JPH10314210A - Applicator for thermotherapy - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an applicator for thermotherapy, of the type usable also in treatment, which can treat uniformly a diseased part in a coelom by guiding an insert for treatment to a predetermined position even within a curved lumen and can effectively treat the diseased part by providing a uniform treatment which is employed along with heating. SOLUTION: An applicator 1 is provided with a heating electrode 3 in an applicator shaft 2, a flexible balloon 4 covering at least the part of the electrode 3, and a tube 23 communicated to a channel 11 formed in the applicator shaft 2, the tube 23 capable of deviating outwards from the outer periphery of the applicator shaft 2 inside the balloon 4, so that a catheter for small-radiation- source treatment, passed through the channel 11, is guided and deviated outwards from the center of the applicator shaft 2.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a thermal treatment applicator, and more particularly, to a thermal treatment applicator which is used in combination with a treatment such as irradiating an affected part such as a tumor with radiation simultaneously with heating.

[0002]

2. Description of the Related Art Japanese Unexamined Patent Publication No. Hei 8-173553 proposes a hyperthermia treatment apparatus combined with radiotherapy, which heats an affected part such as a tumor in a body cavity of a patient and simultaneously irradiates radiation. ing. The hyperthermia treatment device combined with radiotherapy is provided with an intracavity high-frequency electrode and a flexible balloon covering the intracavity high-frequency electrode at the distal end of the applicator shaft, and further, a central lumen is provided on the applicator shaft. The present invention has realized a hyperthermia treatment type applicator structure combined with radiotherapy in which a brachytherapy catheter can be inserted into the central lumen.

[0003]

However, in the conventional thermal treatment apparatus combined with radiation therapy, the portion of the applicator shaft and the portion of the intracavity high-frequency electrode in the applicator main body are harder than the flexible balloon. For example, when the balloon 102 is inserted into a curved lumen 101 as shown in FIG. 13, the balloon 102 is biased and inflated, and the portion of the applicator shaft 103 and the intraluminal high-frequency electrode 104 is
It is shifted from the center of 1. Applicator shaft 10
3 and the portion of the intracavity high-frequency electrode 104 cannot follow the curvature of the lumen 101, so that the brachytherapy source inserted into the central lumen is also displaced from the center of the patient's lumen, and the radiation is transmitted to the entire peripheral surface in the lumen 101. It becomes difficult to uniformly irradiate the radiation, and the radiation irradiation intensity on the displaced side is locally increased, while the radiation irradiated on other parts tends to be less than the expected radiation. In addition, the radiation may not be uniformly applied in the circumferential direction, and the radiation treatment may be incomplete.

[0004] The present invention solves the above-mentioned problems in the prior art, and it is possible to guide a therapeutic insert to a predetermined position even in a curved lumen to uniformly treat an affected part in a body cavity. It is an object of the present invention to provide a treatment-combination type thermal treatment applicator capable of effectively treating a diseased part by uniformly applying treatment combined with warming.

[0005]

SUMMARY OF THE INVENTION The present invention provides an applicator shaft having flexibility so that it can be inserted into a curved body cavity, a heating electrode provided on the applicator shaft, and a heating electrode. A flexible balloon covering at least a portion of the warming electrode, a channel formed in the applicator shaft for introducing a therapeutic insert, and a tube communicating with the channel, wherein the tube is disposed within the balloon in the applicator. A treatment insert disposing means, which can be deflected outside the outer peripheral portion of the shaft and guides the treatment insert inserted through the channel to position the insert outside the applicator shaft; Wherein the treatment insert positioning means includes a treatment insert, such as a brachytherapy catheter, inserted through the channel. By offset outwardly from the center of the re applicator shaft, for example, a thermal therapy applicator can be adjusted so as to coincide with the center of the bent lumen.

[0006]

BEST MODE FOR CARRYING OUT THE INVENTION

<First Embodiment> A first embodiment of the present invention will be described with reference to FIGS.
An embodiment will be described. (Configuration) FIG. 1 shows an applicator 1 of a thermal treatment apparatus. The applicator 1 includes an applicator shaft 2 as a main body member, and a distal end portion of the applicator shaft 2 includes an intracavity high-frequency electrode 3 and an intracavity high-frequency electrode 3.
A flexible balloon 4 is provided so as to cover the balloon. A thermocouple 5 is provided on the balloon 4 as a temperature sensor. The thermocouple 5 detects the temperature of the body part against which the balloon 4 is pressed. A cooling liquid inlet 6 and a cooling liquid outlet 7 are formed at the distal end of the applicator shaft 2 in a region inside the balloon 4.

[0007] The applicator shaft 2 is formed of a tube integrally formed with five lumens, and each of the lumens causes a channel 11 and a channel 11 located at a central portion as shown in FIG. Of the two coolant lines 12a, 12b located above and below the
An electrode wire conduit 13 and a thermocouple conduit 14 are respectively formed on the left and right of 1. The channel 11 is a guide channel for inserting a treatment insert, for example, a brachytherapy catheter 45 described later.

[0008] One coolant line 12a communicates with the coolant inlet 6, and the other coolant line 12b communicates with the coolant outlet 7. Then, the coolant is injected into the balloon 4 from the coolant line 12a through the coolant inlet 6, and the coolant in the balloon 4 is discharged from the coolant outlet 7 through the other coolant line 12b. The cooling liquid is circulated in the heater 1 and the balloon 4 is inflated. The electrode wire conduit 13 passes an electrode wire (not shown) leading to the intracavity high-frequency electrode 3, and the thermocouple conduit 14 passes the thermocouple 5.

As shown in FIG. 1A, a channel base 15, a thermocouple connector 16, a high-frequency connector 17, a coolant IN connector 18, and a coolant OUT connector 19 are provided at the base end of the applicator shaft 2. ing. The channel base 15 is connected to the channel 11, and a brachytherapy catheter 45 is inserted into the channel 11 from the channel base 15. The channel base 15 is provided with a screw portion (not shown) on the base body thereof, and the insert inserted into the channel 11 can be fixed by tightening the screw.

The high-frequency connector 17 is used for the intra-cavity high-frequency electrode 3.
Is connected to the electrode wire leading to Coolant IN connector 1
8 is connected to one coolant line 12a leading to the coolant inlet 6, and the coolant OUT connector 19 is connected to the other coolant line 12b leading to the coolant outlet 7.

As shown in FIGS. 2A and 2B, the distal end of the applicator shaft 2 provided with the intracavity high-frequency electrode 3 and the balloon 4 is formed along the axial direction of the applicator shaft 2. A slit-shaped hole 21 is provided. As a result, as shown in FIG. 2B, the tip of the applicator shaft 2 is divided into two right and left portions 22a and 22b having a semicircular cross section. The intracavity high-frequency electrode 3 is formed by winding a wire-shaped conductive wire around each of the portions 22a and 22b. However, the inside of the slit-shaped hole 21 is in a state where a space is opened.

The channel 11 is formed over substantially the entire length of the applicator shaft 2.
The distal end portion of 1 is constituted by a contractible tube arranged in the hole 21. That is, the portion of the channel 11 in the electrode portion is formed by the channel tube 23. The channel tube 23 is made of a so-called rubber material, which is particularly elastic and elastic. In a normal state, the channel tube 23 contracts as shown in FIGS. 1 and 2, and is disposed coaxially with the applicator shaft 2 inside the storage space defined by the internal space of the hole 21. It fits in. Further, the distal end and the proximal end of the channel tube 23 are fixed to the applicator shaft 2. The channel tube 23 may be formed integrally with the applicator shaft 2.

As shown in FIG. 3, the channel tube 23 has a portion disposed in the hole 21 formed to have a smaller outer diameter than other portions. Since the channel tube 23 is formed of a tube that contracts elastically, it is normally housed linearly in the hole 21 adjacent to the intracavity high-frequency electrode 3,
1 and coaxially with the applicator shaft 2 at the center. The middle portion of the channel tube 23 is configured to be deflected so as to be exposed from the inside of the hole 21 to the outside by being bent and deformed. This guides the therapeutic insert inserted through the channel to allow the applicator shaft 2
And a therapeutic insert locating means capable of positioning the therapeutic insert on the outside of the medical insert.

As shown in FIG. 3, the distal end of the channel 11 is formed as a hole 24 having a diameter smaller than the inner diameter of the other part. When the brachytherapy catheter 45 is inserted through the channel 11, the tip of the brachytherapy catheter abuts on its distal end.

FIG. 4 shows a treatment apparatus for performing treatment using the applicator 1. Bed 32 in treatment room 31,
An extracorporeal electrode 34 to be attached to the extracorporeal epidermis of the patient 33, a thermal treatment apparatus main body 35, and a brachytherapy apparatus main body 36 are provided. The applicator 1 is connected to the thermotherapy apparatus main body 35 via a thermocouple cable 41, a high-frequency supply cord 42 in the body, a coolant injection tube 43, and a coolant recovery tube 44. The channel 11 of the applicator 1 is connected to a brachytherapy device main body 36 via a brachytherapy catheter 45. In addition, the extracorporeal electrode 34 is
6 is connected to the thermal treatment apparatus main body 35. In the controller room 30 outside the treatment room 31, a brachytherapy controller 47 is provided. The condition in the treatment room 31 is changed from the controller room 46 to the transparent radiation shield
It can be observed through.

(Action) When performing treatment using the above-described applicator 1, first, as shown in FIG. 4, the applicator 1 is inserted into the lumen 49 of the patient 33 placed on the bed 32. . Further, the extracorporeal electrode 34 is attached to the patient 33. The in-vivo high-frequency supply cord 42 from the thermotherapy apparatus main body 35 is connected to the high-frequency connector 17, and the in-vivo high-frequency supply cord 42 from the thermotherapy apparatus main body 35 is connected to the extracorporeal electrode 34. A thermocouple cable 41 from the thermotherapy device body 35 is connected to the thermocouple connector 16, and a signal of the temperature detected by the thermocouple 5 is transmitted to the thermotherapy device body 35.
Further, a coolant injection tube 43 and a coolant recovery tube 44 derived from the thermotherapy device main body 35 are connected to the coolant IN connector 18 and the coolant OUT connector 19, respectively, so that the coolant is circulated to the applicator 1. To

Therefore, the hyperthermia treatment device main body 35 is operated, and a high-frequency current is passed between the two electrodes of the intracavity high-frequency electrode 3 and the extracorporeal electrode 34, so that the affected part of the patient 33 is subjected to thermal treatment by dielectric heating. Is done.

On the other hand, before the thermal treatment is started, a brachytherapy catheter 45 connected to the brachytherapy device main body 36 in advance is inserted into the channel 11 from the channel base 15 of the applicator 1, and Abut the wall at the distal end where the channel diameter is reduced. afterwards,
A further pressing force is applied to the brachytherapy catheter 45 to bend the channel tube 23 together with the brachytherapy catheter 45. The channel tube 23 is monitored from the beginning of bending under fluoroscopy, and the pressing force is adjusted to adjust the strength of the channel tube 23 so that the channel tube 23 is exposed to the outside from the hole 21 while being curved, and is displaced. To do it. That is, by bending the contractible channel tube 23 and displacing it from the center position of the applicator shaft 2, the lumen 4 bent as shown in FIG.
9 in the center.

Here, the bending of the brachytherapy catheter 45 becomes the same as the bending of the lumen 49, and when the brachytherapy catheter 45 is located at the center of the lumen 49, the threaded portion of the channel base 15 is formed. To fix the brachytherapy catheter 45. Thereafter, the brachytherapy catheter 45 is connected to the brachytherapy device main body 36.

As an example of this treatment procedure, after preparation for the thermal treatment device and the brachytherapy device is completed, first, the thermal treatment is started. When the heating temperature becomes constant, the operator goes out of the treatment room 31, which is a shield room. in this case,
It is necessary that the thermal treatment apparatus main body 35 has an automatic control function of the heating temperature. With the above function, the heating treatment can be continued by the heat treatment even if the operator is outside the treatment room 31. It is desirable that the temperature condition and the like during the hyperthermia treatment be displayed on a monitor or the like outside the treatment room 31.

Subsequently, the operator uses the brachytherapy device controller 47 outside the treatment room 31 to transmit the lumen of the patient 33 from the brachytherapy device main body 36 via the brachytherapy catheter 45. A small beam source (not shown) is fed into 49. In this state, radiation is emitted from the brachytherapy source, and the affected part in the body cavity is irradiated with radiation for a predetermined time. At this time, since the channel tube 23 is located at the center of the lumen 49, the small ray source is also located at the center of the lumen 49.
Thereafter, the brachytherapy source is collected in the brachytherapy apparatus body 36.

The hyperthermia treatment is continued even after the irradiation of the radiation from the brachytherapy source, and is automatically terminated when a predetermined heating time has elapsed. In addition to this protocol, various protocols can be considered depending on the combination of heating and irradiation time.

(Effect) The balloon 4 and the applicator shaft 2 of the applicator 1 inserted into the bent lumen 49 do not match the bending rate of the lumen 49, and the distance between the applicator shaft 2 and the lumen 49 is reduced. Even when the directions are not uniform, by pushing the brachytherapy catheter 45 inserted into the channel 11 and bending the channel tube 23,
A brachytherapy catheter 45 can be located in the center of the lumen 49. Therefore, radiation can be uniformly applied to the entire circumferential surface in the body cavity, and radiation treatment can be effectively performed.

<Second Embodiment> A second embodiment of the present invention will be described with reference to FIGS. (Configuration) In the configuration of the present embodiment, in the thermal treatment applicator 1 of the first embodiment, the channel 11 is a single tube 54 including a channel distal end 51, a channel tube 52, and a channel portion 53 in a shaft. It is composed. The tube 54 is inserted into a channel lumen 55 in the applicator shaft 2, and the channel tube 52 exits the distal end of the applicator shaft 2 and passes through the balloon 4, and the channel distal end 5.
1 is guided and fixed in the applicator shaft 2. The end of the channel 11 is closed.

A channel lumen 55 is formed on the outer periphery of the applicator shaft 2 near the electrode 3 in the balloon 4, and a channel tube outlet 56 located on the proximal end side of the electrode 3 and a distal end of the electrode 3. The tube 54 is open at two locations at the channel tube inlet 57 located on the distal end side, and a portion of the tube 54 is exposed to the outside of the applicator shaft 2 from the channel tube outlet 56, and is formed inside the applicator shaft 2 at the channel tube inlet 57. Returned to being fixed. The portion between the channel tube outlet 56 and the channel tube inlet 57 constitutes the channel tube 52. At least a portion of the channel tube 52 is made of an elastic, so-called rubber material, and is made of a contractible tube as described above.

The channel tube outlet 56 and the channel tube inlet 57 are provided with a seal structure for keeping watertight inside the channel lumen 55 and outside the applicator shaft 2.

The tube 54 can be advanced and retracted in the channel lumen 55. By pushing the tube 54, a portion of the channel tube 52 can be exposed outside the applicator shaft 2. The tube 54 can be fixed by a fixing tool 62 provided on the applicator grip 61. A tube base 63 is provided at the proximal end of the tube 54.

(Operation) The operation is almost the same as that of the first embodiment, except for the following operation. When preparing for brachytherapy,
The applicator 1 is inserted into the affected area, and the brachytherapy catheter 45 is inserted into the tube 54 of the applicator 1 from the channel tube base 63. Under X-ray fluoroscopy, the tube 54 is advanced and retracted to bend the exposed portion of the channel tube 52 near the electrode 3 so that the brachytherapy catheter 45 is located in the center of the lumen 49. As shown in FIG. 7, the bending of the brachytherapy catheter 45 is
When the bending becomes the same as that of the tube 9, the tube 54 is fixed to the applicator grip 61 by the fixture 62. afterwards,
The brachytherapy catheter 45 is connected to the brachytherapy device main body 36.
To complete preparation for brachytherapy.

Before inserting the applicator 1 into a patient, the tube 54 is advanced and retracted, and the electrode 3 of the applicator 1 is
May be inserted before inserting the applicator 1 into the patient.

(Effects) In addition to the same effects as in the first embodiment, since the electrode 3 of the applicator 1 can be bent before insertion into a patient, insertion into an affected part becomes easy.

<Third Embodiment> A third embodiment of the present invention will be described with reference to FIG. (Construction) A contrast agent injection connector 71 is attached to the coolant IN connector 18 of the applicator 1, and a contrast agent filtering device 72 is attached to the coolant OUT connector 19. The contrast agent injection connector 71 is provided with a syringe taper injection port 73 provided with a check valve (not shown) so that the contrast agent can be injected into the cooling liquid supplied to the applicator 1. I have. Contrast injection connector 71
May be provided not in the coolant IN connector 18 but in a coolant injection tube 43 connecting the coolant IN connector 18 and the applicator shaft 2. Further, the contrast agent filtering device 7
2 may be provided not in the coolant OUT connector 19 but in a coolant recovery tube 44 connecting the applicator shaft 2 and the coolant OUT connector 19. Other configurations are the same as those of any of the above-described embodiments.

(Operation) In this embodiment, the applicator 1
When the position is confirmed in the lumen 49, a contrast agent is injected from the contrast agent injection connector 71 with a syringe or the like. The contrast agent mixes with the cooling water and spreads throughout the applicator 1, so that the position of the applicator 1 and the degree of inflation of the balloon 4 can be confirmed even under fluoroscopy. The contrast agent mixed in the cooling water is filtered by the contrast agent filtering device 72, and only the pure water cooling solution is collected in the thermotherapy device main body 35, and circulates again in the applicator 1.

(Effects) According to this embodiment, in particular, the degree of inflation of the balloon 4 and the position of the applicator 1 can be confirmed under X-ray fluoroscopy, so that the positioning of the applicator 1 becomes easy.

<Fourth Embodiment> A fourth embodiment of the present invention will be described with reference to FIG. (Structure) In this embodiment, the thermal treatment apparatus main body 35, the coolant IN connector 18 of the applicator 1, and the coolant O
Tube portion 81a on the coolant injection side of the coolant relay tube 81 that relays the UT connector 19, respectively.
Is provided with a contrast agent injection connector 71, and a contrast agent filtration device 72 in the tube portion 81b on the coolant discharge side. Other configurations are the same as those of any of the above-described embodiments.

(Operation) In this embodiment, after the cooling fluid relay tube 91 is connected to the thermotherapy apparatus main body 35 and the applicator 1, the operation becomes the same as that of the third embodiment.

(Effects) According to this embodiment, in addition to the same effects as the third embodiment, the contrast agent injection connector 71 and the contrast agent filtration device 72 are separate from the applicator 1, so that the applicator 1 It can be used repeatedly regardless of the number of times it is used.

<Fifth Embodiment> A fifth embodiment of the present invention will be described with reference to FIGS. (Structure) In this embodiment, the thermal treatment apparatus main body 35, the coolant IN connector 18 of the applicator 1, and the coolant O
Coolant relay tube 91 for relaying UT connector 19
Is provided with a forward / backward switching device 92 in the middle of the process. As shown in FIG. 10, the forward / backward switching device 92 is configured to switch the pipeline using four valves 94 to 97. That is, in the coolant relay tube 91, the first valve 94 is provided in the middle of the tube portion 91a on the coolant injection side, and the second valve 95 is provided in the middle of the tube portion 91b on the coolant discharge side. A first conduit 98 connecting the upstream portion of the valve 94 and the upstream portion of the second valve 95, and a first conduit 98 connecting the downstream portion of the first valve 94 and the downstream portion of the second valve 95. 2
The first pipe 98 is provided with a third valve 9.
6 and the second pipe 99 is provided with a fourth valve 97. Each of the valves 94 to 97 may be a stopcock. Other configurations are the same as those of any of the above-described embodiments.

(Operation) In the fifth embodiment, the opening / closing of the valves 94 to 97 of the forward / backward switching device 92 can be operated to change the flow direction of the coolant flowing through the coolant relay tube 91. For example, the first valve 94 and the second valve 94
Of the third valve 96 and the fourth valve 95 are opened.
When the valve 97 is closed, the coolant flows in the direction A (the direction of entering the balloon 4 from the coolant inlet 6 and returning to the applicator shaft 2 from the coolant outlet 7). Also, the first
When the valve 94 and the second valve 95 are closed and the third valve 96 and the fourth valve 97 are opened, the coolant flows into the balloon 4 from the coolant outlet 7 (from the coolant outlet 7 to the coolant inlet 6).
Back into the applicator shaft 2).

(Effects) In this embodiment, since the forward / backward switching device 92 is particularly provided, as in the case where the applicator 1 is inserted upward into the patient, bubbles 100 accumulate near the coolant inlet 6 in the balloon 4. When it is easy (see FIG. 11), if the flow of the cooling liquid is set to the direction B shown in FIG. 10, bubbles hardly accumulate in the balloon 4. Also, as in the case where the applicator 1 is inserted downward into the patient, the air bubbles 1
When the flow of the coolant is in the direction A shown in FIG. 10 when 00 tends to accumulate near the coolant outlet 7 in the balloon 4 (see FIG. 12), the coolant hardly accumulates in the balloon 4. As a result, uneven heating of the affected part due to bubbles can be prevented.

(Supplementary Note) An applicator shaft having flexibility so that it can be inserted into a bent body cavity, a heating electrode provided on the applicator shaft, and a flexible balloon that covers at least a portion of the heating electrode, A channel formed in the applicator shaft for introducing a therapeutic insert, and a tube communicating with the channel, wherein the tube can be deflected outside the center of the applicator shaft within the balloon; A therapeutic insert disposing means for guiding the therapeutic insert inserted through the channel to position the insert outside the applicator shaft. 2. 2. The thermal treatment application according to claim 1, wherein the tube of the treatment insert placement means is formed of a contractible tube, and is usually contracted and stored in a storage space formed in the applicator shaft. Ta. 3. In the first and second paragraphs, the channel is formed of a tube that can advance and retreat with respect to the applicator shaft, and a distal end of the tube for the channel is connected to a tube for the therapeutic insert positioning means. The tube is configured to exit the applicator shaft from the applicator shaft into the balloon space within the balloon and return to the applicator shaft at the distal end. An applicator for hyperthermia, wherein the applicator is offset from the center of the shaft. 4. 3. The applicator for hyperthermia according to paragraphs 1-3, wherein the therapeutic insert is a brachytherapy catheter.

5. A thermotherapy apparatus comprising: a cooling liquid supply line to an applicator; and means for injecting an X-ray opaque agent into the cooling liquid supply line. 6. A thermotherapy apparatus comprising: a cooling liquid relay tube that connects an applicator and a main body of a hyperthermia device; and a means for injecting an X-ray opaque agent into a cooling liquid supply line to the applicator in the cooling liquid relay tube. 7. Item 5. The thermotherapy apparatus according to Item 5 or 6, further comprising a radiopaque agent discharging means. 8. Item 5. The hyperthermia treatment device provided with an X-ray opaque agent filtration means. 9. A thermotherapy device provided with a means for switching a cooling water circulating in an applicator between a forward flow and a backward flow in a coolant supply line.

[0042]

As described above, the present invention provides a channel tube which can be deflected outside the outer peripheral portion of the above-mentioned applicator shaft in a balloon, and guides a treatment insert to the outside of the above-mentioned applicator shaft. Since the insert is positioned at the center, for example, even when the applicator shaft is displaced from the center of the lumen in a bent lumen, the channel tube can be adjusted to be positioned at the center of the lumen, and the channel can be adjusted. The therapeutic insert inserted into the catheter, for example, a brachytherapy catheter is positioned at the center of the bent lumen, and the radiation from the brachytherapy can be uniformly applied to the entire circumferential surface of the lumen. And the combination therapy can be effectively administered.

[Brief description of the drawings]

FIG. 1 (a) is a longitudinal sectional view of an applicator in a thermal treatment apparatus according to a first embodiment, and FIG. 1 (b) is AA in FIG. 1 (a).
Sectional drawing of the part which follows a line.

FIG. 2A is a perspective view of a tip portion of the applicator,
(B) is sectional drawing of the part which follows the BB line in (a).

FIG. 3 is a longitudinal sectional view of a channel tube of the applicator.

FIG. 4 is an explanatory diagram of a schematic configuration of the thermal treatment apparatus according to the first embodiment.

FIG. 5 is an explanatory diagram of a state of use by the applicator.

FIG. 6A is an explanatory view of an applicator of a thermal treatment apparatus according to a second embodiment, and FIG. 6B is a cross-sectional view of a portion along line CC in FIG.

FIG. 7 is an explanatory diagram of a state of use by the applicator.

FIG. 8 is an explanatory view of an applicator of the thermal treatment apparatus according to the third embodiment.

FIG. 9 is an explanatory view of an applicator of the thermal treatment apparatus according to the fourth embodiment.

FIG. 10 is an explanatory view of an applicator of a thermal treatment apparatus according to a fifth embodiment.

FIG. 11 is an explanatory diagram of a use state of the applicator.

FIG. 12 is an explanatory diagram of a use situation of the applicator.

FIG. 13 is an explanatory view of a usage state of a conventional thermal treatment applicator.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Applicator, 2 ... Applicator shaft, 3 ... Intracavity high-frequency electrode, 4 ... Balloon, 6 ... Coolant inlet, 7 ... Coolant outlet, 11 ... Channel, 21 ... Slit-shaped hole,
23 ... channel tube, 45 ... brachytherapy catheter.

Claims (1)

[Claims] 1. An applicator shaft having flexibility so that it can be inserted into a bent body cavity, a heating electrode provided on the applicator shaft, and at least a portion of the heating electrode. A flexible balloon; a channel formed in the applicator shaft for introducing a therapeutic insert; and a tube communicating with the channel, wherein the tube is offset from the center of the applicator shaft in the balloon. A therapeutic insert placement means for guiding the therapeutic insert inserted through the channel to position the insert outside the applicator shaft. Therapeutic applicator.