High dose rate (HDR) brachytherapy technique: For carcinoma of uterine cervix using nucletron applicators

Dosimetric Comparison of Tandem and Ovoids vs. Tandem and Ring for Intracavitary Gynecologic Applications

“…8,9 These include increased patient comfort (because no manipulation of the ovoid placement in fornices is required), applicability in patients with a narrow, proximal vagina or with obliteration of the vaginal fornices, 10 and better repeatability due to a fixed geometry of the ring relative to the tandem. 11 However, these claims of dosimetric identity have not been substantiated in any systematic study. Erickson et al addressed this issue in part in their study, which compared dose distributions of the TR with those of the TO applicator.…”

Evolution of brachytherapy applicators for the treatment of cervical cancer

“…The ring and tandem applicator was developed as an afterloading device. [ 36 37 38 ] Its design was an adaptation of the Stockholm tandem-and-box technique. At that time metallic ring applicators existed in variable diameters (26, 30, 34 mm diameters).…”

Original paper Short-term clinical outcome and dosimetric comparison of tandem and ring versus tandem and ovoids intracavitary applicators

“…The two most common HDR ICBT applicators used in treatment of cervical cancers are the tandem and 2 ovoids (TO) and the tandem and ring (TR) [ 4 ]. TR was introduced after TO to render additional benefits to patients such as increased patient comfort, feasibility in patients with narrow vagina, applicability in women with obliterated vaginal fornices, and improved reproducibility [ 9 , 10 ]. Previous studies have examined the dosimetric profiles of TO and TR via orthogonal radiographs [ 11 ] and computed tomography (CT) images [ 12 ]; however, no correlations have been made in relationship to clinical outcomes such as short-term toxicity.…”