This document discusses teletherapy and brachytherapy for the treatment of cervical cancer. It provides details on the Manchester brachytherapy system, which standardized dose specification by defining the dose delivered to a single point (Point A) located 2cm lateral to the cervical os and 2cm along the uterine canal. This allowed for reproducible and comparable dose delivery across patients regardless of applicator size or positioning. The document also outlines other historical brachytherapy systems and the advantages of intracavitary brachytherapy for cervical cancer treatment.

1. TELETHERAPY & BRACHYTHERAPY IN CARCINOMA CERVIX

5. FIGO STAGING Carcinoma-in-situ 0 Spread to bladder or rectum and/or extending beyond true pelvis IVA Spread to lower third of the vagina IIIA Spread to pelvic side walls IIIB Spread to parametrium but not as far as lat. pelvic wall IIB Spread to distant sites outside true pelvis IVB Carcinoma involves upper 2/3 rd of vagina IIA Clinically invasive carcinoma IB Micro invasive carcinoma confined to cervix IA

24. Composite of 6MV beam 6MV color wash Composite of 15MV beam 15MV color wash

56. LOADING PATTERN Tube Type Length Tubes used Mg Ra loaded Units loaded from fundus to cervix Tubes (mg) used for loading Large 6 3 35 6-4-4 15-10-10 Medium 4 2 25 6-4 15-10 Small 2 1 20 8(10) 20 Ovoid Tubes used Mg Ra loaded Units loaded Tubes (mg) used for loading Large 3 22.5 9 10-10-5 or 20/25* Medium 2 20 8 20 Small 1 17.5 7 10-5-5 or 20/15**

88. DOSE PRESCRIPTION

89. DOSE EVALUATION

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