Clinical Practice of Interstitial Thermoradiotherapy

Abstract

Since the beginning of this century radioactive isotopes have been successfully applied in oncology. Initially, radiotherapists used radium implants, but later various refinements of brachytherapy techniques were developed; recently, in response to the need for radiation protection, the “afterloading technique” has been advocated. This technique requires placement of needles or plastic tubes into the target tissue in various geometrical configurations depending on the individual tumor extension. Iridium-192 or iodine-125 isotopes are loaded into these tubes in the form of ribbons, seeds, or malleable wires. When, in the 1970s, it become known that hyperthermia (HT) acts as a cytotoxic agent by itself or synergistically with ionizing radiation, an attempt was made to combine internal heating devices with radioactive implants. External heating devices were shown to be inadequate for the production of uniform temperatures in many body sites, as they lacked sufficient depth penetration, resulting in critical tumor portions not reaching the desired therapeutic temperatures.