuration, the distal end of the RI catheter insertion tube 91 is provided on the outer peripheral surface of the balloon 82 of the intraluminal applicator 2, and the RI catheter 85 is inserted into the RI catheter insertion tube 91. By directing the RI catheter insertion tube 91 on the balloon 82 to a place where irradiation is desired, the radiation radiated from the RI catheter 85 is directed to the central axis O ₁ of the shaft portion 15. Can be emitted with directivity in the direction in which is arranged.

  Therefore, even in the present embodiment, similarly to the first embodiment, the RI catheter 85 radiates an eccentric diseased part locally existing only in a part of the body cavity of the patient in the circumferential direction. The radiation to be applied can be intensively irradiated with high precision, and the combined use of thermal treatment and radiation treatment can be effectively performed.

  Furthermore, in this embodiment, in addition to the effects described in the first embodiment, the insertion of the RI catheter 85 becomes very easy, and the radiation radiation source for radiation treatment through the RI catheter insertion tube 91. Can be directly introduced into the patient's body cavity.

  FIG. 14 shows a ninth embodiment of the present invention. This is provided with an X-ray marker 101 that cannot transmit X-rays at the distal end of the RI catheter insertion tube 91 of the intraluminal applicator 2 according to the eighth embodiment. The X-ray marker 101 is arranged on the outer peripheral surface of the balloon 82.

  When the intracavity applicator 2 is used, after inserting the applicator 2 into a patient, a doctor manually rotates the applicator 2 while checking the position of the tumor under X-ray fluoroscopy. The X-ray marker 101 is adjusted to the position. Subsequently, the RI catheter 85 is inserted into the RI catheter insertion tube 91 at the same position. Thereby, hyperthermia and radiation therapy can be performed simultaneously. The RI catheter 85 may be inserted into the RI catheter insertion tube 91 before inserting the applicator 2 into the patient.

Therefore, even in the above configuration, an RI catheter insertion tube 91 is mounted on the outer peripheral surface of the balloon 82 of the intraluminal applicator 2 as in the eighth embodiment, and an RI catheter is attached to the RI catheter insertion tube 91. since so as to insert 85, by radiation to the location desired to be irradiated with direct RI catheter insertion tube 91 on the balloon 82, the radiation emitted from the RI catheter 85 relative to the center axis O ₁ of the shaft portion 15, The radiation can be performed in a state in which the direction in which the RI catheter insertion tube 91 is arranged has directivity.

  Therefore, even in the present embodiment, similarly to the first embodiment, the RI catheter 85 radiates an eccentric diseased part locally existing only in a part of the body cavity of the patient in the circumferential direction. The radiation to be applied can be intensively irradiated with high precision, and the combined use of thermal treatment and radiation treatment can be effectively performed.

  Furthermore, in this embodiment, in particular, since the X-ray marker 101 that cannot transmit X-rays is provided at the distal end of the RI catheter insertion tube 91, the doctor confirms the position of the tumor under X-ray fluoroscopy. By rotating the applicator 2 by manual operation, the X-ray marker 101 can be adjusted to the position of this tumor. Therefore, in the present embodiment, it is possible to irradiate a part of a target tumor with radiation more precisely and intensively.

  FIGS. 15A and 15B show a tenth embodiment of the present invention. This is formed inside the shaft portion 15 on the outer peripheral surface of the tip portion of the shaft portion 15 of the intracavity applicator 2 of the first embodiment, and the tip portion of the small-ray source insertion hole 16 that cannot be directly viewed. X-ray markers 111 and 112, which cannot transmit X-rays and indicate positions corresponding to the other one point behind, are provided.

  In the above configuration, after inserting the applicator 2 into the patient, the doctor manually rotates the applicator 2 while confirming the position of the tumor under X-ray fluoroscopy. The X-ray markers 111 and 112 are adjusted to the position of the tumor. Subsequently, the small beam source 28 is inserted into the small beam source insertion hole 16 at the same position. Thereby, hyperthermia and radiation therapy can be performed simultaneously. The brachytherapy source 28 may be inserted into the brachytherapy source insertion hole 16 before inserting the applicator 2 into the patient.

  Therefore, the same effects as in the ninth embodiment can be obtained even with the above-described configuration, and in this embodiment, in particular, the application of the X-ray marker is larger than that of the applicator 2 of the ninth embodiment. Since there are few portions, it is possible to perform treatment with a clearer X-ray image than the applicator 2 of the ninth embodiment.

  FIGS. 16A and 16B show an eleventh embodiment of the present invention. That is, instead of providing the X-ray marker 101 at the distal end of the RI catheter insertion tube 91 as in the ninth embodiment, a small-diameter position display catheter 121 inserted into the RI catheter insertion tube 91 is provided. An X-ray marker 122 is provided at the tip of the catheter 121.

  When using the intracavity applicator 2, the position indicating catheter 121 is inserted into the RI catheter insertion tube 91 in advance. Subsequently, after inserting the applicator 2 into the patient, the doctor checks the position of the tumor under X-ray fluoroscopy, and manually rotates the applicator 2 so that the position display catheter is positioned at the position of the tumor. The X-ray marker 122 of 121 is aligned. Subsequently, the position indicating catheter 121 is pulled out from the RI catheter insertion tube 91 at the position as it is, and the RI catheter 85 as a radiation source is inserted into the RI catheter insertion tube 91 instead. Thereby, hyperthermia and radiation therapy can be performed simultaneously.

  Therefore, it is obvious that the same effects as those of the ninth embodiment can be obtained even with the above configuration, and in this embodiment, in particular, as in the applicator 2 of each of the ninth and tenth embodiments. Since there is no need to provide an X-ray marker on the main body of the applicator 2, it is possible to manufacture an inexpensive applicator 2 and to perform treatment with a clearer X-ray image than the applicator 2 of the ninth and tenth embodiments. Becomes possible.

  FIGS. 17A to 17D show a twelfth embodiment of the present invention. The scale is formed on the outer peripheral surface of the shaft portion 15 of the intracavity applicator 2 of the first embodiment, and is formed inside the shaft portion 15 at a position corresponding to the small-ray source insertion hole 16 which cannot be directly viewed. 131 is provided. In FIG. 17D, D is the width dimension of the small beam source insertion hole 16.

  When the intracavity applicator 2 is used, first, the radiation source is inserted into the brachytherapy source insertion hole 16, and then the applicator 2 is inserted into the patient. Thereafter, the doctor manually rotates the applicator 2 to adjust the position of the scale 131 to adjust the radiation source in the small-beam source insertion hole 16 to the position of the tumor. Note that the radiation source may be inserted into the small-beam source insertion hole 16 after the applicator 2 is adjusted to the position of the tumor.

  Therefore, even with the above configuration, the same effects as those of the tenth embodiment can be obtained. Of course, the present embodiment does not use an X-ray marker or a small-diameter catheter. The applicator 2 can be manufactured at a lower cost than any of the applicators 2 described in the eleventh embodiment.

  Note that the present invention is not limited to the above embodiment. For example, the scale 131 in the twelfth embodiment may be formed by an X-ray marker that cannot transmit X-rays.

  In this case, when using the intracavity applicator 2, the radiation source is first inserted into the brachytherapy source insertion hole 16, and the applicator 2 is inserted into the patient. Thereafter, the position of the tumor is confirmed under fluoroscopy, and the doctor rotates the applicator 2 by hand, adjusts the position of the scale 131, and adjusts the radiation source to the position of the tumor. Then, hyperthermia and radiation therapy are simultaneously performed in the same position. The radiation source may be inserted into the brachytherapy source insertion hole 16 after the applicator 2 is adjusted to the position of the tumor.

  Accordingly, the position of the applicator 2 can be adjusted by using both the scale 131 and the X-ray marker. Therefore, the applicator 2 can be more accurately and quickly moved to the position targeted by the doctor than the applicator 2 of the twelfth embodiment. 2 can be combined.

  Further, it goes without saying that various modifications can be made without departing from the spirit of the present invention.

Next, other characteristic technical matters of the present application will be additionally described as follows.
Record
(Additional item 1) A radiation source insertion hole is provided in the applicator, and when a radiation source guide tube or a direct radiation source is inserted into the radiation source insertion hole, directional irradiation in the cavity direction is possible. An intracavitary hyperthermia applicator, characterized in that a high-frequency electrode for warming treatment and a balloon are provided so as to surround it at the tip.

  (Additional Item 2) The intra-cavity hyperthermia applicator is provided with a source insertion hole, and when a source guide tube or a direct source is inserted into the source insertion hole, the directivity is increased in the inner circumferential direction. It has a structure that allows certain irradiation, and a high-frequency electrode for heating treatment and a balloon are provided so as to surround the electrode at the distal end, and the small hole is inserted into the insertion hole through a small-ray source guide tube or directly. A method of inserting a radiation source, using the high-frequency electrode for warming treatment at the tip of the applicator as an intracavity electrode during warming treatment, and performing both warming treatment and radiation treatment with a single applicator.

  (Appendix 3) A brachytherapy source guide tube or a brachytherapy source insertion hole for directly inserting a brachytherapy source is provided at a position deviated from the central axis of the applicator. Characterized in that a balloon is provided so as to surround the balloon, and a water supply channel and a drainage channel connected to the inside of the balloon are provided.

  (Function of Supplementary Item 3) At a position deviated from the central axis of the applicator, a brachytherapy source guide tube or a brachytherapy source insertion hole for inserting a brachytherapy source directly is opened, and a high-frequency electrode for warming treatment and a high-frequency electrode for heating therapy are provided at the tip. By providing a balloon to surround the cavity, it has a structure that is very suitable for intracavitary heating, and furthermore, in brachytherapy, irradiation with directivity to a part of the affected area around the cavity can be performed. It is possible to perform the heating treatment and the brachytherapy at the same time.

  (Additional Item 4) The intrathecal hyperthermia applicator is provided with a source insertion hole, and when a source guide tube or a direct source is inserted into the source insertion hole, directivity is increased in the inner circumferential direction. It has a structure that allows a certain irradiation, a high-frequency electrode for heating treatment and a balloon surrounding the high-frequency electrode for heating treatment are provided at the tip, and the heating treatment device having an automatic control function of the heating temperature and After starting the heating treatment using the intracavity hyperthermia applicator, insert a high-dose-rate brachytherapy source into the brachytherapy source insertion hole of the intracavity hyperthermia applicator using the remote control. A treatment method in which heating treatment and radiation treatment are simultaneously performed by removing the brachytherapy source in the control.

  (Supplementary note 5) The intra-cavity hyperthermia applicator is provided with a source insertion hole, and when a source guide tube or a direct source is inserted into the source insertion hole, the directivity is increased in the inner circumferential direction. It has a structure that allows certain irradiation, and a high-frequency electrode for warming treatment and a balloon are provided around it at the tip, and a small dose source with a low dose rate is used for an intracavity hyperthermia applicator. After insertion into the brachytherapy source insertion hole and irradiation has been performed for a predetermined period of time, heating is performed by performing a heating treatment using a heating treatment device having an automatic control function of the heating temperature and the intracavity hyperthermia applicator. A treatment that combines treatment and radiation therapy.

  (Supplementary note 6) The intra-cavity hyperthermia applicator is provided with a source insertion hole, and when a source guide tube or a direct source is inserted into the source insertion hole, the directivity is increased in the inner circumferential direction. It has a structure that allows certain irradiation, and has a high-frequency electrode for heating treatment and a balloon surrounding it at the tip, and inserts the brachytherapy source into the intracavity hyperthermia applicator. After insertion into the hole with a remote control, after irradiation for a predetermined time, the brachytherapy source is removed with the same remote control, and then heating treatment using an intracavitary hyperthermia applicator is performed. A treatment that is performed sequentially with a single intracavitary hyperthermia applicator.

  (Additional Item 7) A small-ray source insertion hole is provided in the intracavity hyperthermia applicator, and when a small-ray source guide tube or a small-ray source is directly inserted into the small-ray source insertion hole, the directivity is increased in the inner circumferential direction. It has a structure that allows certain irradiation, a high-frequency electrode for warming treatment and a balloon are provided to surround it at the tip, and performs warming treatment using an intracavity hyperthermia applicator, After completion of the heating treatment, the brachytherapy source is inserted into the brachytherapy source insertion hole of the intracavitary hyperthermia applicator by remote control, and after irradiation for a predetermined time, the brachytherapy source is removed by the same remote control, thereby heating. A treatment method in which treatment and radiation treatment are performed sequentially using a single intracavitary hyperthermia applicator.

  (Additional item 8) A radiation source insertion hole is provided in the applicator, and when a radiation source guide tube or a direct radiation source is inserted into the radiation source insertion hole, directional irradiation in the cavity direction is possible. Confirm the directivity of irradiation in the intracavitary hyperthermia applicator, which has a high-frequency electrode for warming treatment and a balloon surrounding it at the tip. The intracavity hyperthermia applicator according to claim 1, wherein a marker is provided.

  (Purpose of Supplementary Item 8) An object of the present invention is to be able to distinguish the directivity of intracavity irradiation and to irradiate a target site.

  (Supplementary note 9) A small-ray source guide tube or a small-ray source insertion hole for directly inserting a small-ray source is provided at a position shifted from the central axis of the applicator. An intracavity hyperthermia applicator, wherein a balloon is provided so as to surround the balloon, a water supply channel and a drainage channel connected to the balloon are provided, and a temperature sensing part of a temperature sensor is provided on the balloon surface.

  (Appendix 10) A brachytherapy guide tube or a brachytherapy insertion hole for directly inserting a brachytherapy source is provided in the shaft of the applicator. Is provided, a water supply channel and a drainage channel connected to the inside of the balloon are provided, and a temperature sensing portion of a temperature sensor is provided on the balloon surface, and the balloon expands eccentrically with respect to the shaft, and the balloon expands. An intracavity hyperthermia applicator characterized in that the brachytherapy source insertion hole is displaced from the central axis at that time.

  (Function of Supplementary Note 10) A brachytherapy guide tube or a brachytherapy source insertion hole for directly inserting a brachytherapy source is opened in the shaft of the applicator, and a high-frequency electrode for warming treatment and a balloon are arranged so as to surround the tip at the tip. The balloon is eccentrically inflated with respect to the shaft and inflated. By displacing the small-beam source insertion hole from the center axis when the balloon is inflated, while having a structure very suitable for intracavity heating, In the treatment, it is possible to irradiate a part of the affected part in the cavity with directivity, and it is possible to simultaneously perform the heating treatment and the brachytherapy.

  (Additional Item 11) Near the outer circumference of the shaft of the applicator, a small-ray source guide tube or a small-ray insertion hole for directly inserting a small-ray source is provided, and a part of a cross section of the shaft including the small-ray source insertion hole. Is cut off by a balloon, the brachytherapy source insertion hole is open in a cross section of the missing portion, and the electrode is provided inside the location where the brachytherapy source is located. Intra-cavity hyperthermia applicator according to attachment 9.

  (Function of Supplementary Items 9 and 11) At the position deviated from the center axis of the shaft of the applicator, a small-source guide tube or a small-source insertion hole for directly inserting a small-ray source is made, and a high-frequency wave for heating treatment is provided at the distal end. By providing electrodes and balloons surrounding them, it has a structure that is very suitable for intracavity warming, and has directivity to some affected parts of the cavity in brachytherapy during brachytherapy. Irradiation, and the heating treatment and the brachytherapy can be performed simultaneously.

  (Supplementary Note 12) A brachytherapy guide tube or a brachytherapy source insertion hole for directly inserting a brachytherapy source is provided in the center axis of the shaft of the applicator. Is provided with a water supply channel and a drainage channel connected to the inside of the balloon, and a temperature sensing portion of a temperature sensor is provided on the surface of the balloon. 2.) An intracavity hyperthermia applicator, wherein a high-frequency electrode for warming treatment made of a material is provided, and an opening for radiation transmission is provided in the high-frequency electrode for warming treatment.

  (Function of Supplementary Item 12) A brachytherapy source insertion tube for inserting a brachytherapy guide tube or a brachytherapy source directly in the center axis of the shaft of the applicator is provided. A high-frequency electrode for warming treatment is provided outside the brachytherapy insertion hole with a material having low radiation permeability, and an opening for radiation transmission is provided in the electrode, so that intracavity heating is performed. In addition to having a very suitable structure, it is possible to irradiate the affected part of the cavity inside the cavity with directivity in brachytherapy. Can be performed simultaneously.

  (Appendix 13) A brachytherapy guide tube or a brachytherapy source insertion hole for directly inserting a brachytherapy source is provided in the shaft of the applicator, and a radiolucent material is formed outside the brachytherapy source insertion hole. There is a side on which the high-temperature electrode for warming treatment is provided, and a side made of a member having low radiolucency, and a balloon is provided so as to surround the high-frequency electrode for warming treatment, and a water passage leading to the inside of the balloon. An intracavity hyperthermia applicator characterized in that a temperature sensor is provided on the surface of the balloon.

  (Function of Supplementary Item 13) In the shaft of the applicator, a brachy source insertion tube for directly inserting a brachy source guide tube or a brachy source is made, and the outside of the brachy source insertion hole is made of a radiolucent material. By providing the side of the high-frequency electrode for warming treatment and the side of the member with low radiation permeability, and providing a balloon so as to surround the high-frequency electrode for warming treatment, it has a structure very suitable for intracavitary heating. In addition, in the brachytherapy, it is possible to perform directional irradiation on a part of the affected area in the cavity, and it is possible to simultaneously perform the heating therapy and the brachytherapy. .

  (Supplementary item 14) A high-frequency electrode for heating treatment and a balloon are provided so as to surround the distal end portion, and a water supply channel and a drainage channel connected to the inside of the balloon are provided, and a temperature sensing portion of a temperature sensor is provided on the balloon surface. An intracavity hyperthermia applicator characterized in that a brachytherapy guide tube or a brachytherapy insertion hole for directly inserting a brachytherapy source is provided on the balloon surface.

  (Function of Supplementary Item 14) A high-frequency electrode for warming treatment and a balloon are provided so as to surround the distal end portion, and a small source guide tube or a small source insertion hole for directly inserting the small source is provided on the balloon surface. Thus, while having a structure that is very suitable for intracavitary heating, it is possible to irradiate part of the affected area in the cavity with directivity in brachytherapy, Treatment and brachytherapy can be performed simultaneously.

  (Additional Item 15) The intracavity hyperthermia applicator according to Additional Items 1, 3, 9, 9, 10, 12, 13, and 14, wherein a lubricating coating is applied to the inner surface of the brachytherapy source insertion hole.

  (Additional Item 16) The intracavity hyperthermia applicator according to Additional Items 1, 3, 9, 10, 10, 12, 13, and 14, wherein a fluororesin tube is used in the small-beam source insertion hole.

  (Functions of Supplementary Items 1-2, 4-7, and 15-16) A brachytherapy source insertion hole is provided in the applicator, and when a brachytherapy guide tube or a brachytherapy source is directly inserted into the brachytherapy source, a cavity is formed. It has a structure that enables irradiation with directivity in the inner circumferential direction, and has a structure that is very suitable for intraluminal heating by providing a high-frequency electrode for heating treatment and a balloon surrounding it at the tip. In addition, in the brachytherapy, it is possible to perform directional irradiation on a part of the affected area in the cavity, and it is possible to simultaneously perform the heating therapy and the brachytherapy. .

  (Additional Item 17) The intracavity hyperthermia applicator according to Additional Item 8, wherein an X-ray marker is used as a marker for confirming directivity.

  (Additional Item 18) The intracavity hyperthermia applicator according to additional item 17, wherein the X-ray marker is provided in the vicinity of the brachytherapy source insertion hole near the balloon at the tip of the intracavity hyperthermia applicator. .

  (Additional Item 19) The intracavity hyperthermia applicator according to Additional Item 18, wherein the X-ray marker is provided by being divided into two.

  (Additional Item 20) The intracavity hyperthermia applicator according to Additional Item 8, wherein a scale of a shaft is used as a marker for confirming directivity.

  (Additional Item 21) The intracavity hyperthermia applicator according to additional items 17 and 20, wherein the scale is an X-ray marker.

  (Additional Item 22) The X-ray marker can be inserted into the small-ray source insertion hole of the intracavity hyperthermia applicator of Additional Items 1, 3, 9, 10, 12, 13, and 14, and the distal end thereof is provided. A small-diameter catheter characterized by the above-mentioned.

  (Purpose of Supplementary Items 17 to 22) An object of the present invention is to be able to distinguish the directivity of intracavity irradiation and to irradiate a target site.

  (Functions of Supplementary Notes 8, 17 to 22) When a small-ray source insertion hole is provided in the applicator, and the small-ray source guide tube or the small-ray source is directly inserted into the small-ray source insertion hole, the directivity is increased in the inner circumferential direction. By providing a high-frequency electrode for warming treatment, a balloon surrounding the electrode, and a marker for confirming the directivity of irradiation, the intrathecal hyperthermia applicator can be used in a patient cavity. After inserting the applicator, the directivity of the irradiation of the applicator can be clearly recognized by the marker, and the irradiation can be surely performed at the target.

FIG. 2 is a schematic configuration diagram of a main part of an intraluminal applicator of the treatment apparatus according to the first embodiment of the present invention. (A) is a cross-sectional view showing the internal structure of the shaft of the intracavity applicator of the first embodiment, and (B) is the internal structure of the shaft of the intracavity applicator of the modification of the first embodiment. FIG. FIG. 2 is a schematic configuration diagram of a situation where the treatment apparatus according to the first embodiment is used at the time of combined therapy of thermal treatment and radiation treatment. (A) is a schematic configuration diagram showing a state in which the intracavity applicator of the first embodiment is inserted into the esophagus, (B) is a schematic configuration diagram showing a state in which the intracavity applicator is inserted into the rectum and colon, (C) is a schematic configuration diagram showing a state in which the intracavity applicator is inserted into the bile duct, (D) is a schematic configuration diagram showing a state in which the intracavity applicator is inserted in the trachea or bronchi, and (E) is a schematic configuration diagram. The schematic block diagram which shows the state inserted in the prostate and the bladder. The schematic block diagram which shows the state which inserted the intracavity applicator in a vagina, a uterus, etc. FIG. 4 shows a second embodiment of the present invention, in which (A) is a longitudinal sectional view of a main part of an intraluminal applicator, and (B) is a transverse sectional view thereof. FIG. 9 shows a third embodiment of the present invention, in which (A) is a longitudinal sectional view of a main part of an intraluminal applicator, and (B) is a transverse sectional view thereof. The longitudinal section of the important section of the intracavity applicator showing a 4th embodiment of the present invention. FIG. 9 shows a fifth embodiment of the present invention, in which (A) is a perspective view of a distal end portion of a shaft portion of an intracavity applicator, and (B) is a perspective view of a proximal end portion of the intracavity applicator. The perspective view which shows the front-end | tip part of the shaft part of the intracavity applicator of 6th Embodiment of this invention in partial cross section. FIG. 16 is a cross-sectional view of a balloon mounting portion of the intraluminal applicator according to the sixth embodiment. FIG. 9 shows a seventh embodiment of the present invention, wherein (A) is a perspective view of an intraluminal applicator, and (B) is a cross-sectional view taken along line L ₁ -L ₁ of (A). FIG. 17 is a perspective view of an intraluminal applicator according to an eighth embodiment of the present invention. FIG. 19 is a plan view of an intraluminal applicator according to a ninth embodiment of the present invention. FIG. 14 shows a tenth embodiment of the present invention, in which (A) is a perspective view of a distal end portion of a shaft portion of an intracavity applicator, and (B) is a perspective view of a proximal end portion of the intracavity applicator. FIG. 14 shows the eleventh embodiment of the present invention, in which (A) is a plan view of an intraluminal applicator, and (B) is a plan view of a catheter inserted into a radiation source insertion hole. FIG. 14 shows a twelfth embodiment of the present invention, in which (A) is a plan view of a distal end portion of a shaft portion of an intraluminal applicator, (B) is a plan view of a proximal end portion of the intraluminal applicator, ( (C) is a front view of the tip of the shaft portion of the intracavity applicator, and (D) is a plan view showing the scale of the shaft portion.

Explanation of reference numerals

  2 ... intracavity applicator, 15 ... shaft part, 26 ... balloon, 61 ... high-frequency electrode for heating treatment, 62 ... opening (radiation part) for radiation emission, 64 ... catheter passage for RI.

Claims (1)

A radiation source for radiation therapy;
A high-frequency electrode part for heating treatment, which is formed of a material having low radiation permeability and covers the radiation source outer peripheral direction,
An open radiating unit provided on the high-temperature electrode unit for warming treatment and capable of emitting radiation from the radiation source,
A balloon disposed so as to surround the high-frequency electrode for heating treatment,
Therapeutic device having a.

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