JPH08252332A - Thermotherapeutic applicator - Google Patents

Abstract

PURPOSE: To impart directivity to radiating distribution to selectively irradiate only an affected part, and earn the dose by fitting a thermotherapeutic electrode on the top end of a shaft inserted into a body cavity, and arranging a plurality of small beam source guide tubes in the axial direction of the shaft. CONSTITUTION: An applicator 1 is formed of a root part 2, a shaft 3, and a top end part 4, the sectional structure of the shaft 3 is made into multilumen structure. A plurality of small beam source insert holes 5 are formed on the shaft 3 along the axial direction, and small beam source guide tubes 6 are inserted to the small beam source insert holes 5. The small beam source insert holes 5 are continued to a high frequency electrode 7 as thermotherapeutic electrode on the top end part 4, and a small beam source 8 is situated so as to be superposed on the high frequency electrode 7 through the small beam source guide tubes 6. Further. the shaft 3 has a feed passage 5a and drainage 5b for cooling water, a temperature sensor insert passage, and an electrode cable insert passage.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a thermotherapy applicator for irradiating a tumor or the like with radiation and heating the affected area at the same time.

[0002]

2. Description of the Related Art It is known that cancer cells are necrotic when heated at a temperature of about 43 ° C. Also, a method of destroying by irradiation with radiation is known. Conventionally, these two treatments have been performed individually, but in recent years, a method of simultaneously performing heat treatment and radiation treatment has attracted attention as a new technique.

An apparatus provided with a heating means and a radiation irradiating means is disclosed in, for example, Japanese Unexamined Patent Publication No. 58-78654 and Japanese Utility Model Publication No.
-46056 is available. This thermotherapy applicator is one in which a space for a radiation source is provided in a part of a thermotherapy electrode to be inserted into a body cavity, and the thermotherapy and the radiation treatment are performed by inserting the radiation source into the space. It is possible to do at the same time.

[0004]

However, in Japanese Patent Laid-Open No. 58-78654 and Japanese Utility Model Laid-Open No. 64-46056, a radiation source is inserted into one space provided in a part of the thermotherapy electrode. Therefore, there is a problem that the radiation irradiation range is limited to a certain distribution. For example, when the radiation source is located on the central axis of the applicator, the radiation distribution becomes concentric in the radial direction of the applicator, so that it is difficult to selectively irradiate the unevenly distributed affected part only to the affected part.

Further, when the radiation source is located so as to be deviated from the central axis of the applicator, it has been difficult to uniformly irradiate the affected area of the entire circumference with radiation. further,
Since the dose of the radiation source decreases while it is in use, there was also the problem that the irradiation time would gradually increase accordingly.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a plurality of small radiation source insertion holes so that a radiation source is provided in an arbitrarily selected small radiation source insertion hole. By inserting the radiation distribution into a directional pattern, it is possible to selectively irradiate only the affected area, and by inserting multiple brachytherapy sources, it is possible to increase the dose for hyperthermia treatment. To provide an applicator.

[0007]

In order to achieve the above object, the present invention provides a thermotherapy electrode at the tip of a shaft to be inserted into a body cavity, and a plurality of brachytherapy sources in the axial direction of the shaft. It is characterized in that a guide tube or a small radiation source insertion hole for directly inserting the small radiation source is provided.

[0008]

The number of brachytherapy source guide tubes to be inserted into the applicator and the position of the brachytherapy source insertion hole can be selected by the operator according to the form of the affected area to be treated. For example, if the cancer has spread all around, by selecting a small radiation source insertion hole that goes around the outer circumference of the shaft of the applicator and inserting the small radiation source, a radiation distribution that spreads in the entire circumferential direction can be obtained. To be Also,
When the cancer is biased in the circumferential direction, the radiation distribution irradiating only the cancer can be obtained by inserting the brachytherapy source only into the brachytherapy source insertion hole near the place. Further, when the cancer has spread in the axial direction of the applicator, by shifting two or more brachysources in the axial direction of the applicator, a long irradiation distribution in the axial direction can be obtained.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 5 show a first embodiment, FIG. 1 is a configuration diagram of an applicator for thermotherapy, FIG. 2 is a sectional view of a shaft of the applicator, and FIG. 3 is a configuration diagram showing a use state of the applicator. is there.

As shown in FIG. 1, the applicator 1 comprises a hand portion 2, a shaft 3 and a tip portion 4. The cross-sectional structure of the shaft 3 has a multi-lumen structure as shown in FIG. A plurality of small radiation source insertion holes 5 are provided in the shaft 3 in the axial direction, and a small radiation source guide tube 6 is inserted into the small radiation source insertion hole 5.

The small-ray-source insertion hole 5 communicates with the high-frequency electrode 7 serving as the thermotherapy electrode of the tip portion 4, and the small-ray source 8 is inserted through the small-ray source guide tube 6 inserted into the small-ray source insertion hole 5.
Can be positioned so as to overlap the high frequency electrode 7 as shown in FIG. The small-ray-source insertion hole 5 may have either a penetrating end as shown in FIG. 1 or a closed end.

The shaft 3 has a plurality of small radiation source insertion holes 5, a cooling water supply channel 5a and a drain channel 5b, and a temperature sensor insertion channel 5.
c, an electrode cable insertion path 5d is provided. In the hand section 2, the water supply channel 5a and the water supply tube 9 are connected, and the drainage channel 5b and the drainage tube 10 are connected, and the temperature sensor cable 11 is guided to the temperature sensor insertion channel 5c and the electrode cable 12 is guided to the electrode cable insertion channel 5d.

Further, a balloon 13 is attached to the tip portion 4 so as to surround the shaft 3, and cooling water is circulated in the balloon 13 by a water supply passage 5a and a drainage passage 5b. . Temperature sensor cable 1
1 is taken out of the shaft 3 before the balloon 13, and a temperature sensor 14 is attached to the surface of the balloon 13. The electrode cable 12 is taken out from the shaft 3 in the balloon 13 and connected to the high-frequency electrode 7 for heating treatment.

Next, a method of using the thermotherapy applicator will be described with reference to FIG. Heat this applicator
When used as a combination of irradiation, it is used in an electromagnetically shielded room. A patient bed 15, a thermotherapy device body 16, and a brachytherapy device body 17 are installed in the room. Reference numeral 19 is a radiation shield wall, and 20 is a controller for the brachytherapy apparatus.

First, the applicator 1 is connected to the thermotherapy device body 16. Then, air is removed from the water supply / drainage pipeline system, and then the cooling water in the balloon 13 of the applicator 1 is sucked to deflate the balloon 13. In that state, the applicator 1 is inserted into the body cavity of the patient 18. In this case, the brachysource guide tube 6 may be inserted into the brachysource insertion hole 5 of the applicator 1 before the applicator 1 is inserted into the patient 18 or after the applicator 1 is inserted into the patient 18. But it's okay.

The number of brachytherapy source guide tubes 6 to be inserted into the applicator 1 and the position of the brachytherapy source insertion hole 5 can be selected by the operator according to the form of the affected area to be treated. For example, when the cancer has spread all around, if a small radiation source insertion hole 5 that surrounds the outer circumference of the shaft 3 of the applicator 1 is selected and the small radiation source 8 is inserted, the radiation distribution spreads in the entire circumferential direction. Is obtained.
Further, when the cancer is biased in the circumferential direction, the radiation distribution irradiating only the cancer can be obtained by inserting the brachytherapy source 8 only into the brachytherapy source insertion hole 5 close to the location.

When the cancer has spread in the axial direction, by shifting two or more small ray sources 8 in the axial direction of the applicator 1, a long irradiation distribution in the axial direction can be obtained. In addition, the small source 8
When the dose is decreasing, the number of the small ray sources 8 to be inserted may be increased. After inserting the applicator 1 into the patient 18, the cooling water is circulated in the balloon 13 again to inflate the balloon 13. As a result, the surface of the balloon 13 is brought into close contact with the inner surface of the body cavity, and the tip portion 4 of the applicator 1 is
Is fixed in the body cavity. Reference numeral 21 denotes an extracorporeal applicator attached to the outside of the body of the patient 18.

Then, heating is started by the applicator 1, and when the temperature becomes stable, the operator goes out of the shield room. The operator uses the controller 20 for the brachytherapy apparatus outside the shielded room to deliver the radiation source from the brachytherapy apparatus main body 17 to the patient 1 via the brachytherapy guide tube 6.
8 into the body cavity. Since this brachysource guide tube 6 is inserted into the brachysource insertion hole 5 of the applicator 1, the brachysource is located at the tip 4 of the applicator 1.

Therefore, in the simultaneous combination therapy of hyperthermia and brachytherapy, each applicator 1 is separately provided to the patient 18.
Compared to the case where it was inserted in, it only needs to be inserted once, and treatment can be performed easily. Furthermore, the following effects are obtained in such treatment.

Since the small radiation source insertion holes 5 are provided in plural, the arrangement of the small radiation sources 8 can be variously changed in the axial direction and the radial direction of the applicator 1. As a result, it is possible to perform directional irradiation in accordance with the following three types of affected areas. (A) Radiation can be applied in the entire circumferential direction, and the entire cancer that has spread in the circumferential direction can be treated. (B) Only unevenly distributed cancers can be intensively irradiated with radiation, and can be treated without harming other normal tissues. (C) The entire cancer that has spread axially in the cavity can be treated.

As another effect, when a radiation source with a reduced dose is used, the dose can be increased by increasing the number of radiation sources by using a plurality of small radiation source insertion holes 5, and the treatment time can be shortened. Can be achieved.

Since the small radiation source 8 is located inside the high frequency electrode 7, the heating distribution is not distorted by the radiation source. Moreover, the guide tube 6 for a small radiation source does not fall off from the applicator 1 when the tip portion of the small radiation source insertion hole 5 is closed, so that it is safer. In addition to the small radiation source 8, the small radiation source insertion hole 5 is open to the tip,
The affected area can be directly diagnosed and treated by penetrating the endoscope and treatment tools.

FIGS. 4 and 5 show a state in which the applicator 1 is mounted in the body cavity. FIG. 4 (a) shows the case where it is attached to the esophagus 22, and FIG. 4 (b) shows the rectum 23, the colon 24 and the sigmoid colon. FIG. 4 (c) shows the case of being attached to the hepatic duct 25 when attached to the blood vessel 24a. Further, FIG. 5 (a) shows the case where it is attached to the prostate 26 and bladder 27, FIG. 5 (b) shows the case where it is attached to the trachea 28 and bronchus 29, and FIG. 5 (c) shows the case where it is attached to the vagina 30 and uterus 31. Show.

FIG. 6 shows a second embodiment, in which the construction of the shaft 3 is different from that of the first embodiment. In this embodiment, the shaft 3
A plurality of small radiation source insertion holes 5 provided in the shaft 3 are located at the tip of the shaft 3 at equal distances from the central axis of the shaft 3 and at equal intervals. The shaft 3 and the hand portion 2 do not have to be equidistant from the central axis and equidistant from each other. Also,
In this embodiment, eight brachytherapy source insertion holes 5 are provided, but the number thereof is not limited.

The operation is the same as that of the first embodiment, but the following operation is further added in this embodiment. That is,
Also in this embodiment, the number of brachytherapy source guide tubes 6 to be inserted into the applicator 1 and the position of the brachytherapy source insertion hole 5 can be selected by the operator according to the form of the affected part to be treated. The feature here is that when the small radiation sources 8 are inserted into all the small radiation source insertion holes 5, a uniform radiation distribution is obtained in the radial direction. For a cancer that has spread in the circumferential direction, radiation is evenly applied by inserting the radiation sources into all the small radiation source insertion holes 8.

Therefore, in addition to the effects of the first embodiment,
The following effects are obtained. That is, all the brachytherapy source insertion holes 5
By inserting the radiation source into the
Is uniform around the central axis of the radiation and the dose is larger than that in the case of one radiation source. Therefore, it is possible to realize effective treatment and shorten the treatment time for a cancer that has spread in the circumferential direction.

7 and 8 show the third embodiment, and the construction of the shaft 3 is different from that of the first embodiment. In this embodiment,
As shown in FIG. 7, a plurality of small radiation source insertion holes 5 are formed in the shaft 3.
Exists at the tip of the shaft 3 asymmetrically with respect to the central axis of the shaft 3. Further, as shown in FIG. 8, a marking 32 is provided on the proximal portion 2 so that it can be seen to which side the small radiation source insertion hole 5 is biased with respect to the central axis of the shaft 3.
Is given.

The applicator 1 shown in this embodiment is suitable for cancer which is unevenly distributed in the body cavity in the circumferential direction. The applicator 1 is inserted into the patient 18 so that the smaller radiation source insertion hole 5 is closer to the cancer position, that is, the one having the marking 32 on the proximal portion 2 comes. Then, depending on how the cancer spreads, some brachysources 8 are inserted. For example, when the spread of cancer is small, the number of brachysources 8 is reduced, and when it is large, the brachysources 8 are used.
Increase the number of. When the number of inserted radiation sources is small, a narrow radiation distribution is obtained, and when there are many radiation sources, a wide radiation distribution is obtained.

Therefore, similarly to the first embodiment, it is possible to intensively irradiate only the ubiquitous cancer with radiation, and it is possible to treat without damaging other normal tissues. In addition, since the purpose of the present embodiment is to bias the radiation distribution from the beginning, it is possible to reduce the number of the small radiation source insertion holes 5, improve the strength of the applicator 1, simplify the manufacturing, and reduce the manufacturing cost. The cost can be reduced.

9 and 10 show a fourth embodiment,
9 shows a sectional view of the tip of the applicator 1, and FIG. 10 shows a sectional view of the shaft 3 of the applicator 1. In this embodiment, the small radiation source insertion hole 5 in the shaft 3 of the applicator 1 is opened in the vicinity of the outer periphery, and the other insertion paths are formed in the vicinity of the central portion. The diameter of the shaft 3 is reduced only in a part located inside the balloon 13, and the part other than the small-source insertion hole 5 communicates with the thin shaft 3 in that part. The tube 33 is connected to the end of the tube 33. The tube 33 may be omitted.

Therefore, the tube 33 connected to the opening portion of the small radiation source insertion hole 5 positions the small radiation source guide tube 6 in the balloon 13. However, even if this tube 33 is not provided, the brachysource guide tube 6
Can be positioned. Further, since the high-frequency electrode 7 for warming treatment is inside the arrangement of the brachytherapy source 8, it is possible to prevent the disorder of the dose distribution due to the high-frequency electrode 7 for warming treatment.

According to this embodiment, the effects are the same as those of the first to third embodiments. The tube 3 is placed in the opening of the small radiation source insertion hole 5.
When 3 is connected, the brachysource 8 can be positioned more reliably. Further, when the connection is not made, the assembly becomes easy and the manufacturing cost can be suppressed.

FIG. 11 shows the tip of the applicator of the fifth embodiment. In this embodiment, a plurality of tubes 34 having a small frictional resistance such as Teflon tubes are used as the small radiation source insertion holes.
In parallel with the shaft 3 of the applicator 1 and the adhesive 35
It is fixed to the shaft 3 by. Similar to the first embodiment, a small radiation source 8 is provided inside the shaft 3 via a high frequency electrode 7 and a small radiation source guide tube 6, and a cooling water supply passage 5a and a drainage passage 5b are provided. .

According to the present embodiment, the same effects as those of the first embodiment are obtained, but since the structure is simpler, the manufacture is easier, and the applicator 1 at a lower cost can be provided. 12
13 and 14 show the applicator of the sixth embodiment. This embodiment is basically the same as the first embodiment,
The brachysource insertion hole 36 is not in the shaft 3 but in the balloon 13
It is mounted at four locations on the top, spaced apart in the circumferential direction. That is, although they are arranged at intervals of 90 ° vertically and horizontally on the central axis of the shaft 3, they may be changed depending on the purpose.

As described above, the small radiation source insertion hole 36 is formed in the balloon 1.
The radiation source is more closely attached to the affected area by being provided on top of 3.
Therefore, in addition to the effect of the first embodiment, since the distance to the mucous membrane is closer, the radiation distribution can be easily calculated. Also,
It is possible to irradiate the affected area with a high dose of radiation as compared with the case where a radiation source is present inside the shaft 3.

FIGS. 14 and 15 show a seventh embodiment, which is almost the same as the sixth embodiment, but has a hole in which a plurality of brachysource guide tubes 6 can be inserted together on the balloon 13. A plurality of large small radiation source insertion holes 37 are provided.

By providing the small-ray-source insertion hole 37 in this manner, one small-ray-source insertion hole 37 can be formed by inserting a large number of small-ray-source guide tubes 6 into the same small-ray-source insertion hole 37.
Dose can be increased.

Therefore, in addition to the effects of the sixth embodiment,
Since a large number of small radiation source guide tubes 6 can be inserted into one small radiation source insertion hole 37, even a radiation source with a reduced dose can be treated without increasing the treatment time.

FIG. 16 shows an eighth embodiment, which is almost the same as the sixth embodiment, but in this embodiment, the brachytherapy source insertion hole 37 provided on the balloon 13 is not only provided on the balloon 13. The shaft 3 is also provided so as to be extended. According to the present embodiment, in addition to the effect of the sixth embodiment, the brachysource insertion hole 37
It becomes easy to insert the brachysource guide tube 6 or the brachysource 8 directly.

17 and 18 show the ninth embodiment, and FIG. 17 shows the overall construction of the radiation therapy combined applicator 101. The combined radiotherapy applicator 101 includes a shaft 102 made of flexible silicone rubber or the like, and first and second balloons 103a, 103b made of thin silicone rubber or the like placed on the shaft 102.
And a plurality of heating treatment electrodes (not shown) spirally wound with tin-plated copper wires contained in the first and second balloons 103a and 103b, and the first and second balloons 1
A plurality of temperature sensors 104a to 104d having sensitive points on the surfaces of 03a and 103b, lumens 105a to 105d extending the axial center of the shaft 102, and the first
A refrigerant inlet connector 106a and an outlet connector 106b for circulating a refrigerant such as purified water into the second balloons 103a and 103b, and a temperature sensor connector for transmitting output signals of the temperature sensor temperature sensors 104a to 104d. 107a and 107b, and an RF connector 108a for supplying RF power to the heating treatment electrode.
And the connectors 109a to 109d which are installed at the rear ends of the lumens 105a to 105d and can be directly connected to a remote operation device (not shown) for the sealed brachytherapy source.

As shown in FIG. 18, the applicator 101 has a shaft 102 made of a flexible silicone rubber or the like, and a shaft 102 made of a material such as a fluororesin having a small frictional resistance. Lumens 105a to 105d, and the first and second balloons 10
Lumens 106a and 106b for supplying and discharging the refrigerant to 3a and 103b, and a temperature sensor signal line 104
And a lead wire 108 for supplying RF power to the warming treatment electrode.
It consists of and. It is to be noted that 110a to 110d indicate a brachytherapy source, and 103a and 103b indicate outer shapes of the first and second balloons 103a and 103b when inflated. In addition, although the number of lumens is four in this embodiment, the configuration may be changed to two, three, five, six, or the like.

Next, the operation will be described. The radiation therapy combined applicator 101 includes a heating treatment apparatus main body (not shown), a refrigerant inlet connector 106a, and an outlet connector 10.
6b, the temperature sensor connectors 107a and 107b, and the RF connector 108a are connected to each other and inserted into the body lumen. An extracorporeal electrode (not shown) opposite to the heating treatment electrode is also connected to the heating treatment apparatus main body, and a state capable of performing heating treatment is created.

On the other hand, the connectors 109a to 109d are connected to the brachysource remote control device, and the sealed brachysource is inserted into the lumens 105a to 105d inside the applicator 101 to prepare a state where radiation therapy is possible.

For example, ¹⁹² Ir (φ1.1 × 3.5 mm, 370 GBq) is used as a typical high-dose-rate sealed brachytherapy source, and irradiation treatment is performed by introducing it into the living body by remote control using a wire or air. Done. On the other hand, since the heating treatment with electromagnetic waves generally takes about 1 hour, the applicator 101 of the present embodiment can be used for the heating treatment and the irradiation treatment together.

Further, since the dose distribution of the sealed brachytherapy source sharply decreases with the square of the distance, and at the same time, the dose rate decreases, the distance of about 5 mm or more is required when the radiation source is used in the living body. The biological effects are said to decrease sharply with distance. Therefore, when the radiotherapy is used in combination with the warming treatment by electromagnetic waves, the biological effect of radiation must be fully considered.

The arrangement of the small-beam source irradiation section shown in FIGS. 17 and 18 is made in view of the above circumstances, and the small-beam source is evenly arranged in the vicinity of the outer circumference of the shaft 102 of the applicator 101. As a result, the small radiation source can be arranged in the immediate vicinity of the treatment site of the living body, and further, uniform irradiation can be performed at a high dose rate by a plurality of small radiation sources.

In the applicator 101, a small ray source may be inserted into all the lumens 105a to 105d for uniform irradiation, or a small ray source may be selectively inserted to have directivity. Irradiation may be performed.

Therefore, according to the present embodiment, irradiation therapy can be carried out at the same time while maintaining a high biological effect of radiation in a region heated by electromagnetic waves, thus improving the therapeutic effect, shortening the treatment time, and reducing the burden on the patient. It is possible to plan. Further, since the applicator 101 is positioned in advance for the warming treatment, the positioning of the brachytherapy source becomes reliable and easy, and the safety of the treatment can be improved.

FIG. 19 shows a tenth embodiment of the present invention and shows a radiation therapy combined applicator 201. The basic structure is the same as that of the ninth embodiment, but this applicator 201 has three
It is composed of two balloons 111a to 111c and a plurality of lumens 112a and 112b extending in the shaft 112 and having different closed positions in the shaft 112. Here, the closing points of the lumens 112a and 112b are arranged between the different balloons 111a to 111c.

According to the applicator 201 of this embodiment,
Since the small-beam source irradiation positions can be arranged substantially in series on the shaft 112, it is possible to obtain a linear dose distribution in the living body. Then, radiation treatment and warming treatment can be effectively and simultaneously performed on a wider range of tumors.

20 and 21 show an eleventh embodiment, showing a radiation therapy combined applicator 301. The basic structure is the same as that of the ninth embodiment, but this applicator 301 includes a first balloon 1 containing a heating treatment electrode.
A second balloon 12 having a small beam source irradiation portion behind 21
2, the operating lumens 124a and 124b for guiding the small ray source inside the second balloon 122, and the operating lumens 124a and 124b, and one end of which is fixed to the inner wall of the second balloon 122. Flap 123
a and 123b, and a connector 125 for supplying a medium such as gas or liquid to the second balloon 122.

As shown in FIG. 21, the applicator 301 includes operating lumens 124a to 124c installed in three directions at an angle of 120 ° and a flap 123a.
~ 123c and a lumen 130 for supplying a gas or liquid medium to the second balloon 122.

Here, 127a to 127c represent the brachytherapy sources, which may be inserted in all directions as shown in the figure, or may be selectively inserted and used. In addition, the operating lumens 124a to 124c and the flaps 123a and 12c.
The installation direction of 3b may be four directions or other directions with an angle of 90 °.

The second balloon 122 in this embodiment.
Is superior in performing radiation treatment on a relatively large lumen. That is, the operating lumens 124a to 124c
The second radiation source 122 is inflated and the flaps 123a and 123b pull the brachysource away from the outer periphery of the applicator 301, and as a result, the small radiation source is positioned very close to the affected part of the living body. As a result, effective treatment can be performed without impairing the dose rate of the brachytherapy source.
Further, if the operating lumens 124a to 124c are pre-biased in the axial direction of the applicator 301, not only the operation when the second balloon 122 is deflated but also the inflation of the second balloon 122 is not hindered. Sometimes, the small radiation source does not carelessly approach the affected area of the living body.

As described above, according to the present embodiment, it is possible to effectively carry out the radiation treatment and the heating treatment at the same time even for a tumor having a large lumen. According to the above embodiment, the following configuration is obtained.

(Supplementary Note 1) A thermotherapy electrode is provided at the tip of a shaft to be inserted into a body cavity, and a brachysource for inserting a plurality of brachysource guide tubes or direct brachylines in the axial direction of the shaft. An applicator for hyperthermia treatment, which is provided with an insertion hole.

(Supplementary Note 2) A plurality of small radiation source guide tubes or small radiation source insertion holes for directly inserting small radiation sources are provided at equal distances from the central axis of the shaft and at equal intervals from each other. The applicator for hyperthermia treatment according to Appendix 1.

(Additional remark 3) A plurality of small radiation source guide tubes or small radiation source insertion holes for directly inserting a small radiation source are provided at positions asymmetric with respect to the central axis of the shaft. The applicator for thermotherapy according to 1.

(Supplementary Note 4) The applicator for hyperthermia treatment according to Supplementary Note 1, wherein the plurality of small radiation source insertion holes are provided so as to penetrate to the tip of the shaft. (Supplementary Note 5) The applicator for hyperthermia treatment according to Supplementary Note 1, wherein the plurality of small-ray-source insertion holes are closed at the tip of the shaft.

(Supplementary note 6) The applicator for hyperthermia treatment according to supplementary note 1, wherein a brachytherapy source insertion hole for disposing the brachytherapy source guide tube is provided outside the electrode in the vicinity of the outer periphery of the shaft.

(Supplementary note 7) The applicator for hyperthermia treatment according to supplementary note 1, characterized in that a brachytherapy source insertion passage is provided in the vicinity of the outer circumference of the shaft for directly inserting the brachytherapy source to the outside of the electrode.

(Supplementary Note 8) A high-frequency electrode for heating treatment is provided at the tip of the shaft, and a first balloon is provided on the shaft so as to surround the high-frequency electrode for heating treatment.
The thermotherapy applicator according to appendix 1, wherein the shaft in the first balloon is provided with a water supply channel and a drainage channel.

(Supplementary Note 9) A shaft, a heating treatment radio-frequency electrode provided at a tip portion of the shaft, a first balloon provided on the shaft so as to surround the heating treatment radio-frequency electrode, and a first balloon. Water supply channel and drainage channel provided on the shaft in the first balloon, a temperature-sensitive portion of a temperature sensor provided on the surface of the first balloon, and a brachysource guide tube or direct braid provided on the shaft. An applicator for hyperthermia treatment, comprising: a second balloon having a small ray source insertion hole for inserting a radiation source; and means for independently expanding the first and second balloons.

Here, the applicator has a small radiation source insertion hole of 1
Considering the case in which there is one, in general, FIG.
As shown in (a), the radiation spreads spherically around the radiation source. Therefore, there is one source in the applicator.
If there is one, the radiation distribution will be spherical around the source. That is, the radiation distribution is determined as one pattern depending on the position and intensity of the radiation source.

However, as described in Supplementary Notes 1 to 5, consider the case where there are a plurality of small ray source insertion holes. At this time, first, when focusing on the radial direction of the applicator, there are roughly the following two states. (A) In the case where all the small ray source insertion holes are equidistant from the applicator center axis and are equidistant from each other. (B) In the case where the small radiation source insertion hole is asymmetrical to the applicator center axis.

The case (A) can be further divided into two cases. (A1) When inserting the radiation source into all of the insertion holes. (A2) When inserting the radiation source into some of the multiple insertion holes.

In the case of (a1), since the small radiation source insertion holes are arranged at equal distances from the applicator center axis and at equal intervals, when the radiation sources are inserted into all the small radiation source insertion holes, the radiation distribution is As shown in FIG. 22B, the shape is centered on the applicator shaft. In this case, the intensity of the radiation becomes stronger in proportion to the number of inserted radiation sources than in the case of one radiation source.

In the case of the above (a2), when the radiation source is inserted into the small radiation source insertion hole deviated from the central axis of the applicator of FIG. 22 (c), the radiation is concentric with the position of the inserted small radiation source as the center. As shown in FIG. 22 (c), a radiation distribution is obtained that is deviated from the central axis of the applicator.

When a radiation source is inserted into some of the plurality of small radiation source insertion holes as shown in FIG. 23 (a), the radiation generated from each radiation source overlaps with each other, resulting in the radiation distribution as shown in FIG. 23 (a). To create. By selecting the small radiation source insertion hole and inserting the radiation source, a radial radiation distribution suitable for the affected area is obtained.

Naturally, when one radiation source is inserted into the small radiation source insertion hole in the center of the applicator shaft, a concentric radiation distribution centered on the applicator shaft can be obtained, and the same use as in the conventional method can be achieved. it can.

The case of (B) will be described. Since the small ray source insertion hole originally exists at a position deviated from the applicator center axis, even if the small ray source is inserted into all the small ray source insertion holes or only a part of the small ray source insertion holes is inserted, as shown in FIG. The radiation distribution is deviated from the central axis of the applicator as shown in (b).

Next, focusing on the axial direction of the applicator, there are roughly the following two states. (B1) When the radiation source is at the same position in the axial direction. (B2) When the radiation sources are located at different positions in the axial direction.

In the case of (b1), the radiation spread in the axial direction of the applicator is almost the same as in the case where there is one radiation source, and there is a spherical distribution around the axis of the applicator. In the case of (b2), when the radiation source is shifted in the axial direction of the applicator and inserted as shown in FIG. 23 (c), an asymmetrical radiation distribution is obtained, which is biased and expanded in the axial direction. By inserting a plurality of radiation sources by appropriately shifting the positions in the axial direction, a radiation distribution suitable for the form of the affected area is obtained.

As described above, the radiation distribution can be changed in the radial direction and the axial direction by changing the insertion position of the radiation source by utilizing the plurality of small radiation source insertion holes. Further, according to Supplementary Note 2, by arranging the small ray sources in all the small ray source insertion holes, a uniform irradiation distribution is obtained in the entire circumference of the cavity. As a result, it is possible to treat the combined heating / irradiation therapy evenly on the affected area of the entire circumference. Further, by arranging the small ray sources only in some of the small ray source insertion holes, it is possible to obtain an irradiation distribution having directivity in the circumferential direction. As a result, it is possible to intensively irradiate only the affected part with respect to the affected part having a bias, so that it is possible to prevent exposure to the other part than the affected part. Furthermore, even if a radiation source with a small dose is used, it is possible to earn a dose by inserting multiple sources. In general, the radiation dose of a radiation source decreases with time. When the same radiation source was used for a long time, in order to irradiate the same dose, it was necessary to irradiate for a long time due to the reduced dose. Therefore, the treatment time can be shortened by increasing the dose.

According to Supplementary Note 3, it is possible to perform irradiation having directivity in the radial direction. Although an applicator in which the small radiation source insertion hole is provided equidistant from the central axis of the shaft can also have directivity, some small radiation source insertion holes are not used. Therefore, if such a small radiation source insertion hole is eliminated, the number of small radiation source insertion holes is reduced, so that the strength of the applicator can be improved, the manufacturing can be simplified, and the manufacturing cost can be reduced.

According to appendix 4, the affected area can be directly diagnosed and treated by penetrating the endoscope and the treatment tool in addition to the brachytherapy. Appendix 5
According to this, it is possible to prevent the guide tube for the small radiation source from falling off from the applicator.

According to Supplementary Note 6, the high-frequency electrode for heating treatment is provided inside the brachytherapy source insertion hole to prevent disturbance of the dose distribution due to the high-frequency electrode for heating treatment. According to Appendix 9, the radiofrequency electrode for heating treatment and the brachytherapy source are separated from each other to prevent mutual interference and prevent disturbance of the heating distribution and the dose distribution.

[0078]

As described above, according to the present invention,
In the combination therapy of hyperthermia and brachytherapy, it becomes possible for the operator to arbitrarily control the radiation irradiation range and selectively irradiate only the affected area, and effective and safe treatment can be carried out.

Further, since a plurality of small radiation source insertion holes are provided, the dose can be increased by using a plurality of small radiation source insertion holes even when a radiation source having a reduced dose is used, and the treatment time can be increased. There is an effect that it can be shortened.

[Brief description of drawings]

FIG. 1 is an overall configuration diagram of a thermotherapy applicator showing a first embodiment of the present invention.

FIG. 2 is a sectional view taken along the line AA of FIG. 1;

FIG. 3 is a configuration diagram of a usage state of the thermotherapy applicator of the embodiment.

FIG. 4 is a usage state diagram of the applicator for hyperthermia treatment of the same Example.

FIG. 5 is a usage state diagram of the thermotherapy applicator of the same embodiment.

FIG. 6 is a cross-sectional view of a shaft of a thermotherapy applicator showing a second embodiment of the present invention.

FIG. 7 is a cross-sectional view of a shaft of a thermotherapy applicator showing a third embodiment of the present invention.

FIG. 8 is a perspective view of the applicator for hyperthermia treatment of the same embodiment.

FIG. 9 is a side view of the distal end portion of the thermotherapy applicator showing the fourth embodiment of the present invention.

FIG. 10 is a cross-sectional view of the shaft of the thermotherapy applicator of the embodiment.

FIG. 11 is a vertical cross-sectional side view of a distal end portion of a thermotherapy applicator showing a fifth embodiment of the present invention.

FIG. 12 is an overall configuration diagram of a thermotherapy applicator showing a sixth embodiment of the present invention.

13 is a cross-sectional view taken along the line BB of FIG.

FIG. 14 is a side view of the distal end portion of the thermotherapy applicator showing the seventh embodiment of the present invention.

FIG. 15 is a cross-sectional view taken along the line CC of FIG.

FIG. 16 is an overall configuration diagram of a thermotherapy applicator showing an eighth embodiment of the present invention.

FIG. 17 is an overall configuration diagram of an applicator for thermotherapy showing a ninth embodiment of the present invention.

FIG. 18 is an enlarged cross-sectional view taken along the line DD of FIG.

FIG. 19 is an overall configuration diagram of a thermotherapy applicator showing a tenth embodiment of the present invention.

FIG. 20 is an overall configuration diagram of an applicator for thermotherapy showing an eleventh embodiment of the present invention.

21 is an enlarged cross-sectional view taken along the line EE of FIG.

FIG. 22 is a radiation distribution diagram showing the action of the present invention.

FIG. 23 is a radiation distribution diagram showing the operation of the present invention.

[Explanation of symbols]

1 ... Applicator, 3 ... Shaft, 5 ... Small source insertion hole,
6 ... Small source guide tube, 8 ... Small source.

Claims (1)

[Claims] 1. A thermotherapy electrode is provided at the tip of a shaft to be inserted into a body cavity, and a plurality of small radiation source guide tubes or a small radiation source insertion hole for directly inserting a small radiation source is provided in the axial direction of the shaft. An applicator for hyperthermia treatment, which is provided.