Nasopharyngeal Brachytherapy for Lymphoid Hyperplasia: Review of Dosimetry

Abstract

Nasopharyngeal implants of radium sources were used in the 1940s and 1950s to treat children with otitis media and military personnel who had aerotitis media. Individuals received one or more treatments, typically for a total of 30 to 50 milligram-hours (mgh). Documentation of treatment parameters, including source strength and treatment times, allows estimation of organ doses in these patients. For example, for 40 mgh, radiation-absorbed doses to adjacent organs in an adult are estimated as follows: brain, 3; pituitary gland 16; salivary glands, 8.5; and thyroid gland, 1.4 cGy. For a child 6 years of age, the doses for 40 mgh are: brain, 4; pituitary gland, 27; salivary glands, 11; and thyroid gland, 3.1 cGy. β-Particles, in addition to γ-rays, produce a high dose within a few millimeters of the source, but beyond 10 mm the dose is due to γ-rays alone.

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References

Farrior

Richardson

. Nasopharyngeal applicator. Arch Otolaryngol 1942;35:811–2.

Burnam

Crowe

. The monel metal radium applicator designed for maximum use of hard beta rays in treatment of nasopharyngeal hyperplastic lymphoid tissue. Miss Val Med J 1945;67:109–11.

Braestrup

. Measurements of the radiation dose from the nasopharynx radium beta-gamma-ray applicator. Trans Am Acad Ophthalmol Otolaryngol 1950;54:496–501.

Crowe

. Irradiation of the nasopharynx. Trans Am Acad Ophthalmol 1946;51:29–35.

Glasser

Quimby

Taylor

Weatherwax

Morgan

. Physical foundations of radiology. 3rd ed. New York: Harper & Row, 1961.

Robbins

Schulz

. Potential hazards from radiation treatment of hypertrophied lymphoid tissue in the nasopharynx. Laryngoscope 1949;59:147–55.

Hanson

Shalek

Kennedy

. Dosimetry quality assurance in the U.S. from the experience of the Radiological Physics Center. In: Quality assurance in radiotherapy physics, Proceedings of an American College of Medical Physics Symposium. Madison, Wis.: Medical Physics Publishing, 1991.

Fowler

Jr . Radon treatment for otitis due to barotrauma. J Laryngol Otolaryngol 1943;58:489–92.

Fowler

Jr . Use of radon to prevent otitis media due to hyperplasia of lymphoid tissue and barotrauma (aero-otitis). Arch Otolaryngol 1944;40:402–5.

10.

Fowler

Jr . Irradiation of the eustachian tube: An anatomic, physical and clinical study of a treatment for recurrent otitis media applied to aero-otitis. Arch Otolaryngol 1946;43:1–11.

11.

Bordley

Hardy

. The use of radium in the aerotitis control program of the Army Air Force. Ann Otol Rhinol Laryngol 1945;54:650–60.

12.

Shilling

Haines

Harris

Kelly

. The prevention and treatment of aerotitis media. Naval Med Bull 1946;46:1520–58.

13.

Hazen

Pifer

Toyooka

Livingood

Hempelmann

. Neoplasms following irradiation of the head. Cancer Res 1966;26:305–11.

14.

Boies

. Irradiation of nasopharyngeal lymphoid tissue: An evaluation. Arch Otolaryngol 1946;44:129–40.

15.

Proctor

Polvogt

Crowe

. Irradiation of lymphoid tissue in diseases of the upper respiratory tract. Bull Johns Hopkins Hosp 1948;83:383–428.

16.

Pratt

. Nasopharyngeal irradiation treatment of hyperplastic adenoids. Otolaryngol Head Neck Surg 1981;89:47–53.

17.

Sandler

Comstock

Matanoski

. Neoplasms following childhood radium irradiation of the nasopharynx. J Natl Cancer Inst 1982;68:3–8.

18.

Verduijn

Hayes

Habbema

JDF

Looman

van der Maas

. Mortality after nasopharyngeal radium irradiation for eustachian tube dysfunction. Ann Otol Rhinol Laryngol 1989;98:839–44.

19.

Fowler

Jr . Eustachian tube irradiation. NY J Med 1949;49:187–90.

20.

Shalek

Stovall

. Brachytherapy dosimetry. In: Kase

Bjärngard

Attix

, eds. The dosimetry of ionizing radiation. Vol. III. New York: Academic Press, 1990.