US3750653A - Irradiators for treating the body - Google Patents

Irradiators for treating the body Download PDF

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US3750653A
US3750653A US00070311A US3750653DA US3750653A US 3750653 A US3750653 A US 3750653A US 00070311 A US00070311 A US 00070311A US 3750653D A US3750653D A US 3750653DA US 3750653 A US3750653 A US 3750653A
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tube
source
cavity
radioactive
uterus
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US00070311A
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N Simon
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SCHOOL OF MEDICINE UNIVERSITY
SCHOOL OF MEDICINE UNIVERSITY NY US
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/10X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1001X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
    • A61N5/1027Interstitial radiation therapy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M31/00Devices for introducing or retaining media, e.g. remedies, in cavities of the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/10X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1001X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
    • A61N5/1014Intracavitary radiation therapy
    • A61N5/1016Gynaecological radiation therapy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42Gynaecological or obstetrical instruments or methods
    • A61B2017/4216Operations on uterus, e.g. endometrium
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/10X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1001X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
    • A61N5/1007Arrangements or means for the introduction of sources into the body
    • A61N2005/1011Apparatus for permanent insertion of sources
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00Radiation therapy
    • A61N5/10X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1001X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
    • A61N2005/1019Sources therefor
    • A61N2005/1025Wires

Definitions

  • a capsule which comprises a thin-walled narrow tube, on the lead end of which may or may not be provided an elongated and enlarged bulbous body portion.
  • the inner diameter of the lead end of the tube is sufficient to accommodate a source of radioactive material.
  • the tube is arranged so as to permit the insertion of a radio active source into the lead end of the tube through the trailing portion thereof.
  • the outside diameter of the tube is no greater than 2 mm.
  • the portion of the human body may be packed with a number of such capsules. Due to the small internal diameter of the. tube, a radioactive source, whose specific activity is higher than that of radium is implanted in the tube by being introduced through the trailing end thereof.
  • FIG. 2/ /Z'Z QZ MKZ'14 his ATTORNEYS IRRADIATORS FOR TREATING THE BODY
  • This invention relates to the treatment of cancer of the fundus of the uterus and of other portions of the human body. It relates in particular to apparatus and procedure for packing the uterus or other portions of the human body with devices for the treatment of cancer.
  • Heyman applicators are metal cylinders about 8 mm. in diameter and 2 cm. long containing 5 to milligrams of radium in each.
  • the applicator (or irradiator) has a long wire attached to it, and a special introducing apparatus is used to place the applicator into the uterine cavity, leaving the long wire to lie in the vagina.
  • these irradiators as possible are packed into the uterine cavity, usually 6 to 10 of such l-leyman capsules.
  • Such method of treatment of adenocarcinoma of theuterine cavity has been used as the sole form of treatment or as preoperative radiation for adenocarcinoma of the fundus of the uterus.
  • Objects of the present invention include the provision of apparatus and methods by the use of which exposure of operating room personnel is reduced appreciably.
  • Another object is to provide such methods and apparatus by the use of which the operator can insert and implant devices within the body without at the same time being exposed to radiation, and under conditions such that he can employ the usual precision of the surgeon.
  • Still another object of the invention is to avoid the second'operation which has heretofore been necessary to implant the irradiators after diagnosis.
  • Yet another object of this invention is to provide a method and apparatus which use the after loading technique and are adaptable for radiating cancerous cells in or adjacent to any portion of the human body.
  • a further object of this invention is to provide such an after loading apparatus that is significantly smaller than any known in the prior art.
  • Still a further object of this invention is to provide a novel method of inserting the after loading apparatus into certain portions of the human body where cancerous cells are located.
  • Yet a further object of the invention is to provide means for radiation treatment of the uterus without the disadvantages attended with the use of radium.
  • a capsule which is adapted to be inserted into the uterus through the cervical os and retained by the uterus.
  • Such capsule has an elongated and an enlarged bulbous body portion with a cavity therein, the cavity being disposed generally longitudinally within the body. The diameter of the cavity. is sufficient to accommodate a source of radioactive material therein.
  • a thinwalled narrow tube which is arranged coaxially with the cavity so as to permit the insertion of a radioactive source into the cavity through the tube.
  • the capsule and tube are so formed that an array of similar devices may be implanted in the uterus.
  • an important feature of the invention is the outside diameter of the tube, which is not greater than about 2 mm.
  • the radioactive sources then may be'inserted into the respective cavities of an array of said capsules after the capsules are positioned in the uterus.
  • a capsule comprising a thin-walled narrow tube, with or without an elongated and enlarged bulbous body portion attached to the lead end, is provided which is adapted to be inserted in and retained by any portion of the human body.
  • the invention is also adaptable to be used adjacent to diseased portions of the surface of the human body.
  • the outside diameter of the tube is preferably no greater than 2 mm. in diameter.
  • a trailing portion of the tube projects outwardly through the portion of the human body in which the tube is inserted so that a source of radioactive material may be after loaded into the tube, that is, inserted into the tube after it has been placed in proper position.
  • an array of capsules is preferably implanted and retained in the human body portion.
  • an elongated stiffening member is provided in the tube during insertion into the human body portion. After the tube has been implanted the elongated stiffening member is withdrawn and replaced by a preformed elongated member in which is located a radioactive source.
  • the outside diameter of the thin-walled tube is preferably no greater than 2 mm. Because of the small diameter the tubes can easily be inserted and retained by any portion of the human body. Such miniaturization was technically impossible until just recently with the development of radioactive isotopes with a specific activity higher than that of radium. Now very minute portions of radioactive isotopes such as iridium-I92, cesium- 137 and cobalt-60 emit sufficient radiation for the treatment of tumors.
  • FIG. 1 shows a capsule including its appended tube
  • FIG. la is a longitudinal sectional view of a capsule of FIG. I with the intermediate portion of the tube broken away shown on an enlarged scale;
  • FIG. 2 illustrates another tube constructed in accordance with the invention
  • FIG. 2a is a longitudinal sectional view of a capsule of FIG. 2 with the intermediate portion of the tube broken away shown on an enlarged scale;
  • FIG. 3 is a sectional view through the uterus and vagina showing the implantation of one of the capsules;
  • FIG. 4 is a view similar to FIG. 3 but showing the implantation of a number of the capsules
  • FIG. 5 shows the capsules after the insertion of the radioactive sources
  • FIG. 6 shows the type of capsule illustrated in FIG. 2 implanted in the uterus, also including the radioactive sources.
  • FIG. 7 is a perspective view of a thin-walled tube without the bulbous body portion
  • FIG. 8 shows a tube in which an elongated stiffening member has been inserted
  • FIG. 9 is a perspective view of a preformed elongated member including a charge of radioactive isotope in one end thereof;
  • FIG. 10 shows the special adaptation of the tubes for treatment of cancer of the cervix of the uterus, the tubes containing elongated needle members and being used in conjunction with Manchester ovoids;
  • FIG. 11 is similar to FIG. 10 with the elongated stiffening members being replaced by the preformed elongated members containing charges of radioactive isotopes;
  • FIG. 12 shows the position of one tube for treatment of a tumor remote from the surface of the body
  • FIG. 13 shows an array of tubes containing elongated stiffening members for treatment of a tumor remote from the surface of the body
  • FIG. 14 is similar to FIG. 13, however the elongated needle members have been replaced by elongated members containing radioactive charges;
  • FIG. 15 shows an adaptation of the tubes for treatment of a tumor near the surface of the body
  • FIG. 16 is a perspective view of the expanded portion of the trailing end of a tube, the expanded portion containing a hole through which a suture can be passed for connecting the tube to the outer surface of the human body;
  • FIG. 17 is similar to FIG. 16, however the expanded trailing end of the tube includes an annular groove instead of a hole for connecting by suturing the tube to the outer surface of the human body;
  • FIG. 18 shows a tube with a needle inserted therein, an end of which projects through the lead end of the tube for puncturing the skin of the human body and inserting the tube within a human body portion;
  • FIG. 18a shows a tube with a closed sharpened end for puncturing the body
  • FIG. 19 shows the tube being contained within a needle for insertion of the tube into a human body portion
  • FIG. 20 shows the positioning of a tube for treatment of cancer on the surface of the human body.
  • FIG. 21 shows an array of tubes for treating cancer on the surface of the human body.
  • the bulbous body portion suitably constructed of plastic material (such as nylon), is indicated at 10 and has a cavity 11 therein. It is preferably about 6 mm. in diameter and 2 cm. in length, although larger or smaller dimensions, for example, up to about 10 mm. diameter, may be used. It will be noted that, as previously indicated,.the cavity 1 I is elongated in the axial direction of the bulbous portion 10.
  • a thin-walled tube 12 which also may be made of suitable plastic material (such as nylon). As previously suggested, and as explained more fully below, the outside diameter of the tube 12 is of considerable significance.
  • the remote end 15 of the tube 12 is flared to facilitate the insertion therein or .the radiation source as subsequently described.
  • the bulbous body portion 20 is found to have a longer axial dimension, (for example, 4 to 5 cm.) and may be somewhat smaller in diameter (e.g., 3mm.) than the bulbous portion 10 of the device shown in FIG. 1. It is also provided with a connecting tube 22 which has a flared end '25 to facilitate the insertion of the radioactive source.
  • a feature of the bulbous end 20 of the FIG. 2a device is that it is made of a'plasticmaterial which has a memory" so that it will tend to retain a certain predetermined shape after being deformed. The importance of this feature will be explained more fully below. Otherwise, the capsule and tube of FIG. 2 are the same as that of FIG. 1.
  • the cervix Under general anesthesia, the cervix is exposed (as indicated in FIG. 3, but without showing the apparatus used) and is grasped with tanaculum. The area affected by cancer is indicated by the shaded area 28.'The cervix is dilated in a known manner and the uterine cavity is sounded to ascertain its shape and approximate volume. The first of the capsules is then inserted, as indicated in FIG. 3, the bulbous end first by holding its thin tail and pushing the bulbous end as far as possible into the depths of the uterine cavity as shown in FIG. 3.
  • the physician continues to insert as many capsules as the cavity will hold by pushing the bulbous end of each as high as possible into the cavity (as shown in FIG. 4).
  • the semirigidity of the tail or tube 12 will prevent excessive pressure which otherwise could perforate the uterus. After the uterus has been packed with empty capsules, anesthesia may be stopped.
  • Radioactive material 30 is mounted in the end of a thinner plastic tube 31. Prior to use, it is stored in suitable lead shielded receptacles ready for rapid loading into the pre-placed capsules. At the time of irradiation treatment, the radioactive sources are rapidly inserted into the flared ends 15 of the tubes 12. After a suitable time interval for irradiation treatment, the radioactive material is removed from the capsules and tubes may be discarded or sterilized for re-use.
  • the elongated or hockey stick capsules illustrated in FIGS. 2 and 2a may be loaded and charged in a similar manner as illustrated in FIG. 6. It will be observed that after being pushed in the uterus, they assume the shape determined by their elastic memory so as to conform with the contours of uterus walls. It is also significant that, due to the greater length of the hockey stickshaped capsules, the radioactive sources may be arranged in an array within the uterus to provide the desired location and intensity of irradiation. This is indicated by the location of the radioactive source material within the capsules as shown by reference No. 40 in FIG. 6.
  • one of the principal features of the invention is the small outside diameter of tubes 12 and 22.
  • the importance of this feature will now be appreciated since in order to pack the uterus with the desired number of capsules, it will be necessary to have a separate connecting tube for each such capsule within the uterus.
  • the uterine os will tolerate only a certain maximum total cross-sectional area of tubes, so as if the tube diameter is too great it will not be possible to use this type of therapy. I have found that a maximum outside diameter of 2 mm. per tube is consistent with the desired uterine packing without encountering the problem of too great a cross-sectional area of tubes passing through the uterine os.
  • the outside diameter of the tubes 12 and 22 is about l.6 mm. and its inner diameter is about I mm.
  • the capsule in which the radioactive charge is to be inserted is a thin-walled tube 50 that preferably does not include a bulbous portion around its lead end 52.
  • Tube 50 is adaptable for treatment of cancerous tissue in any portion of the human body, and is especially suitable for such use when the outside diameter of tube 50 is no greater than 2 mm.
  • the small size is important for facility of insertion and implantation of the tube and for the elimination of an additional operation procedure.
  • this miniaturization was technically not feasible because of the relatively low specific activity of the known radioactive isotopes and the relatively large amounts that had to be used.
  • very small amounts of isotopes with a higher specific activity are now suffficient for use with the after loading device that is the subject of this invention.
  • Tube 50 preferably includes at its trailing end an expanded bell-shaped portion 54 to promote quick and accurate insertion of elements into tube 50, whereby undue radioactive exposure during the loading step is prevented.
  • Tube 50 is preferably formed of a flexible plastic material and, as illustrated in FIG. 8, an elongated stiffening element 56, which can be an 18 guage needle, is contained in tube 50. Stiffening'element 56 prevents tube 50 from excessive bending or distorting during the implantation process and is formed of a radioactive inert material.
  • X-rays may be taken to determine whether tube 50 has been placed in its proper treatment position. If so, stiffening element 56 is withdrawn by grasping and pulling gripping portion 58.
  • Element 60 includes a gripping end 66 one portion of which is smooth and flat on which can be etched or printed information concerning the isotope, the date the element was charged, and the specific activity of the isotope.
  • FIGS. 10 and 11 show an adaptation of three suchtubes for treatment of cancerous portions, generally designated by numeral 68, of the cervix 70.
  • Tube 50a is inserted through the cervix and into the uterine cavity 72.
  • a collar 74 preferably formed of a plastic material is adjustably positioned along the length of tube 50a to prevent it from puncturing the back wall of the uterus 72.
  • the small size of tube 500 permits the insertion of the single tube without anesthesia having been administered to the patient and eliminates the need for performing the process in an elaborate operating room.
  • Tubes 50b are held in place in the vagina 76 by means of ovoidal elements 78, such as standard Manchester ovoids in which holes have been drilled to receive the the lead ends of tube 50b.
  • the ovoidal elements 78 can be manually grasped and inserted, a feature heretofore considered foolhardy and dangerous because a radioactive charge had to have been placed in the ovoidal elements 78 before their insertion.
  • stiffening elements 56 are contained in each tube 50.
  • the stiffening elements 56 are removed and replaced by preformed elongated members 60, each containing a charge of radioactive isotope 62 as best illustrated in FIG. 11.
  • FIGS. 12 to 14 the adaptation of a tube 50 is illustrated for treatment of a tumor 79 located deep within the human body.
  • a tumor of this type could be unresectable and lying in the retroperitoneal region which is near thepancreas, behind the lining of the abdominal cavity and directly in front of the spine.
  • a surgical wound 80 isinflicted on the patient and extends to the tumor 79 which is notched" at strategic points where tubes 50 are to enter the tumor 79.
  • a tube 50 containing a stiffening member 56 is inserted through wound 80 to a notch" and then pushed into the tumor a distance considered best by the treating physician.
  • FIG. 13 illustrates an array of tubes 50 implanted in such a tumor.
  • the tubes 50 need not be implanted in the tumor 79 itself, but may be placed in or around the tumor within what is called the "target volume, that is, the general area considered by the physician to be best and most effective for treatment of the cancerous portion.
  • FIG. 14 is similar to FIG. 13, however a charge of radioactive isotope 62 has been inserted in a portion of each tube 50 in or near tumor 79.
  • FIG. 15 illustrates a further adaptation of tubes 50 for treatment of a tumor 82 in a portion of the body near its surface, or what may be described as a relatively superficial tumor such as one in the female breast 84.
  • the tumor 82 is normally 1 to 4 cm. deep, thereby a tube of about 2 to 5 cm. long would be used for treatment.
  • a hole 86 or an annular groove 88 may be formed in the expanded bellshaped portion 54 through which a suture may be passed and attached to the skin.
  • FIG. 18 illustrates the use of a standard 18 guage syringe needle in conjunction with a tube 50.
  • the needle 90 whose outside diameter is about 1 mm. is inserted through tubeSO and projects outwardly from its lead end 52.
  • the needle 90 is'then used to puncture the portion of the body to be treated, with needle 90 and tube 50 being pushed in or near the cancerous portion. Needle 90 is then withdrawn and replaced by a preformed member 60 containing a radioactive charge 62 as described above.
  • FIG. 19 illustrates a variation of the insertion technique wherein tube 50 is contained within needle 90, which in this case is preferably a 14 guage needle whose outside diameter is about 2.5 mm. in this latter variation tube 50 would necessarily have to be formed without an expanded bell-shaped portion at its trailing end.
  • FIGS. 20 and 21 A still further adaptation of tube 50 for treating cancerous portions of the body is illustrated in FIGS. 20 and 21.
  • tube 50 instead of being inserted into the body, tube 50 is laid adjacent a surface tumor 92.
  • an array of tubes 50 is laid on the tumor and secured thereto by means of bandages or the like.
  • preformed members 60 containing radioactive charges 62 are inserted into each of the tubes 50.
  • tubes 50 may be used for treating cancer in many other portions of the human body and may be adaptable for use with other specially designed elements.
  • I employ other radioactive material whose specific activity is higher than that of radium.
  • iridium-I92 a radioactive isotope
  • Ir-l92 a radioactive isotope
  • radium can be supplied in a tiny rod 0.3 mm. in diameter and mm. inlength.
  • lts particular gamma radiation makes it suitable as a radium substitute, and its lesser energy makes it easier to shield. [ts half-life of 75 days is long enough to keep lr-l92 clinically useful over a practical period of time and short enough to reduce its hazard in comparison with radium. Y
  • Another suitable type of radiation source is cobalt-6O or cesium-137.
  • a charge having sufficient activity can be mounted in a thin tube which is small enough to avoid rejection by the uterus or discomfort to the patient, which would be caused by larger tubes.
  • Tubes of appropriate size can always be'available for use in the operating room.
  • patients with suspected adenocarcinoma can be spared an extra operating procedure. That is, for treatment of the uterus it may be packed at the time of dilatation and curettage.
  • radioactive material can be inserted through the tubes into the capsules. This insertion is done simply in the patients room with minimum assistance and personnel, rapidly without exposure and painlessly without anesthesia.
  • the elimination of an extra operative procedure in the treatment of adenocarcinoma of the uterus is often very important, for these patients as a group tend to be elderly and may have associated diseases whichmake their operation technically hazardous.
  • a capsuleadapted to be inserted in and retained by the uterus comprising an elongated and enlarged bulbous body portion with a cavity therein, said cavity being disposed generally longitudinally within said body portion and having a diameter sufficient to accommodate a source of radioactive material therein, a thin-walled narrow tube connected to said body portion and arranged coaxially with said cavity so as to permit insertion of a radioactive source into said cavity through said tube, the outside diameter of said tube being not greater than 2 mm. so as to permit said capsule to be retained within and tolerated by the uterus with said tube projecting through the cervical os so that said source may be inserted into the cavity after the capsule is positioned in the uterus.
  • a capsule as described in claim 1 implanted in an array of similar capsules, with respective tubes passing through and tolerated by the cervical os.
  • a device as described in claim 1 in which the tube and the cavity in said bulbous portion have an inside diameter of at least about 1 mm. so as to receive an effective radiation source of iridium-192.
  • a device as described in claim 1 in which said cavity contains as a radioactive source, a charge of radioactive isotope of the group consisting of iridiuml92, cesium-137 and cobalt-60, about 0.3 mm. in diameter and about 15 mm. long implanted in a tube introduced into said cavity through said thin-walled tube.
  • a device adapted to be inserted in and retained by the uterus comprising a thinwalled narrow tube including an inside diameter sufficient to accomodate a source of radioactive material therein and further including an outside diameter not greater than 2 mm. so as to permit the device to be inserted into the uterus without excessive pain and to be tolerated while it remains in the uterus, with the trailing portion of the tube projecting outwardly from the uterus so that the source of radioactive material may be'inserted into the tube after the device is positioned in the uterus.
  • a device in accordance with claim 13 including an elongated stiffening member which is adapted to be inserted into the tube before the latter is inserted into the uterus and withdrawn before the radioactive source is inserted into the tube.
  • the tube contains as a radioactive source a charge of radioactive isotope whose specific activity is higher than radium, implanted in a tube introduced through 10 side diameter small enough to fit within the thin-walled narrow tube and being long enough to reach from the lead end thereof to the open end thereof so that the source may be inserted through the thin-walled tube to a point within the human body.
  • radioactive source is a charge of radioactive isotope whose specific activity is higher than radium.
  • radioactive isotope is of the group consisting of iridium-192, cesium-137 and cobalt-60.
  • the method for treating diseases ofthe uterus which comprises dilating the cervical os, introducing 25 therein the bulbous end of a capsule comprising an elongated and enlarged bulbous body portion with a cavity therein, said cavity being disposed generally longitudinally within said body portion and having a diameter sufficient to accommodate a source of radioactive material therein, said body portion being connected to a thin-walled narrow tube, said tube being arranged coaxially with said cavity so as to permit insertion of a radioactive source into said cavity through said tube, the outside diameter of said tube being small so as to permit said capsule to be retained within and tolerated by the uterus with said tube projecting through the cervical os, leaving said tube lying in the 0s and the vagina introitus, and thereafter introducing a radioactive source to the cavity of said bulbous body through said tube.

Abstract

This application discloses apparatus and a technique for the treatment of cancer of the fundus of the uterus and of other portions of the human body. A capsule is provided which comprises a thin-walled narrow tube, on the lead end of which may or may not be provided an elongated and enlarged bulbous body portion. The inner diameter of the lead end of the tube is sufficient to accommodate a source of radioactive material. The tube is arranged so as to permit the insertion of a radioactive source into the lead end of the tube through the trailing portion thereof. The outside diameter of the tube is no greater than 2 mm. so as to permit the tube to be retained within and tolerated by a portion of the human body into which the tube is to be inserted. Furthermore, due to the aforementioned small diameter of the tube, the portion of the human body may be packed with a number of such capsules. Due to the small internal diameter of the tube, a radioactive source whose specific activity is higher than that of radium is implanted in the tube by being introduced through the trailing end thereof.

Description

United States Patent 1 Simon 1 1 Aug. 7, 1973 [54] IRRADIATORS FOR TREATING THE BODY 3,500,819 3/1970 Silverman 128/1.2
[75] Inventor: Norman Simon, Scarsdale, NY. FOREIGN PATENTS OR APPLICATIONS 73 Assignea Mount Sinai School of Medicine of 193,885 1/1965 Sweden 128/214.4
[63] Continuation-impart of Ser. No. 587,335, Oct. 17,
1966, abandoned.
[52] U.S. Cl. 128/12 [51] Int. Cl. A61] l/00 [58] Field of Search 128/l.l,1.2,130131,
[56] References Cited UNITED STATES PATENTS 2,836,180 5/1958 Strauss, Jr 128/2l4.4 3,370,587 2/1968 Vizcarra 128l2l4.4 3,380,448 4/1968. S adove et a1. 128/348 1,543,859 6/1925 Leman 128/l.2 1,603,767 10/1926 Harris 128/l.l 1,688,245 10/1928 Muir 12811.2 2,429,438 10/1947 Wappler.. 128/1.2 2,546,761 3/1951 Loftus 128/l.2 2,750,517 6/1956 Baum 128/1.2 2,829,636 4/1958 l-lenschke 128/12 3,323,511 6/1967 l-lolter 128/l.2 3,351,049 11/1967 Lawrence 128/1.2
Filed:
Appl. No.: 70,31 1
Sept. 8, 1970 Related U.S. Application Data Primary Examiner-Charles F. Rosenbaum Attorney-Brumbaugh, Graves, Donohue & Raymond [57] ABSTRACT This application discloses apparatus and a technique for the treatment of cancer of the fundus of the uterus and of other portions of the human body. A capsule is provided which comprises a thin-walled narrow tube, on the lead end of which may or may not be provided an elongated and enlarged bulbous body portion. The inner diameter of the lead end of the tube is sufficient to accommodate a source of radioactive material. The tube is arranged so as to permit the insertion of a radio active source into the lead end of the tube through the trailing portion thereof. The outside diameter of the tube is no greater than 2 mm. so as to permit the tube to be retained within and tolerated by a portion of the human body into which the tube is to be inserted. Furthermore, due to the aforementioned small diameter of the tube, the portion of the human body may be packed with a number of such capsules. Due to the small internal diameter of the. tube, a radioactive source, whose specific activity is higher than that of radium is implanted in the tube by being introduced through the trailing end thereof.
25 Claims, 24 Drawing Figures PAIENKD Hm 3.750.853
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SHEET 2 BF 5 INVENTOR, NORMAN SWON jjFa-mznw (5/ K his ATTORNEYS 'PAIENIEW 3.750.653
SHEET 3 0F 5 INVENTOR. NORMAN SIMON his ATTORNEYS PAIENIEM 3,750.653
sum u or 5 I N VEN TOR.
NORMAN :MON BY/CZ QK Lug.
his ATTORNEYS PMENIED 3.750.653
sum 5 er 5 l N VEN TOR.
FIG. 2/ /Z'Z QZ MKZ'14 his ATTORNEYS IRRADIATORS FOR TREATING THE BODY This application is a continuation-in-part of my copending application, Ser. No. 587,335, filed Oct. 17, 1966 and now abandoned.
This invention relates to the treatment of cancer of the fundus of the uterus and of other portions of the human body. It relates in particular to apparatus and procedure for packing the uterus or other portions of the human body with devices for the treatment of cancer.
in the past, the most popular and effective technique for the radiation treatment of cancer of the uterine cavity has been the use of Heyman applicators. These are metal cylinders about 8 mm. in diameter and 2 cm. long containing 5 to milligrams of radium in each. The applicator (or irradiator) has a long wire attached to it, and a special introducing apparatus is used to place the applicator into the uterine cavity, leaving the long wire to lie in the vagina. As many of these irradiators as possible are packed into the uterine cavity, usually 6 to 10 of such l-leyman capsules. Such method of treatment of adenocarcinoma of theuterine cavity has been used as the sole form of treatment or as preoperative radiation for adenocarcinoma of the fundus of the uterus. I
ln'ordinary use, a patient, whose diagnosis of cancer of the uterus has been established by previous dilatation and curettage, is once again anesthetized, and the capsules are inserted one at a time into the uterus through the dilated cervix. Technical difficulty may slow the procedure even in experienced hands, and the radiation exposure to the operators may be high, usually 50 to 100 milliRoentgens (100 mR is the Federal Radiation guide for one weeks exposure). Some of the disadvantages of the Heyman capsules are attributable to the use of radium which has a relatively low specific activity and a relatively high energy. There is also the danger of leakage of radon gas. The low specific activity requires larger size sources to obtain the activity in the area desired, The higher energetic gamma radiation on the other hand makes it difficult to shield for protection. Moreover, its long half-life frequently presents a decontamination problem. Since each capsule contains radium of considerable intensity, there is a quite natural tendency on the part of the operator to work rapidly in order to minimize exposure to himself and to other operating room personnel. Such conditions tend to make for compromises with the ideal therapeutic treatment.
Similar disadvantages were found upon treatment of cancer in portions of the human body other than the uterus, such as the cervix, unresectable masses in the pelvis, abdomen, chest, head, neck, breasts, and other places.
Objects of the present invention, therefore, include the provision of apparatus and methods by the use of which exposure of operating room personnel is reduced appreciably.
Another object is to provide such methods and apparatus by the use of which the operator can insert and implant devices within the body without at the same time being exposed to radiation, and under conditions such that he can employ the usual precision of the surgeon.
Still another object of the invention is to avoid the second'operation which has heretofore been necessary to implant the irradiators after diagnosis.
Yet another object of this invention is to provide a method and apparatus which use the after loading technique and are adaptable for radiating cancerous cells in or adjacent to any portion of the human body.
A further object of this invention is to provide such an after loading apparatus that is significantly smaller than any known in the prior art.
Still a further object of this invention is to provide a novel method of inserting the after loading apparatus into certain portions of the human body where cancerous cells are located.
Yet a further object of the invention is to provide means for radiation treatment of the uterus without the disadvantages attended with the use of radium.
In accordance with the present invention, a capsule is provided which is adapted to be inserted into the uterus through the cervical os and retained by the uterus. Such capsule has an elongated and an enlarged bulbous body portion with a cavity therein, the cavity being disposed generally longitudinally within the body. The diameter of the cavity. is sufficient to accommodate a source of radioactive material therein. Connected with the body and in communication with the cavity there is a thinwalled narrow tube which is arranged coaxially with the cavity so as to permit the insertion of a radioactive source into the cavity through the tube. Preferably, the capsule and tube are so formed that an array of similar devices may be implanted in the uterus. An important feature of the invention, as will appear hereinafter, is the outside diameter of the tube, which is not greater than about 2 mm. In this way a number of such capsules and tubes can be retained within and tolerated by the uterus with said tubes projecting through the cervical os. The radioactive sources then may be'inserted into the respective cavities of an array of said capsules after the capsules are positioned in the uterus.
Also in accordance with the invention a capsule comprising a thin-walled narrow tube, with or without an elongated and enlarged bulbous body portion attached to the lead end, is provided which is adapted to be inserted in and retained by any portion of the human body. The invention is also adaptable to be used adjacent to diseased portions of the surface of the human body. The outside diameter of the tube is preferably no greater than 2 mm. in diameter. A trailing portion of the tube projects outwardly through the portion of the human body in which the tube is inserted so that a source of radioactive material may be after loaded into the tube, that is, inserted into the tube after it has been placed in proper position. As in the previously described adaptation for use in the uterus, an array of capsules is preferably implanted and retained in the human body portion. In one embodiment of the invention an elongated stiffening member is provided in the tube during insertion into the human body portion. After the tube has been implanted the elongated stiffening member is withdrawn and replaced by a preformed elongated member in which is located a radioactive source.
Extremely important to this invention is the fact that the outside diameter of the thin-walled tube is preferably no greater than 2 mm. Because of the small diameter the tubes can easily be inserted and retained by any portion of the human body. Such miniaturization was technically impossible until just recently with the development of radioactive isotopes with a specific activity higher than that of radium. Now very minute portions of radioactive isotopes such as iridium-I92, cesium- 137 and cobalt-60 emit sufficient radiation for the treatment of tumors.
The invention may be readily understood by reference to the appended drawings, in which FIG. 1 shows a capsule including its appended tube;
FIG. la is a longitudinal sectional view of a capsule of FIG. I with the intermediate portion of the tube broken away shown on an enlarged scale;
FIG. 2 illustrates another tube constructed in accordance with the invention;
FIG. 2a is a longitudinal sectional view of a capsule of FIG. 2 with the intermediate portion of the tube broken away shown on an enlarged scale;
FIG. 3 is a sectional view through the uterus and vagina showing the implantation of one of the capsules;
FIG. 4 is a view similar to FIG. 3 but showing the implantation of a number of the capsules;
FIG. 5 shows the capsules after the insertion of the radioactive sources;
FIG. 6 shows the type of capsule illustrated in FIG. 2 implanted in the uterus, also including the radioactive sources. I
'FIG. 7 is a perspective view of a thin-walled tube without the bulbous body portion;
FIG. 8 shows a tube in which an elongated stiffening member has been inserted;
FIG. 9 is a perspective view of a preformed elongated member including a charge of radioactive isotope in one end thereof; I
FIG. 10 shows the special adaptation of the tubes for treatment of cancer of the cervix of the uterus, the tubes containing elongated needle members and being used in conjunction with Manchester ovoids;
FIG. 11 is similar to FIG. 10 with the elongated stiffening members being replaced by the preformed elongated members containing charges of radioactive isotopes;
FIG. 12 shows the position of one tube for treatment of a tumor remote from the surface of the body;
FIG. 13 showsan array of tubes containing elongated stiffening members for treatment of a tumor remote from the surface of the body; 7
FIG. 14 is similar to FIG. 13, however the elongated needle members have been replaced by elongated members containing radioactive charges;
FIG. 15 shows an adaptation of the tubes for treatment of a tumor near the surface of the body;
FIG. 16 is a perspective view of the expanded portion of the trailing end of a tube, the expanded portion containing a hole through which a suture can be passed for connecting the tube to the outer surface of the human body;
FIG. 17 is similar to FIG. 16, however the expanded trailing end of the tube includes an annular groove instead of a hole for connecting by suturing the tube to the outer surface of the human body;
FIG. 18 shows a tube with a needle inserted therein, an end of which projects through the lead end of the tube for puncturing the skin of the human body and inserting the tube within a human body portion;
FIG. 18a shows a tube with a closed sharpened end for puncturing the body;
FIG. 19 showsthe tube being contained within a needle for insertion of the tube into a human body portion;
FIG. 20 shows the positioning of a tube for treatment of cancer on the surface of the human body; and
FIG. 21 shows an array of tubes for treating cancer on the surface of the human body.
Referring then to FIGS. 1 and la, the bulbous body portion, suitably constructed of plastic material (such as nylon), is indicated at 10 and has a cavity 11 therein. It is preferably about 6 mm. in diameter and 2 cm. in length, although larger or smaller dimensions, for example, up to about 10 mm. diameter, may be used. It will be noted that, as previously indicated,.the cavity 1 I is elongated in the axial direction of the bulbous portion 10.
Inserted within the cavity 11, there is a thin-walled tube 12 which also may be made of suitable plastic material (such as nylon). As previously suggested, and as explained more fully below, the outside diameter of the tube 12 is of considerable significance. The remote end 15 of the tube 12 is flared to facilitate the insertion therein or .the radiation source as subsequently described.
Referring now to FIGS. 2 and 2a, the bulbous body portion 20 is found to have a longer axial dimension, (for example, 4 to 5 cm.) and may be somewhat smaller in diameter (e.g., 3mm.) than the bulbous portion 10 of the device shown in FIG. 1. It is also provided with a connecting tube 22 which has a flared end '25 to facilitate the insertion of the radioactive source. A feature of the bulbous end 20 of the FIG. 2a device is that it is made of a'plasticmaterial which has a memory" so that it will tend to retain a certain predetermined shape after being deformed. The importance of this feature will be explained more fully below. Otherwise, the capsule and tube of FIG. 2 are the same as that of FIG. 1.
The manner of insertingthe devices of the invention will now be described. Under general anesthesia, the cervix is exposed (as indicated in FIG. 3, but without showing the apparatus used) and is grasped with tanaculum. The area affected by cancer is indicated by the shaded area 28.'The cervix is dilated in a known manner and the uterine cavity is sounded to ascertain its shape and approximate volume. The first of the capsules is then inserted, as indicated in FIG. 3, the bulbous end first by holding its thin tail and pushing the bulbous end as far as possible into the depths of the uterine cavity as shown in FIG. 3. Thereafter, the physician continues to insert as many capsules as the cavity will hold by pushing the bulbous end of each as high as possible into the cavity (as shown in FIG. 4). The semirigidity of the tail or tube 12 will prevent excessive pressure which otherwise could perforate the uterus. After the uterus has been packed with empty capsules, anesthesia may be stopped.
Radioactive material 30 is mounted in the end of a thinner plastic tube 31. Prior to use, it is stored in suitable lead shielded receptacles ready for rapid loading into the pre-placed capsules. At the time of irradiation treatment, the radioactive sources are rapidly inserted into the flared ends 15 of the tubes 12. After a suitable time interval for irradiation treatment, the radioactive material is removed from the capsules and tubes may be discarded or sterilized for re-use.
The elongated or hockey stick capsules illustrated in FIGS. 2 and 2a may be loaded and charged in a similar manner as illustrated in FIG. 6. It will be observed that after being pushed in the uterus, they assume the shape determined by their elastic memory so as to conform with the contours of uterus walls. It is also significant that, due to the greater length of the hockey stickshaped capsules, the radioactive sources may be arranged in an array within the uterus to provide the desired location and intensity of irradiation. This is indicated by the location of the radioactive source material within the capsules as shown by reference No. 40 in FIG. 6.
As previously indicated, one of the principal features of the invention is the small outside diameter of tubes 12 and 22. The importance of this feature will now be appreciated since in order to pack the uterus with the desired number of capsules, it will be necessary to have a separate connecting tube for each such capsule within the uterus. The uterine os, however, will tolerate only a certain maximum total cross-sectional area of tubes, so as if the tube diameter is too great it will not be possible to use this type of therapy. I have found that a maximum outside diameter of 2 mm. per tube is consistent with the desired uterine packing without encountering the problem of too great a cross-sectional area of tubes passing through the uterine os. Preferably, the outside diameter of the tubes 12 and 22 is about l.6 mm. and its inner diameter is about I mm.
Now, referring to FIGS. 7 and 8, the capsule in which the radioactive charge is to be inserted is a thin-walled tube 50 that preferably does not include a bulbous portion around its lead end 52. Tube 50 is adaptable for treatment of cancerous tissue in any portion of the human body, and is especially suitable for such use when the outside diameter of tube 50 is no greater than 2 mm. The small size is important for facility of insertion and implantation of the tube and for the elimination of an additional operation procedure. Until just recently this miniaturization was technically not feasible because of the relatively low specific activity of the known radioactive isotopes and the relatively large amounts that had to be used. However, very small amounts of isotopes with a higher specific activity, as will be described below, are now suffficient for use with the after loading device that is the subject of this invention.
Tube 50 preferably includes at its trailing end an expanded bell-shaped portion 54 to promote quick and accurate insertion of elements into tube 50, whereby undue radioactive exposure during the loading step is prevented. Tube 50 is preferably formed of a flexible plastic material and, as illustrated in FIG. 8, an elongated stiffening element 56, which can be an 18 guage needle, is contained in tube 50. Stiffening'element 56 prevents tube 50 from excessive bending or distorting during the implantation process and is formed of a radioactive inert material. After tube 50 containing stiffening element 56 is implanted, X-rays may be taken to determine whether tube 50 has been placed in its proper treatment position. If so, stiffening element 56 is withdrawn by grasping and pulling gripping portion 58.
The after loading process is completed by inserting through tube 50 a preformed sealed elongated element 60 which contains a charge of radioactive isotope as indicated by shaded portion 62, best illustrated in FIG. 9. Element 60 includes a gripping end 66 one portion of which is smooth and flat on which can be etched or printed information concerning the isotope, the date the element was charged, and the specific activity of the isotope.
One example of the wide variety of uses to which tube 50 may be put is illustrated in FIGS. 10 and 11 which show an adaptation of three suchtubes for treatment of cancerous portions, generally designated by numeral 68, of the cervix 70. Tube 50a is inserted through the cervix and into the uterine cavity 72. A collar 74 preferably formed of a plastic material is adjustably positioned along the length of tube 50a to prevent it from puncturing the back wall of the uterus 72. The small size of tube 500 permits the insertion of the single tube without anesthesia having been administered to the patient and eliminates the need for performing the process in an elaborate operating room.
Tubes 50b are held in place in the vagina 76 by means of ovoidal elements 78, such as standard Manchester ovoids in which holes have been drilled to receive the the lead ends of tube 50b. The ovoidal elements 78 can be manually grasped and inserted, a feature heretofore considered foolhardy and dangerous because a radioactive charge had to have been placed in the ovoidal elements 78 before their insertion. As described above stiffening elements 56 are contained in each tube 50.
After X-rays confirm the proper location of the tubes 50 in relation to the cancerous area 68, the stiffening elements 56 are removed and replaced by preformed elongated members 60, each containing a charge of radioactive isotope 62 as best illustrated in FIG. 11.
In FIGS. 12 to 14 the adaptation of a tube 50 is illustrated for treatment of a tumor 79 located deep within the human body. A tumor of this type could be unresectable and lying in the retroperitoneal region which is near thepancreas, behind the lining of the abdominal cavity and directly in front of the spine. A surgical wound 80 isinflicted on the patient and extends to the tumor 79 which is notched" at strategic points where tubes 50 are to enter the tumor 79. A tube 50 containing a stiffening member 56 is inserted through wound 80 to a notch" and then pushed into the tumor a distance considered best by the treating physician. FIG. 13 illustrates an array of tubes 50 implanted in such a tumor.
The tubes 50 need not be implanted in the tumor 79 itself, but may be placed in or around the tumor within what is called the "target volume, that is, the general area considered by the physician to be best and most effective for treatment of the cancerous portion. FIG. 14 is similar to FIG. 13, however a charge of radioactive isotope 62 has been inserted in a portion of each tube 50 in or near tumor 79.
FIG. 15 illustrates a further adaptation of tubes 50 for treatment of a tumor 82 in a portion of the body near its surface, or what may be described as a relatively superficial tumor such as one in the female breast 84. In this case the tumor 82 is normally 1 to 4 cm. deep, thereby a tube of about 2 to 5 cm. long would be used for treatment. Because of the relatively short length of the tubes and of the various angles at which the tubes may be implanted, it may be desirable to attach the tubes 50 to the skin of the breast to prevent them from falling out during treatment. As illustrated in FIGS. 16 and 17, respectively, a hole 86 or an annular groove 88 may be formed in the expanded bellshaped portion 54 through which a suture may be passed and attached to the skin.
The implantation procedure is similar to those described above, except for the preferable technique used for insertion of tubes 50. A surgical wound may be utilized, however, a simpler and quicker procedure may be desirable such as that now used in the insertion of catheters into blood vessels of the human body. FIG. 18 illustrates the use of a standard 18 guage syringe needle in conjunction with a tube 50. The needle 90 whose outside diameter is about 1 mm. is inserted through tubeSO and projects outwardly from its lead end 52. The needle 90 is'then used to puncture the portion of the body to be treated, with needle 90 and tube 50 being pushed in or near the cancerous portion. Needle 90 is then withdrawn and replaced by a preformed member 60 containing a radioactive charge 62 as described above. For puncturing and inserting a tube 50 into certain portions of the human body, lead end 52 need not be open but can be closed, as illustrated in H6. 18a, and provided with a relatively sharp end. Either a stiffening element 56 or a needle 90 can be contained within tube 50 during insertion. FIG. 19 illustrates a variation of the insertion technique wherein tube 50 is contained within needle 90, which in this case is preferably a 14 guage needle whose outside diameter is about 2.5 mm. in this latter variation tube 50 would necessarily have to be formed without an expanded bell-shaped portion at its trailing end.
A still further adaptation of tube 50 for treating cancerous portions of the body is illustrated in FIGS. 20 and 21. Here, instead of being inserted into the body, tube 50 is laid adjacent a surface tumor 92. As in treatment of tumors in other locations an array of tubes 50 is laid on the tumor and secured thereto by means of bandages or the like. Then, preformed members 60 containing radioactive charges 62 are inserted into each of the tubes 50. Obviously, tubes 50 may be used for treating cancer in many other portions of the human body and may be adaptable for use with other specially designed elements.
Within the restrictions of the internal diameter of such a small tube, it is not possible to use radium as a radioactive source. This is due to the lower specific activity of rad'ium'which requires that sources having larger physical dimensions be used. Accordingly, in accordance with the present invention I employ other radioactive material whose specific activity is higher than that of radium. Preferably, iridium-I92, a radioactive isotope, is used. This may be mounted at the tip of a thin nylon tube (slightly less than the internal diameter of thetubes l2 and 22). The activity of Ir-l92 is such that a sufficiently active source may be mounted in such a thin tube. Iridium-192 has the advantage of a high specific activity so that the equivalent of 5 mgm. of radium can be supplied in a tiny rod 0.3 mm. in diameter and mm. inlength. lts particular gamma radiation makes it suitable as a radium substitute, and its lesser energy makes it easier to shield. [ts half-life of 75 days is long enough to keep lr-l92 clinically useful over a practical period of time and short enough to reduce its hazard in comparison with radium. Y
Another suitable type of radiation source is cobalt-6O or cesium-137. With each of such radiation sources, a charge having sufficient activity can be mounted in a thin tube which is small enough to avoid rejection by the uterus or discomfort to the patient, which would be caused by larger tubes.
When the operator inserts the radioactive source into the blank tubes, he may do so with the usual precision of the surgeon and without haste which might be caused by working under conditions of harmful radiation. Correction and repeated checks of the position of the tubes are feasible as by X-ray.
Tubes of appropriate size can always be'available for use in the operating room. As a result, patients with suspected adenocarcinoma can be spared an extra operating procedure. That is, for treatment of the uterus it may be packed at the time of dilatation and curettage. The following day if the biopsy proves cancer to be present, radioactive material can be inserted through the tubes into the capsules. This insertion is done simply in the patients room with minimum assistance and personnel, rapidly without exposure and painlessly without anesthesia. The elimination of an extra operative procedure in the treatment of adenocarcinoma of the uterus is often very important, for these patients as a group tend to be elderly and may have associated diseases whichmake their operation technically hazardous.
I claim:
l. A capsuleadapted to be inserted in and retained by the uterus, comprising an elongated and enlarged bulbous body portion with a cavity therein, said cavity being disposed generally longitudinally within said body portion and having a diameter sufficient to accommodate a source of radioactive material therein, a thin-walled narrow tube connected to said body portion and arranged coaxially with said cavity so as to permit insertion of a radioactive source into said cavity through said tube, the outside diameter of said tube being not greater than 2 mm. so as to permit said capsule to be retained within and tolerated by the uterus with said tube projecting through the cervical os so that said source may be inserted into the cavity after the capsule is positioned in the uterus.
2. A capsule as described in claim 1, implanted in an array of similar capsules, with respective tubes passing through and tolerated by the cervical os.
3. A device as described in claim 1 in which the tube outside diameter is about l.6 mm.
4. A device as described in claim 1 in which the tube and the cavity in said bulbous portion have an inside diameter of at least about 1 mm. so as to receive an effective radiation source of iridium-192.
5. A device as described in claim 1 in which said tube is made of nylon.
6. A device as described in claim 1 in which the outside diameter of said bulbous portion is about 6 10 mm.
7. A device as described in claim 1 in which said cavity contains as a radioactive source, a charge of radioactive isotope of the group consisting of iridiuml92, cesium-137 and cobalt-60, about 0.3 mm. in diameter and about 15 mm. long implanted in a tube introduced into said cavity through said thin-walled tube.
8. A device as described in claim 1 in which said bulbous portion is about 3 mm. outside diameter and 4 to 5 cm. long, is normally'curved substantially to conform to the shape of the inside wall of the uterus, and has an elastic memory.
9. The combination of the capsule described in claim 1 and a radioactive source having dimensions adapted to fit within said cavity in said bulbous body portion of said capsule, said source being mounted at the end of a long tube or rod having an outside diameter small enough to fit within said thin-walled narrow tube and long enough to reach from said cavity to the open end of said last-mentioned tube so that said source may be inserted through said last-mentioned tube into said cavity.
10. The combination described in claim 9 in which said source is a charge of radioactive isotope whose specific activity is greater than that of radium.
11. The combination described in claim 10 in which said source is a charge of radioactive isotope of the group consisting of iridium-192, cesium-I37 and cobah-60.
12. The combination described in claim 11 in which said source has an outside diameter of about 0.3 mm. and a length of about mm.
13. A device adapted to be inserted in and retained by the uterus, comprising a thinwalled narrow tube including an inside diameter sufficient to accomodate a source of radioactive material therein and further including an outside diameter not greater than 2 mm. so as to permit the device to be inserted into the uterus without excessive pain and to be tolerated while it remains in the uterus, with the trailing portion of the tube projecting outwardly from the uterus so that the source of radioactive material may be'inserted into the tube after the device is positioned in the uterus.
14. Devices in accordance with claim 13 implanted in an array with respective tubes being retained in and tolerated by the uterus.
15. A device in accordance with claim 13 including an elongated stiffening member which is adapted to be inserted into the tube before the latter is inserted into the uterus and withdrawn before the radioactive source is inserted into the tube.
16. A device in accordance with claim 13 wherein the outside diameter of the tube is about 1.6 mm.
17. A device in accordance with claim 13 wherein the inside diameter of the tube is at least about 1 mm.
so as to receive an effective radioactive source.
18. A device in accordance with claim 13 wherein the tube is made of nylon.
19. A device in accordance with claim 13 wherein the tube contains as a radioactive source a charge of radioactive isotope whose specific activity is higher than radium, implanted in a tube introduced through 10 side diameter small enough to fit within the thin-walled narrow tube and being long enough to reach from the lead end thereof to the open end thereof so that the source may be inserted through the thin-walled tube to a point within the human body.
22. The combination in accordance with claim 21 wherein the radioactive source is a charge of radioactive isotope whose specific activity is higher than radium.
23. The combination in accordance with claim 22 wherein the charge of radioactive isotope is of the group consisting of iridium-192, cesium-137 and cobalt-60.
24. The method for treating diseases ofthe uterus which comprises dilating the cervical os, introducing 25 therein the bulbous end of a capsule comprising an elongated and enlarged bulbous body portion with a cavity therein, said cavity being disposed generally longitudinally within said body portion and having a diameter sufficient to accommodate a source of radioactive material therein, said body portion being connected to a thin-walled narrow tube, said tube being arranged coaxially with said cavity so as to permit insertion of a radioactive source into said cavity through said tube, the outside diameter of said tube being small so as to permit said capsule to be retained within and tolerated by the uterus with said tube projecting through the cervical os, leaving said tube lying in the 0s and the vagina introitus, and thereafter introducing a radioactive source to the cavity of said bulbous body through said tube.
25. The method as described in claim 24 in which the implantation of capsules is repeated until the uterine cavity is substantially filled, and multiple implantations of radioactive sources are made through respective tubes.

Claims (25)

1. A capsule adapted to be inserted in and retained by the uterus, comprising an elongated and enlarged bulbous body portion with a cavity therein, said cavity being disposed generally longitudinally within said body portion and having a diameter sufficient to accommodate a source of radioactive material therein, a thin-walled narrow tube connected to said body portion and arranged coaxially with said cavity so as to permit insertion of a radioactive source into said cavity through said tube, the outside diameter of said tube being not greater than 2 mm. so as to permit said capsule to be retained within and tolerated by the uterus with said tube projecting through the cervical os so that said source may be inserted into the cavity after the capsule is positioned in the uterus.
2. A capsule as described in claim 1, implanted in an array of similar capsules, with respective tubes passing through and tolerated by the cervical os.
3. A device as described in claim 1 in which the tube outside diameter is about 1.6 mm.
4. A device as described in claim 1 in which the tube and the cavity in said bulbous portion have an inside diameter of at least about 1 mm. so as to receive an effective radiation source of iridium-192.
5. A device as described in claim 1 in which said tube is made of nylon.
6. A device as described in claim 1 in which the outside diameter of said bulbous portion is about 6 - 10 mm.
7. A device as described in claim 1 in which said cavity contains as a radioactive source, a charge of radioactive isotope of the group consisting of iridium-192, cesium-137 and cobalt-60, about 0.3 mm. in diameter and about 15 mm. long implanted in a tube introduced into said cavity through said thin-walled tube.
8. A device as described in claim 1 in which said bulbous portion is about 3 mm. outside diameter and 4 to 5 cm. long, is normally curved substantially to conform to the shape of the inside wall of the uterus, and has an elastic memory.
9. The combination of the capsule described in claim 1 and a radioactive source having dimensions adapted to fit within said cavity in said bulbous body portion of said capsule, said source being mounted at the end of a long tube or rod having an outside diameter small enough to fit within said thin-walled narrow tube and long enough to reach from said cavity to the open end of said last-mentioned tube so that said source may be inserted through said last-mentioned tube into said cavity.
10. The combination described in claim 9 in which said source is a charge of radioactive isotope whose specific activity is greater than that of radium.
11. The combination described in claim 10 in which said source is a charge of radioactive isotope of the group consisting of iridium-192, cesium-137 and cobalt-60.
12. The combination described in claim 11 in which said source has an outside diameter of about 0.3 mm. and a length of about 15 mm.
13. A device adapted to be inserted in and retained by the uterus, comprising a thin-walled narrow tube including an inside diameter sufficient to accomodate a source of radioactive material therein and further including an outside diameter not greater than 2 mm. so as to permit the device to be inserted into the uterus without excessive pain and to be tolerated while it remains in the uterus, with the trailing portion of the tube projecting outwardly from the uterus so that the source of radioactive material may be inserted into the tube after the device is positioned in the uterus.
14. Devices in accordance with claim 13 implanted in an array with respective tubes being retained in and tolerated by the uterus.
15. A device in accordance with claim 13 including an elongated stiffening member which is adapted to be inserted into the tube before the latter is inserted into the uterus and withdrawn before the radioactive source is inserted into the tube.
16. A device in accordance with claim 13 wherein the outside diameter of the tube is about 1.6 mm.
17. A device in accordance with claim 13 wherein the inside diameter of the tube is at least about 1 mm. so as to receive an effective radioactive source.
18. A device in accordance with claim 13 wherein the tube is made of nylon.
19. A device in accordance with claim 13 wherein the tube contains as a radioactive source a charge of radioactive isotope whose specific activity is higher than radium, implanted in a tube introduced through the Trailing end of the thin-walled tube.
20. A device in accordance with claim 19 wherein the charge of radioactive isotope is a member of the group consisting of iridium-192, cesium-137 and cobalt-60.
21. The combination of the device described in claim 13 and a radioactive source having dimensions adapted to fit within the thin-walled tube, the source being mounted at the end of a long tube or rod having an outside diameter small enough to fit within the thin-walled narrow tube and being long enough to reach from the lead end thereof to the open end thereof so that the source may be inserted through the thin-walled tube to a point within the human body.
22. The combination in accordance with claim 21 wherein the radioactive source is a charge of radioactive isotope whose specific activity is higher than radium.
23. The combination in accordance with claim 22 wherein the charge of radioactive isotope is of the group consisting of iridium-192, cesium-137 and cobalt-60.
24. The method for treating diseases of the uterus which comprises dilating the cervical os, introducing therein the bulbous end of a capsule comprising an elongated and enlarged bulbous body portion with a cavity therein, said cavity being disposed generally longitudinally within said body portion and having a diameter sufficient to accommodate a source of radioactive material therein, said body portion being connected to a thin-walled narrow tube, said tube being arranged coaxially with said cavity so as to permit insertion of a radioactive source into said cavity through said tube, the outside diameter of said tube being small so as to permit said capsule to be retained within and tolerated by the uterus with said tube projecting through the cervical os, leaving said tube lying in the os and the vagina introitus, and thereafter introducing a radioactive source to the cavity of said bulbous body through said tube.
25. The method as described in claim 24 in which the implantation of capsules is repeated until the uterine cavity is substantially filled, and multiple implantations of radioactive sources are made through respective tubes.
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Cited By (67)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4096862A (en) * 1976-05-17 1978-06-27 Deluca Salvatore A Locating of tubes in the human body
US4167179A (en) * 1977-10-17 1979-09-11 Mark Kirsch Planar radioactive seed implanter
US4706652A (en) * 1985-12-30 1987-11-17 Henry Ford Hospital Temporary radiation therapy
US4754745A (en) * 1984-11-21 1988-07-05 Horowitz Bruce S Conformable sheet material for use in brachytherapy
US4763642A (en) * 1986-04-07 1988-08-16 Horowitz Bruce S Intracavitational brachytherapy
EP0292630A1 (en) * 1984-11-21 1988-11-30 Bruce S. Dr. Horowitz Radiation therapy delivery systems
DE3823604A1 (en) * 1988-06-23 1990-01-18 Nii Medicinskoj Radiologii Aka Device for the intracavitary radiation therapy of malignant rectal tumours
WO1990003827A1 (en) * 1988-10-07 1990-04-19 Hayman Michael H Apparatus for in situ radiotherapy
US4998912A (en) * 1989-03-02 1991-03-12 Board Of Regents, The University Of Texas System Diverging gynecological template
WO1992000776A1 (en) * 1990-07-13 1992-01-23 Mallinckrodt Medical, Inc. Device for introducing a radioactive source into the body
US5183455A (en) * 1988-10-07 1993-02-02 Omnitron International, Inc. Apparatus for in situ radiotherapy
US5277201A (en) * 1992-05-01 1994-01-11 Vesta Medical, Inc. Endometrial ablation apparatus and method
WO1994026205A1 (en) * 1993-05-06 1994-11-24 Kernforschungszentrum Karlsruhe Gmbh Vascular implant
US5443470A (en) * 1992-05-01 1995-08-22 Vesta Medical, Inc. Method and apparatus for endometrial ablation
US5562720A (en) * 1992-05-01 1996-10-08 Vesta Medical, Inc. Bipolar/monopolar endometrial ablation device and method
US5882290A (en) * 1996-02-29 1999-03-16 Scimed Life Systems, Inc. Intravascular radiation delivery system
US6019718A (en) * 1997-05-30 2000-02-01 Scimed Life Systems, Inc. Apparatus for intravascular radioactive treatment
US6036631A (en) * 1998-03-09 2000-03-14 Urologix, Inc. Device and method for intracavitary cancer treatment
US6060036A (en) * 1998-02-09 2000-05-09 Implant Sciences Corporation Radioactive seed implants
US6059812A (en) * 1997-03-21 2000-05-09 Schneider (Usa) Inc. Self-expanding medical device for centering radioactive treatment sources in body vessels
US6059713A (en) * 1997-03-06 2000-05-09 Scimed Life Systems, Inc. Catheter system having tubular radiation source with movable guide wire
US6071227A (en) * 1993-07-01 2000-06-06 Schneider (Europe) A.G. Medical appliances for the treatment of blood vessels by means of ionizing radiation
US6099454A (en) * 1996-02-29 2000-08-08 Scimed Life Systems, Inc. Perfusion balloon and radioactive wire delivery system
US6102844A (en) * 1995-12-18 2000-08-15 Kerisma Medical Products, L.L.C. Fiberoptic-guided interstitial seed manual applicator and seed cartridge
US6110097A (en) * 1997-03-06 2000-08-29 Scimed Life Systems, Inc. Perfusion balloon catheter with radioactive source
US6146322A (en) * 1995-12-05 2000-11-14 Schneider (Europe) Ag Irradiating filament and method of making same
US6203485B1 (en) 1999-10-07 2001-03-20 Scimed Life Systems, Inc. Low attenuation guide wire for intravascular radiation delivery
US6231494B1 (en) 1994-06-10 2001-05-15 Schneider (Europe) A.G. Medical device with radiation source
US6234951B1 (en) 1996-02-29 2001-05-22 Scimed Life Systems, Inc. Intravascular radiation delivery system
US6258019B1 (en) 1997-09-26 2001-07-10 Scimed Life Systems, Inc. Catheter for intraluminal treatment of a vessel segment with ionizing radiation
US6264596B1 (en) 1997-11-03 2001-07-24 Meadox Medicals, Inc. In-situ radioactive medical device
US6302865B1 (en) 2000-03-13 2001-10-16 Scimed Life Systems, Inc. Intravascular guidewire with perfusion lumen
US6352501B1 (en) 1999-09-23 2002-03-05 Scimed Life Systems, Inc. Adjustable radiation source
US6398708B1 (en) 1996-02-29 2002-06-04 Scimed Life Systems, Inc. Perfusion balloon and radioactive wire delivery system
US6398709B1 (en) 1999-10-19 2002-06-04 Scimed Life Systems, Inc. Elongated member for intravascular delivery of radiation
US6413203B1 (en) 1998-09-16 2002-07-02 Scimed Life Systems, Inc. Method and apparatus for positioning radioactive fluids within a body lumen
US6416457B1 (en) 2000-03-09 2002-07-09 Scimed Life Systems, Inc. System and method for intravascular ionizing tandem radiation therapy
US6616629B1 (en) 1994-06-24 2003-09-09 Schneider (Europe) A.G. Medical appliance with centering balloon
US6676590B1 (en) 1997-03-06 2004-01-13 Scimed Life Systems, Inc. Catheter system having tubular radiation source
WO2004024236A1 (en) * 2002-09-10 2004-03-25 Curay Medical, Inc Brachytherapy apparatus
US20040176302A1 (en) * 2001-05-01 2004-09-09 Rodgers Kathleen E. Methods for inhibiting tumor cell proliferation
US20070106108A1 (en) * 2005-11-10 2007-05-10 Hermann George D Brachytherapy Apparatus and Methods for Using Them
US20070153954A1 (en) * 2004-05-05 2007-07-05 Actinium Pharmaceuticals, Inc. Radium target and method for producing it
US20070167664A1 (en) * 2005-10-31 2007-07-19 Hermann George D Brachytherapy apparatus and methods of using same
WO2008020931A2 (en) * 2006-08-08 2008-02-21 Peak Biosciences, Inc. Device for delivery of anti-cancer agents to tissue
US20080064916A1 (en) * 2006-06-21 2008-03-13 Mick Felix W Split-ring brachytherapy device and method for cervical brachytherapy treatment using a split-ring brachytherapy device
US20080091055A1 (en) * 2006-10-08 2008-04-17 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US20080146863A1 (en) * 2004-07-26 2008-06-19 Stillwagon Gary B Internal radiation therapy device
US20080221384A1 (en) * 2006-06-02 2008-09-11 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US20090157145A1 (en) * 2007-11-26 2009-06-18 Lawrence Cauller Transfer Coil Architecture
US20090156882A1 (en) * 2007-12-16 2009-06-18 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US20090157142A1 (en) * 2007-11-26 2009-06-18 Microtransponder Inc. Implanted Driver with Charge Balancing
US20090191122A1 (en) * 2006-02-21 2009-07-30 Actinium Pharmaceuticals Inc. Method for purification of 225ac from irradiated 226ra-targets
US20090198293A1 (en) * 2003-12-19 2009-08-06 Lawrence Cauller Microtransponder Array for Implant
US20090264696A1 (en) * 2004-11-05 2009-10-22 Theragenics Corporation Expandable brachytherapy device
US20100004705A1 (en) * 2008-07-02 2010-01-07 Microtransponder Inc. Systems, Methods and Devices for Treating Tinnitus
US20100022908A1 (en) * 2003-12-19 2010-01-28 Board Of Regents, The University Of Texas System System and Method for Interfacing Cellular Matter with a Machine
US20100048978A1 (en) * 2008-08-18 2010-02-25 Cianna Medical, Inc. Brachytherapy apparatus, systems, and methods for using them
US20100069994A1 (en) * 2007-06-25 2010-03-18 Microtransponder, Inc. Methods of inducing paresthesia using wireless neurostimulation
US7887476B2 (en) 2005-11-10 2011-02-15 Cianna Medical, Inc. Helical brachytherapy apparatus and methods of using same
US20110230700A1 (en) * 2010-03-18 2011-09-22 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
WO2012013229A1 (en) * 2010-07-28 2012-02-02 Fondazione Irccs Therapeutic agent, composition including said agent, implantable device and process for the treatment of cervical cancer and/or for the prevention of the formation of neoplasms in correspondence of the cervix in a human female genital system.
US8457757B2 (en) 2007-11-26 2013-06-04 Micro Transponder, Inc. Implantable transponder systems and methods
US8715598B2 (en) 2006-09-08 2014-05-06 Actinium Pharmaceuticals Inc. Method for the purification of radium from different sources
US9067063B2 (en) 2010-11-03 2015-06-30 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
CN103096873B (en) * 2010-07-28 2016-11-30 Irccs国立肿瘤研究所基金会 For treating cervical cancer and/or the therapeutic agent formed for prophylaxis of tumours, comprising the compositions of described therapeutic agent, implantable device and method in the cervix uteri of people's female reproductive system
US9883919B2 (en) 2010-07-21 2018-02-06 Cianna Medical, Inc. Brachytherapy apparatus, systems, and methods for using them

Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1543859A (en) * 1922-10-27 1925-06-30 United States Radium Corp Radium therapeutic device
US1603767A (en) * 1926-03-12 1926-10-19 Harris John Means for treating organs of the body
US1688245A (en) * 1926-09-02 1928-10-16 Radium Emanation Corp Removable emanation seed
US2429438A (en) * 1940-06-01 1947-10-21 American Cystoscope Makers Inc Tubular bodies such as radium seeds
US2546761A (en) * 1950-01-13 1951-03-27 Radium Chemical Company Inc Radium nasopharyngeal applicator
US2750517A (en) * 1953-12-21 1956-06-12 Wilhelm M Baum Method of handling radio-active materials
US2829636A (en) * 1957-07-15 1958-04-08 Ulrich K Henschke Apparatus for the radioactive treatment of animals
US2836180A (en) * 1954-08-31 1958-05-27 Charles C Chapple Fluid conduit and flow control apparatus
US3323511A (en) * 1962-03-05 1967-06-06 Holter Company Radiation source applicator
US3351049A (en) * 1965-04-12 1967-11-07 Hazleton Nuclear Science Corp Therapeutic metal seed containing within a radioactive isotope disposed on a carrier and method of manufacture
US3370587A (en) * 1962-07-17 1968-02-27 Fernando R. Vizcarra Method of introducing a catheter into a body vessel
US3380448A (en) * 1964-11-24 1968-04-30 Abbott Lab Cervical-pudendal indwelling catheter set with tissue piercing means
US3500819A (en) * 1965-10-24 1970-03-17 Daniel Silverman Medical probe adapted to be everted under pressure and method

Patent Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1543859A (en) * 1922-10-27 1925-06-30 United States Radium Corp Radium therapeutic device
US1603767A (en) * 1926-03-12 1926-10-19 Harris John Means for treating organs of the body
US1688245A (en) * 1926-09-02 1928-10-16 Radium Emanation Corp Removable emanation seed
US2429438A (en) * 1940-06-01 1947-10-21 American Cystoscope Makers Inc Tubular bodies such as radium seeds
US2546761A (en) * 1950-01-13 1951-03-27 Radium Chemical Company Inc Radium nasopharyngeal applicator
US2750517A (en) * 1953-12-21 1956-06-12 Wilhelm M Baum Method of handling radio-active materials
US2836180A (en) * 1954-08-31 1958-05-27 Charles C Chapple Fluid conduit and flow control apparatus
US2829636A (en) * 1957-07-15 1958-04-08 Ulrich K Henschke Apparatus for the radioactive treatment of animals
US3323511A (en) * 1962-03-05 1967-06-06 Holter Company Radiation source applicator
US3370587A (en) * 1962-07-17 1968-02-27 Fernando R. Vizcarra Method of introducing a catheter into a body vessel
US3380448A (en) * 1964-11-24 1968-04-30 Abbott Lab Cervical-pudendal indwelling catheter set with tissue piercing means
US3351049A (en) * 1965-04-12 1967-11-07 Hazleton Nuclear Science Corp Therapeutic metal seed containing within a radioactive isotope disposed on a carrier and method of manufacture
US3500819A (en) * 1965-10-24 1970-03-17 Daniel Silverman Medical probe adapted to be everted under pressure and method

Cited By (140)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4096862A (en) * 1976-05-17 1978-06-27 Deluca Salvatore A Locating of tubes in the human body
US4167179A (en) * 1977-10-17 1979-09-11 Mark Kirsch Planar radioactive seed implanter
US4754745A (en) * 1984-11-21 1988-07-05 Horowitz Bruce S Conformable sheet material for use in brachytherapy
EP0292630A1 (en) * 1984-11-21 1988-11-30 Bruce S. Dr. Horowitz Radiation therapy delivery systems
US4815449A (en) * 1984-11-21 1989-03-28 Horowitz Bruce S Delivery system for interstitial radiation therapy including substantially non-deflecting elongated member
US4706652A (en) * 1985-12-30 1987-11-17 Henry Ford Hospital Temporary radiation therapy
US4763642A (en) * 1986-04-07 1988-08-16 Horowitz Bruce S Intracavitational brachytherapy
DE3823604A1 (en) * 1988-06-23 1990-01-18 Nii Medicinskoj Radiologii Aka Device for the intracavitary radiation therapy of malignant rectal tumours
US5183455A (en) * 1988-10-07 1993-02-02 Omnitron International, Inc. Apparatus for in situ radiotherapy
WO1990003827A1 (en) * 1988-10-07 1990-04-19 Hayman Michael H Apparatus for in situ radiotherapy
US4976680A (en) * 1988-10-07 1990-12-11 Hayman Michael H Apparatus for in situ radiotherapy
US4998912A (en) * 1989-03-02 1991-03-12 Board Of Regents, The University Of Texas System Diverging gynecological template
WO1992000776A1 (en) * 1990-07-13 1992-01-23 Mallinckrodt Medical, Inc. Device for introducing a radioactive source into the body
US5713942A (en) * 1992-05-01 1998-02-03 Vesta Medical, Inc. Body cavity ablation apparatus and model
US6041260A (en) * 1992-05-01 2000-03-21 Vesta Medical, Inc. Method and apparatus for endometrial ablation
US5277201A (en) * 1992-05-01 1994-01-11 Vesta Medical, Inc. Endometrial ablation apparatus and method
US5443470A (en) * 1992-05-01 1995-08-22 Vesta Medical, Inc. Method and apparatus for endometrial ablation
US5562720A (en) * 1992-05-01 1996-10-08 Vesta Medical, Inc. Bipolar/monopolar endometrial ablation device and method
US5674177A (en) * 1993-05-06 1997-10-07 Kernforschungszentrum Karlsruhe Gmbh Vascular implant
WO1994026205A1 (en) * 1993-05-06 1994-11-24 Kernforschungszentrum Karlsruhe Gmbh Vascular implant
US6074338A (en) * 1993-07-01 2000-06-13 Schneider (Europe) A.G. Medical appliances for the treatment of blood vessels by means of ionizing radiation
US6514191B1 (en) 1993-07-01 2003-02-04 Schneider (Europe) A.G. Medical appliances for the treatment of blood vessels by means of ionizing radiation
US6071227A (en) * 1993-07-01 2000-06-06 Schneider (Europe) A.G. Medical appliances for the treatment of blood vessels by means of ionizing radiation
US6582352B2 (en) 1994-06-10 2003-06-24 Schneider (Europe) A.G. Medical appliance for treatment by ionizing radiation
US6231494B1 (en) 1994-06-10 2001-05-15 Schneider (Europe) A.G. Medical device with radiation source
US6616629B1 (en) 1994-06-24 2003-09-09 Schneider (Europe) A.G. Medical appliance with centering balloon
US6146322A (en) * 1995-12-05 2000-11-14 Schneider (Europe) Ag Irradiating filament and method of making same
US6592508B1 (en) 1995-12-18 2003-07-15 Integrated Implant Systems, Llc Fiberoptic-guided interstitial seed manual applicator and seed cartridge
US6102844A (en) * 1995-12-18 2000-08-15 Kerisma Medical Products, L.L.C. Fiberoptic-guided interstitial seed manual applicator and seed cartridge
US6428463B1 (en) 1995-12-18 2002-08-06 Integrated Implant Systems, L.L.C. Fiberoptic-guided interstitial seed manual applicator and seed cartridge
US6432035B1 (en) 1995-12-18 2002-08-13 Integrated Implant Systems, L.L.C. Fiberoptic-guided interstitial seed manual applicator and cartridge
US6508755B1 (en) 1995-12-18 2003-01-21 Integrated Implant Systems, L.L.C. Fiberoptic-guided interstitial seed manual applicator and seed cartridge
US6099454A (en) * 1996-02-29 2000-08-08 Scimed Life Systems, Inc. Perfusion balloon and radioactive wire delivery system
US6398708B1 (en) 1996-02-29 2002-06-04 Scimed Life Systems, Inc. Perfusion balloon and radioactive wire delivery system
US5882290A (en) * 1996-02-29 1999-03-16 Scimed Life Systems, Inc. Intravascular radiation delivery system
US6234951B1 (en) 1996-02-29 2001-05-22 Scimed Life Systems, Inc. Intravascular radiation delivery system
US6599230B2 (en) 1996-02-29 2003-07-29 Scimed Life Systems, Inc. Intravascular radiation delivery system
US6582353B1 (en) 1996-02-29 2003-06-24 Scimed Life Systems, Inc. Intravascular radiation delivery system
US6117065A (en) * 1997-03-06 2000-09-12 Scimed Life Systems, Inc. Perfusion balloon catheter with radioactive source
US6676590B1 (en) 1997-03-06 2004-01-13 Scimed Life Systems, Inc. Catheter system having tubular radiation source
US6059713A (en) * 1997-03-06 2000-05-09 Scimed Life Systems, Inc. Catheter system having tubular radiation source with movable guide wire
US6110097A (en) * 1997-03-06 2000-08-29 Scimed Life Systems, Inc. Perfusion balloon catheter with radioactive source
US6267775B1 (en) 1997-03-21 2001-07-31 Schneider (Usa) Inc. Self-expanding medical device for centering radioactive treatment sources in body vessels
US6059812A (en) * 1997-03-21 2000-05-09 Schneider (Usa) Inc. Self-expanding medical device for centering radioactive treatment sources in body vessels
US6422989B1 (en) 1997-05-30 2002-07-23 Scimed Life Systems, Inc. Method for intravascular radioactive treatment
US6019718A (en) * 1997-05-30 2000-02-01 Scimed Life Systems, Inc. Apparatus for intravascular radioactive treatment
US6258019B1 (en) 1997-09-26 2001-07-10 Scimed Life Systems, Inc. Catheter for intraluminal treatment of a vessel segment with ionizing radiation
US6264596B1 (en) 1997-11-03 2001-07-24 Meadox Medicals, Inc. In-situ radioactive medical device
US6060036A (en) * 1998-02-09 2000-05-09 Implant Sciences Corporation Radioactive seed implants
US6036631A (en) * 1998-03-09 2000-03-14 Urologix, Inc. Device and method for intracavitary cancer treatment
US6413203B1 (en) 1998-09-16 2002-07-02 Scimed Life Systems, Inc. Method and apparatus for positioning radioactive fluids within a body lumen
US6352501B1 (en) 1999-09-23 2002-03-05 Scimed Life Systems, Inc. Adjustable radiation source
US6203485B1 (en) 1999-10-07 2001-03-20 Scimed Life Systems, Inc. Low attenuation guide wire for intravascular radiation delivery
US6398709B1 (en) 1999-10-19 2002-06-04 Scimed Life Systems, Inc. Elongated member for intravascular delivery of radiation
US6416457B1 (en) 2000-03-09 2002-07-09 Scimed Life Systems, Inc. System and method for intravascular ionizing tandem radiation therapy
US6302865B1 (en) 2000-03-13 2001-10-16 Scimed Life Systems, Inc. Intravascular guidewire with perfusion lumen
US20040176302A1 (en) * 2001-05-01 2004-09-09 Rodgers Kathleen E. Methods for inhibiting tumor cell proliferation
US7122523B2 (en) * 2001-05-01 2006-10-17 University Of Southern California Methods for inhibiting tumor cell proliferation
US20040116767A1 (en) * 2002-09-10 2004-06-17 Lebovic Gail S. Brachytherapy apparatus and methods of using same
WO2004024236A1 (en) * 2002-09-10 2004-03-25 Curay Medical, Inc Brachytherapy apparatus
US8795145B2 (en) 2002-09-10 2014-08-05 Cianna Medical, Inc. Brachytherapy apparatus and methods for using same
EP2008690B1 (en) * 2002-09-10 2013-11-06 Cianna Medical, Inc. Brachytherapy apparatus
US20080027266A1 (en) * 2002-09-10 2008-01-31 Cianna Medical, Inc. Brachytherapy apparatus and methods for using same
US8323171B2 (en) * 2002-09-10 2012-12-04 Cianna Medical, Inc. Brachytherapy apparatus and methods for using same
US7601113B2 (en) 2002-09-10 2009-10-13 Cianna Medical, Inc. Brachytherapy apparatus and methods of using same
US20090216064A1 (en) * 2002-09-10 2009-08-27 Lebovic Gail S Brachytherapy apparatus and methods for using same
US20090198293A1 (en) * 2003-12-19 2009-08-06 Lawrence Cauller Microtransponder Array for Implant
US20100022908A1 (en) * 2003-12-19 2010-01-28 Board Of Regents, The University Of Texas System System and Method for Interfacing Cellular Matter with a Machine
US8349391B2 (en) * 2004-05-05 2013-01-08 Actinium Pharmaceuticals Inc. Radium target and method for producing it
US20070153954A1 (en) * 2004-05-05 2007-07-05 Actinium Pharmaceuticals, Inc. Radium target and method for producing it
US20080146863A1 (en) * 2004-07-26 2008-06-19 Stillwagon Gary B Internal radiation therapy device
US8079947B2 (en) * 2004-07-26 2011-12-20 Stillwagon Gary B Internal radiation therapy device
US20100121129A1 (en) * 2004-11-05 2010-05-13 Theragenics Corporation Expandable brachytherapy device
US20100130807A1 (en) * 2004-11-05 2010-05-27 Theragenics Corporation Expandable brachytherapy device
US9623260B2 (en) 2004-11-05 2017-04-18 Theragenics Corporation Expandable brachytherapy device
US8684899B2 (en) 2004-11-05 2014-04-01 Theragenics Corporation Expandable brachytherapy device
US8398534B2 (en) 2004-11-05 2013-03-19 Theragenics Corporation Expandable brachytherapy device
US9808650B2 (en) 2004-11-05 2017-11-07 Theragenics Corporation Expandable brachytherapy device
US8562504B2 (en) 2004-11-05 2013-10-22 Theragenics Corporation Expandable brachytherapy device
US20090264696A1 (en) * 2004-11-05 2009-10-22 Theragenics Corporation Expandable brachytherapy device
US8568284B2 (en) 2004-11-05 2013-10-29 Theragenics Corporation Expandable brachytherapy device
US20100222628A1 (en) * 2004-11-05 2010-09-02 Theragenics Corporation Expandable brachytherapy device
US7662082B2 (en) 2004-11-05 2010-02-16 Theragenics Corporation Expandable brachytherapy device
US8690746B2 (en) 2004-11-05 2014-04-08 Theragenics Corporation Expandable brachytherapy device
US20070167664A1 (en) * 2005-10-31 2007-07-19 Hermann George D Brachytherapy apparatus and methods of using same
US7736292B2 (en) 2005-10-31 2010-06-15 Cianna Medical, Inc. Brachytherapy apparatus and methods of using same
US10201716B2 (en) 2005-11-10 2019-02-12 Cianna Medical, Inc. Brachytherapy apparatus and methods for using them
US8858415B2 (en) 2005-11-10 2014-10-14 Cianna Medical, Inc. Brachytherapy apparatus and methods for using them
US20110137103A1 (en) * 2005-11-10 2011-06-09 Hermann George D Brachytherapy apparatus and methods for using them
US20070106108A1 (en) * 2005-11-10 2007-05-10 Hermann George D Brachytherapy Apparatus and Methods for Using Them
US7862496B2 (en) 2005-11-10 2011-01-04 Cianna Medical, Inc. Brachytherapy apparatus and methods for using them
US7887476B2 (en) 2005-11-10 2011-02-15 Cianna Medical, Inc. Helical brachytherapy apparatus and methods of using same
US11130004B2 (en) 2005-11-10 2021-09-28 Cianna Medical, Inc. Brachytherapy apparatus and methods for using them
US20100204537A1 (en) * 2005-11-10 2010-08-12 Hermann George D Brachytherapy apparatus and methods for using them
US9534277B1 (en) 2006-02-21 2017-01-03 Actinium Pharmaceuticals, Inc. Method for purification of 225AC from irradiated 226RA-targets
US9790573B2 (en) 2006-02-21 2017-10-17 Actinium Pharmaceuticals Inc. Method for purification of 225AC from irradiated 226RA-targets
US20090191122A1 (en) * 2006-02-21 2009-07-30 Actinium Pharmaceuticals Inc. Method for purification of 225ac from irradiated 226ra-targets
US20080221384A1 (en) * 2006-06-02 2008-09-11 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US9072893B2 (en) 2006-06-02 2015-07-07 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US8033979B2 (en) 2006-06-21 2011-10-11 Mick Radio-Nuclear Instruments, Inc. Split-ring brachytherapy device and method for cervical brachytherapy treatment using a split-ring brachytherapy device
US20080064916A1 (en) * 2006-06-21 2008-03-13 Mick Felix W Split-ring brachytherapy device and method for cervical brachytherapy treatment using a split-ring brachytherapy device
US20100152520A1 (en) * 2006-06-21 2010-06-17 Mick Felix W Split-ring brachytherapy device and method for cervical brachytherapy treatment using a split-ring brachytherapy device
US7666130B2 (en) * 2006-06-21 2010-02-23 Mick Radio-Nuclear Instruments, Inc. Split-ring brachytherapy device and method for cervical brachytherapy treatment using a split-ring brachytherapy device
US20090304576A1 (en) * 2006-08-08 2009-12-10 Warren Stephen L Device for delivery of anti-cancer agents to tissue
WO2008020931A3 (en) * 2006-08-08 2008-11-06 Peak Biosciences Inc Device for delivery of anti-cancer agents to tissue
WO2008020931A2 (en) * 2006-08-08 2008-02-21 Peak Biosciences, Inc. Device for delivery of anti-cancer agents to tissue
US8715598B2 (en) 2006-09-08 2014-05-06 Actinium Pharmaceuticals Inc. Method for the purification of radium from different sources
US8771161B2 (en) 2006-10-08 2014-07-08 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US20080091055A1 (en) * 2006-10-08 2008-04-17 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US7862498B2 (en) 2006-10-08 2011-01-04 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US20100099939A1 (en) * 2006-10-08 2010-04-22 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US20100069994A1 (en) * 2007-06-25 2010-03-18 Microtransponder, Inc. Methods of inducing paresthesia using wireless neurostimulation
US20090157142A1 (en) * 2007-11-26 2009-06-18 Microtransponder Inc. Implanted Driver with Charge Balancing
US8457757B2 (en) 2007-11-26 2013-06-04 Micro Transponder, Inc. Implantable transponder systems and methods
US20090157150A1 (en) * 2007-11-26 2009-06-18 Microtransponder Inc. Implanted Driver with Resistive Charge Balancing
US20090163889A1 (en) * 2007-11-26 2009-06-25 Microtransponder, Inc. Biodelivery System for Microtransponder Array
US20090157145A1 (en) * 2007-11-26 2009-06-18 Lawrence Cauller Transfer Coil Architecture
US20090156882A1 (en) * 2007-12-16 2009-06-18 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US8517907B2 (en) 2007-12-16 2013-08-27 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US9345886B2 (en) 2008-07-02 2016-05-24 Microtransponder, Inc. Timing control for paired plasticity
US9272145B2 (en) 2008-07-02 2016-03-01 Microtransponder, Inc. Timing control for paired plasticity
US20100004717A1 (en) * 2008-07-02 2010-01-07 Microtransponder Inc. Timing Control for Paired Plasticity
US20100003656A1 (en) * 2008-07-02 2010-01-07 The Board Of Regents, The University Of Texas System Systems, methods and devices for paired plasticity
US20100004705A1 (en) * 2008-07-02 2010-01-07 Microtransponder Inc. Systems, Methods and Devices for Treating Tinnitus
US8934967B2 (en) 2008-07-02 2015-01-13 The Board Of Regents, The University Of Texas System Systems, methods and devices for treating tinnitus
US8489185B2 (en) 2008-07-02 2013-07-16 The Board Of Regents, The University Of Texas System Timing control for paired plasticity
US11116933B2 (en) 2008-07-02 2021-09-14 The Board Of Regents, The University Of Texas System Systems, methods and devices for paired plasticity
US9089707B2 (en) 2008-07-02 2015-07-28 The Board Of Regents, The University Of Texas System Systems, methods and devices for paired plasticity
US9339654B2 (en) 2008-07-02 2016-05-17 Microtransponder, Inc. Timing control for paired plasticity
US20100048978A1 (en) * 2008-08-18 2010-02-25 Cianna Medical, Inc. Brachytherapy apparatus, systems, and methods for using them
US8636635B2 (en) 2008-08-18 2014-01-28 Cianna Medical, Inc. Brachytherapy apparatus, systems, and methods for using them
US20100048977A1 (en) * 2008-08-18 2010-02-25 Cianna Medical, Inc. Brachytherapy apparatus, systems, and methods for using them
US8475353B2 (en) 2008-08-18 2013-07-02 Cianna Medical, Inc. Brachytherapy apparatus, systems, and methods for using them
US20110230700A1 (en) * 2010-03-18 2011-09-22 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US8814775B2 (en) 2010-03-18 2014-08-26 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them
US9883919B2 (en) 2010-07-21 2018-02-06 Cianna Medical, Inc. Brachytherapy apparatus, systems, and methods for using them
CN103096873A (en) * 2010-07-28 2013-05-08 Irccs国立肿瘤研究所基金会 Therapeutic agent, composition including said agent, implantable device and process for the treatment of cervical cancer and/or for the prevention of the formation of neoplasms in correspondence of the cervix in a human female genital system
WO2012013229A1 (en) * 2010-07-28 2012-02-02 Fondazione Irccs Therapeutic agent, composition including said agent, implantable device and process for the treatment of cervical cancer and/or for the prevention of the formation of neoplasms in correspondence of the cervix in a human female genital system.
CN103096873B (en) * 2010-07-28 2016-11-30 Irccs国立肿瘤研究所基金会 For treating cervical cancer and/or the therapeutic agent formed for prophylaxis of tumours, comprising the compositions of described therapeutic agent, implantable device and method in the cervix uteri of people's female reproductive system
US9067063B2 (en) 2010-11-03 2015-06-30 Cianna Medical, Inc. Expandable brachytherapy apparatus and methods for using them

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