Varian Brachytherapy Applicators and Accessories

Transcription

1 Varian Brachytherapy Applicators and Accessories

2 BrachyTherapy Applicators and Accessories 2011 Varian Medical Systems, Inc.

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4 VARIAN = Innovation For more than 50 years, Varian Medical Systems has pioneered a broad range of dynamic products. Working in partnership with clinicians in more than 600 healthcare facilities throughout the world, Varian BrachyTherapy offers a comprehensive line of afterloaders, applicators and accessories, and treatment planning systems. Varian can create a system perfectly matched to your brachytherapy needs. The products in this catalogue are part of Varian s integrated approach to treatment planning and delivery aiming at improving the health and quality of life of people everywhere. The applicators and accessories in this catalogue are designed for use with Varian BrachyTherapy afterloaders only. Items that may only be used with the GammaMedplus or VariSource afterloaders are so noted. For assistance in selecting the appropriate applicators and accessories for your clinical situation, please inquire at applicators@varian.com, or call Varian BrachyTherapy Technical Support at Specifications are subject to change without notice. For the most current updates and information on Varian BrachyTherapy products, visit: BrachyTherapy Applicators and Accessories 2011 Varian Medical Systems, Inc.

5 How To Order All applicator sets, components, accessories and quality assurance accessories are available directly from Varian BrachyTherapy except where otherwise noted in this catalogue. To order from the United States, Latin America or Canada, call You may use a major credit card or purchase order. From the European Union or Asia, order from our office in Haan Germany at A purchase order is required. To obtain the most current information on prices and availability, applicators@varian.com. Return Policy Any supplied sterile applicators or accessories are unable to be returned. Any non-sterile supplied applicators and accessories may be returned subject to agreement and under the express condition that the applicators or accessories are unused. Unopened and sealed non-sterile applicators and accessories may be returned within 90 days, subject to a 15% restocking fee. VARIAN = Reliability

6 VARIAN = Performance Technical Support Varian BrachyTherapy is committed to providing the latest brachytherapy technology in applicators and accessories. For assistance in selecting the components, please contact our Technical Support Help Desk at in North America, or use the direct dial toll free contact information below. Your Questions To submit a question, please send an with a blank subject line, to: brachyhelp@varian.com or applicators@varian.com. Please indicate the name of your institution, your name and phone number, the product you are commenting on, and your system number, if known, as well as the description of the problem or question. Fax Your Support Questions You may fax your questions to BrachyTherapy Technical Support at: UK: USA: Toll Free Technical Support Toll free access using the AT&T International direct dialing network is available in over 150 countries. To access the number, dial first the AT&T access number in your area. For the access code in your area, see internet address: At the prompt, Please enter the number you are calling, dial: For countries not listed below or not in the AT&T International dialing network, telephone support may be obtained via the following numbers. Our applications specialists can immediately return any calls received on these numbers. UK: USA: Direct Dial Toll Free Technical Support Australia Holland Japan Spain Belgium Hong Kong Luxembourg South Africa Canada Hungary Malaysia Sweden Denmark Indonesia New Zealand Switzerland Finland Ireland Norway Taiwan France Israel Portugal UK Germany Italy Singapore USA

7 Catalogue Sections Intracavitary Applicators Intraluminal Applicators Interstitial Applicators Intraoperative and Surface Applicators Accessories Quality Assurance Spare Parts for Discontinued Applicators Index

8 Intracavitary Applicators GM / GM Accessory Kits for Intracavitary/GYN Applicators GM Vaginal Applicator Set with CT Cylinders CT Compatible / MR Compatibility: Conditional 1.3 GM Segmented Cylinder Applicator Set CT Compatible / MR Compatibility: Conditional 1.4 GM Stump Applicator Set with CT Cylinders CT Compatible / MR Compatibility: Conditional 1.5 GM Shielded Applicator Set 1.6 GM Cervix Applicator Set CT Compatible 1.7 GM Segmented Cervix Applicator Set CT Compatible / MR Compatibility: Conditional 1.8 GM Endometrial Applicator Set CT Compatible / MR Compatibility: Conditional 1.9 GM Heyman Packing Applicator Set CT Compatible / MR Compatibility: Conditional 1.10 GM Fletcher-style Applicator Set Defined Geometry 1.11 GM Titanium Fletcher-style Applicator Set Defined Geometry CT Compatible 1.12 AL Fletcher-Suit-Delcos-style Applicator Set Flexible Geometry CT Compatible / MR Compatibility: Conditional 1.13 GM Manchester-style Applicator Set Flexible Geometry 1.14 AL Ring & Tandem Combination Applicator Set CT Compatible / MR Compatibility: Conditional 1.15 Optional Components for Vienna-Style Ring Applicator 1.16 GM Ring Applicator, 45 Set CT Compatible / MR Compatibility: Conditional 1.17 GM Ring Applicator, 60 Set CT Compatible / MR Compatibility: Conditional 1.18 GM Ring Applicator, 90 Set CT Compatible / MR Compatibility: Conditional 1.19 AL Miami-style Applicator Set CT Compatible 1.20

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10 GM / GM Accessory Kits for GammaMed Intracavitary / GYN Applicators Afterloader: GammaMedplus ix / GammaMedplus Many Varian intracavitary applicators use the same set of accessories. The following accessory kits make ordering easier and help prevent ordering duplicate spare parts. You will find the kit number listed in the required accessories section for each applicator set in this chapter. 1.1 Qty.* GM Basic Accessory Kit for Intracavitary / GYN Applicators, GammaMedplus 3 GM Source guide tube with locking mechanism for 320mm Applicators, GammaMedplus 3 GM X-ray marker for 320mm applicators, 0.9mm diameter, uncoded, GammaMedplus 2 GM Mandrin for 113mm length 1 GM Length gauge 2 GM Tool for vaginal cylinders 5 GM Cleaning caps, black, pack of 20 5 GM Cleaning caps, grey, pack of 20 Qty.* GM Completer Kit for Heyman Packing Applicator & Catheter Flap Sets, GammaMedplus (in addition to Kit GM ) 9 GM Source guide tube with lock mechanism for 320mm Applicators, GammaMedplus 1 GM X-ray marker BV set I, up to 320mm applicators, 0.9mm diameter, coded GM X-ray marker BV set II, up to 320mm applicators, 0.9mm diameter, coded GM Mandrin for 200mm length 2 GM Leak stop buttons, non-sterile, pack of 50 2 GM Cleaning caps, black, pack of 20 2 GM Cleaning caps, grey, pack of 20 *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description.

11 1.2 GM Accessory Kit for VariSource Intracavitary/GYN Applicator Afterloader: VariSource ix / VariSource 200 Many Varian intracavitary applicators use the same set of accessories. The following accessory kits make ordering easier and help prevent ordering duplicate spare parts. You will find the kit number listed in the required accessories section for each applicator set in this chapter. Qty.* GM Basic Accessory Kit for Intracavitary Applicators (GYN & ENT), VariSource 1 GM ClickFit Transfer Guide Tube Set, Channels 1-4 (200 Series) 3 GM X-ray marker BV for 320mm applicators, 0.9mm diameter, uncoded 2 GM Tool for vaginal cylinders 5 GM Cleaning caps, grey, pack of 20 2 GM Mandrin for 113mm length *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. TO ORDER: applicators@varian.com

12 GM Vaginal Applicator Set CT Compatible / MR Compatibility: Conditional Intended for: HDR or PDR intracavitary brachytherapy of the vagina and rectum Afterloader: VariSource ix / VariSource 200 / GammaMedplus ix / GammaMedplus Modality: HDR, PDR 1.3 The Vaginal Applicator Set is used to treat cancer of the vagina or rectum. The set offers a variety of cylinder diameters that maintain an optimal distance between the source and the layers of tissue to be treated. For any given cylinder, the distance between its tip and the source remains constant ensuring a targeted, homogenous treatment dose. Suitable for vagina or rectum CT Compatible MR Compatibility: Conditional for 1.5 and 3 Tesla Minimal assembly required Multiple cylinder diameters Provides a centered first-source position to ensure a homogenous dose parallel to cylinder walls Steam sterilizable

13 1.3 GM Vaginal Applicator Set with CT Cylinders CT Compatible / MR Compatibility: Conditional Qty.* Product # Components of the Applicator Set 1 GM Closed CT vaginal cylinder, 20mm, with plastic clamping screw 1 GM Closed CT vaginal cylinder, 23mm, with plastic clamping screw 1 GM Closed CT vaginal cylinder, 26mm, with plastic clamping screw 1 GM Closed CT vaginal cylinder, 30mm, with plastic clamping screw 1 GM Closed CT vaginal cylinder, 35mm, with plastic clamping screw 1 GM Flexible applicator probe, 3.2mm, braced PVDF 4 GM Sterilization plugs, cream (pack of 25) Required Accessories (choose one afterloader-specific kit) 1 GM Basic accessory kit for Intracavitary/GYN applicators, VariSource 200 and ix 1 GM Basic accessory kit for Intracavitary/GYN applicators, GammaMedplus series Optional Components and Accessories 1 GM Flexible fixation device for gynecological applicators 1 GM Universal applicator clamping device 1 GM Source guide tube support, GammaMed units only 1 GM Plastic clamping bolt 1 GM Leak stop buttons, non-sterile, pack of 50 *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

14 GM Segmented Cylinder Applicator Set CT Compatible / MR Compatibility: Conditional Intended for: HDR intracavitary brachytherapy of the vagina, vaginal stump, and rectum Afterloader: VariSource ix / VariSource 200 / GammaMedplus ix / GammaMedplus Modality: HDR 1.4 The Segmented Cylinder Applicator Set is used to treat cancer of the vagina, including the vaginal stump, as well as rectal cancer. Depending on a chosen front segment, the first source dwell position can be either in the center of the front segment to provide a vaginal wall treatment, or be in the distal position for a vaginal stump treatment. This segmented construction of the applicator allows it to adapt easily to each patient s anatomy. Suitable for vagina, vaginal stump and rectum CT Compatible MR Compatibility: Conditional for 1.5 and 3 Tesla Front segments with centered first source position for shaping of dose to cylinder wall Front segments with distal first source position for shaping of dose to cylinder tip Four segment diameters allow for easy adaption to patient anatomy Provides a homogenous dose parallel to cylinder wall Steam sterilizable

15 1.4 GM Segmented Cylinder Applicator Set CT Compatible / MR Compatibility: Conditional Qty.* Product # Components of the Applicator Set 1 GM Front segment, 20mm diameter, distal source position 1 GM Front segment, 25mm diameter, distal source position 1 GM Front segment, 30mm diameter, distal source position 1 GM Front segment, 35mm diameter, distal source position 1 GM Front segment, 20mm diameter, centered source position 1 GM Front segment, 25mm diameter, centered source position 1 GM Front segment, 30mm diameter, centered source position 1 GM Front segment, 35mm diameter, centered source position 4 GM Cylinder segment, 20mm diameter, 30mm length 4 GM Cylinder segment, 25mm diameter, 30mm length 4 GM Cylinder segment, 30mm diameter, 30mm length 4 GM Cylinder segment, 35mm diameter, 30mm length 1 GM Guide tube for segmented cylinders 1 GM Flexible probe, 2.8mm diameter x 320mm length 1 GM Clamping segment 4 GM Sterilization plugs, cream (pack of 25) Required Accessories (choose one afterloader-specific kit) 1 GM Basic accessory kit for intracavitary/gyn applicators, VariSource 200 and ix 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus series Optional Components and Accessories 1 GM Universal applicator clamping device 1 GM Flexible fixation device for gynecological applicators 1 GM Source guide tube support, GammaMed units only 1 GM Clamping nut for guide tube 1 GM Leak stop buttons, non-sterile, pack of 50 1 GM Sterilization box for segmented cylinder set GM *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

16 GM Stump Applicator Set with CT Cylinders CT Compatible / MR Compatibility: Conditional Intended for: HDR or PDR intracavitary brachytherapy of the vaginal stump Afterloader: VariSource ix / VariSource 200 / GammaMedplus ix / GammaMedplus Modality: HDR, PDR 1.5 The Stump Applicator Set is used for post-operative treatment of the vaginal stump. The cylinders are designed so that the distal source dwell position is located in each cylinder s most forward position. This enables a higher dose delivery to the vaginal stump. A variety of cylinder diameters are available to provide the optimal distance between the source and the layers of tissue to be treated. Suitable for vaginal stump CT Compatible MR Compatibility: Conditional for 1.5 and 3 Tesla Minimal assembly required Multiple cylinder diameters Distal first source position which focuses dose distribution to the vaginal stump Steam sterilizable

17 1.5 GM Stump Applicator Set with CT Cylinders CT Compatible / MR Compatibility: Conditional Qty.* Product # Components of the Applicator Set 1 GM CT vaginal stump applicator, 20mm diameter, with plastic clamping screw 1 GM CT vaginal stump applicator, 23mm diameter, with plastic clamping screw 1 GM CT vaginal stump applicator, 26mm diameter, with plastic clamping screw 1 GM CT vaginal stump applicator, 30mm diameter, with plastic clamping screw 1 GM CT vaginal stump applicator, 35mm diameter, with plastic clamping screw 1 GM Flexible applicator probe, 3.2mm diameter, braced PVDF 4 GM Sterilization plugs, cream (pack of 25) Required Accessories (choose one afterloader-specific kit) 1 GM Basic accessory kit for intracavitary/gyn applicators, VariSource 200 and ix 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus series Optional Components and Accessories 1 GM Universal applicator clamping device 1 GM Flexible fixation device for gynecological applicators 1 GM Source guide tube support, GammMed units only 1 GM Plastic clamping bolt 1 GM Leak stop button, non-sterile, pack of 50 *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

18 GM Shielded Applicator Set Intended for: HDR or PDR intracavitary brachytherapy of the vagina, vaginal stump or rectum Afterloader: VariSource ix / VariSource 200 / GammaMedplus ix / GammaMedplus Modality: HDR, PDR 1.6 The Shielded Applicator Set is used to treat cancer of the vagina or rectum where partial shielding is required. The 90 and 180 tungsten alloy shielding segments provide a variety of different shielding positions. After insertion, the marking screw allows for external identification of the area being shielded inside. Suitable for vagina, vaginal stump or rectum Easy-to-read key allows for outside identification of the inside shielded area Multiple cylinder diameters allows for various shielding positions Provides optimal dose adaptation to patient anatomy EtO sterilizable Shielding segments not recommended for PDR treatments

19 1.6 GM Shielded Applicator Set Qty.* Product # Components of the Applicator Set 1 GM Shielded cylinder, 20mm diameter 1 GM Shielded cylinder, 23mm diameter 1 GM Shielded cylinder, 26mm diameter 1 GM Shielded cylinder, 30mm diameter 1 GM Shielded cylinder, 35mm diameter 1 GM Marking screw, 0, shielded 1 GM Marking screw, 90, shielded 1 GM Marking screw, 2 x 90, shielded 1 GM Marking screw, 180, shielded 1 GM Marking screw, 270, shielded 4 GM Clamping nut for marking screw 4 GM Clamping screw for probe, 3mm diameter 2 GM Tungsten alloy shielding, 90 1 GM Tungsten alloy shielding, GM Plexiglas filler piece, 90 1 GM Applicator probe, 3mm diameter x 320mm length, straight 4 GM Sterilization plugs, cream (pack of 25) Required Accessories for HDR (choose one afterloader-specific kit) 1 GM Basic accessory kit for intracavitary/gyn applicators, VariSource 200 and ix 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus series Required for GammaMedplus Series PDR Treatments 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus series 1 GM Cervical stop 1 GM Allen wrench ø 2.0 mm Optional Components and Accessories 1 GM Flexible fixation device for gynecological applicators 1 GM Universal applicator clamping device 1 GM Source guide tube support, GammMed units only 1 GM Leak stop buttons, non-sterile, pack of 50 *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

20 GM Cervix Applicator Set CT Compatible Intended for: HDR or PDR intracavitary brachytherapy of the vagina, endometrium, cervix, uterus, or vaginal stump Afterloader: VariSource ix / VariSource 200 / GammaMedplus ix / GammaMedplus Modality: HDR, PDR 1.7 The Cervix Applicator Set is suitable for the combined treatment of the vagina and the endometrium. It can also be used for irradiation of the cervix, uterus or vaginal stump. For easy insertion, the 6mm tubes have a tapered 3mm intrauterine part. Suitable for cervix, uterus, endometrium, vagina or vaginal stump CT Compatible Minimal assembly required Includes a variety of cylinder diameters Probes with 3mm diameter intrauterine tandem allow for easy insertion into cervical channel and maximum patient comfort Optional cervical sleeves available which allow for easy application of multiple fractions Steam sterilizable

21 1.7 GM Cervix Applicator Set CT Compatible Qty.* Product # Components of the Applicator Set 1 GM Open CT vaginal cylinder, 20mm diameter x 140mm length 1 GM Open CT vaginal cylinder, 23mm diameter x 140mm length 1 GM Open CT vaginal cylinder, 26mm diameter x 140mm length 1 GM Open CT vaginal cylinder, 30mm diameter x 140mm length 1 GM Open CT vaginal cylinder, 35mm diameter x 140mm length 1 GM Applicator probe, 6/3mm diameter x 320mm length, straight 1 GM Applicator probe, 6/3mm diameter x 320mm length, curved 20 1 GM Applicator probe, 6/3mm diameter x 320mm length, curved 40 4 GM Sterilization plugs, cream (pack of 25) Required Accessories (choose one afterloader-specific kit) 1 GM Basic accessory kit for intracavitary/gyn applicators, VariSource 200 and ix 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus series Optional Components and Accessories 1 GM Flexible fixation device for gynecological applicators 1 GM Universal applicator clamping device 1 GM Source guide tube support, GammaMed units only 1 GM Cervical stop 1 GM Leak stop buttons, non-sterile, pack of 50 1 GM Fixation screw with nut 1 GM Applicator probe, 6/3mm diameter, curved 15, length 320mm 1 GM Applicator probe, 6/3mm diameter, curved 30, length 320mm 1 GM Applicator probe, 6/3mm diameter, curved 45, length 320mm 1 GM Cervical sleeve, 30mm 1 GM Cervical sleeve, 40mm 1 GM Cervical sleeve, 50mm 1 GM Cervical sleeve, 60mm 1 GM Cervical sleeve, 70mm 1 GM Cervical sleeve, 80mm 1 AL Cervical sleeve, 20mm length, single use 1 AL Cervical sleeve, 40mm length, single use 1 AL Cervical sleeve, 60mm length, single use 1 AL Cervical sleeve, 80mm length, single use *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

22 GM Segmented Cervix Applicator Set CT Compatible / MR Compatibility: Conditional Intended for: HDR intracavitary brachytherapy of the vagina, endometrium, uterus, cervix, or vaginal stump Afterloader: VariSource ix / VariSource 200 / GammaMedplus ix / GammaMedplus Modality: HDR 1.8 The Segmented Cervix Applicator Set is used for the combined treatment of the vagina, the endometrium, the cervix, the uterus and the vaginal stump. A variety of segment diameters are available to provide the optimal distance between the source and the layers of tissue to be treated. The segmented construction of the applicator allows for easy adaptation to each patient s anatomy. The cylinder segments can be used with Smit cervical sleeves as well as with or without flexible intrauterine probes. Suitable for cervix, uterus, endometrium, vagina, vaginal stump CT Compatible MR Compatibility: Conditional for 1.5 and 3 Tesla Extremely flexible offering multiple cylinder diameters and various possible tandem configurations Probes with 2.8mm diameter intrauterine tandem allow for easy insertion into cervical channel to provide maximum patient comfort Smit cervical sleeves allow for easy multiple fraction application and provide maximum patient comfort Can be used with or without flexible intrauterine probes to accommodate individual patient anatomy Steam sterilizable

23 1.8 GM Segmented Cervix Applicator Set CT Compatible / MR Compatibility: Conditional Qty.* Product # Components of the Applicator Set 1 GM Guide tube for segments and cervical sleeves, straight 1 GM Guide tube for segments and cervical sleeves, curved 15 1 GM Guide tube for segments and cervical sleeves, curved 30 1 GM Guide tube for segments and flexible probes, straight 1 GM Guide tube for segments and flexible probes, curved 15 1 GM Guide tube for segments and flexible probes, curved 30 1 GM Front segment, open, 20mm diameter x 60mm length, straight 1 GM Front segment, open, 25mm diameter x 60mm length, straight 1 GM Front segment, open, 30mm diameter x 60mm length, straight 1 GM Front segment, open, 35mm diameter x 60mm length, straight 1 GM Front segment, open, 20mm diameter x 60mm length, curved 15 1 GM Front segment, open, 25mm diameter x 60mm length, curved 15 1 GM Front segment, open, 30mm diameter x 60mm length, curved 15 1 GM Front segment, open, 35mm diameter x 60mm length, curved 15 1 GM Front segment, open, 20mm diameter x 60mm length, curved 30 1 GM Front segment, open, 25mm diameter x 60mm length, curved 30 1 GM Front segment, open, 30mm diameter x 60mm length, curved 30 1 GM Front segment, open, 35mm diameter x 60mm length, curved 30 2 GM Cylinder segment, 20mm diameter x 30mm length 2 GM Cylinder segment, 25mm diameter x 30mm length 2 GM Cylinder segment, 30mm diameter x 30mm length 2 GM Cylinder segment, 35mm diameter x 30mm length 1 GM Cervical sleeves, 40mm, with clamp for guide tube 1 GM Cervical sleeves, 60mm, with clamp for guide tube 1 GM Cervical sleeves, 80mm, with clamp for guide tube 1 GM Clamping segment 1 GM Flexible probe, 2.8mm diameter x 320mm length 4 GM Sterilization plugs, cream (pack of 25) Required Accessories (choose one afterloader-specific kit) 1 GM Basic accessory kit for intracavitary/gyn applicators, VariSource 200 and ix 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus series Optional Components and Accessories 1 GM Universal applicator clamping device 1 GM Flexible fixation device for gynecological applicators 1 GM Source guide tube support, GammaMed units only 1 GM Cervical sleeves, 30mm, with clamp for guide tube 1 GM Cervical sleeves, 50mm, with clamp for guide tube 1 GM Cervical sleeves, 70mm, with clamp for guide tube 1 GM Sterilization box for segmented cervix applicator set GM *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

24 GM Universal Endometrial Applicator Set CT Compatible / MR Compatibility: Conditional Intended for: HDR or PDR intracavitary brachytherapy of the vagina, cervix, paracervical area, endometrium, uterus and ovaries Afterloader: VariSource ix / VariSource 200 / GammaMedplus ix / GammaMedplus Modality: HDR, PDR 1.9 The Universal Endometrial Applicator Set is used to treat the vagina, cervix, paracervical area, endometrium, uterus and ovaries. The set contains seven 320mm long intracavitary tandems and a vaginal cylinder of 30mm diameter and 50mm long to fix the tandems and pack the vagina. In addition to stabilizing the applicator, the vaginal cylinder makes it safe to treat the proximal portion of the vagina contiguously with the uterus and cervix. This design can be extremely useful for certain patients being treated for cervical or vaginal cancer. The standard kit contains tandems of 6cm, 7cm and 8cm intrauterine length. The ability to rotate the tandems provides better flexibility with respect to the width of the uterus at the fundus. In addition, longitudinal shifts of the tandem allow further adaptation to the patient s anatomy. Suitable for endometrial cancer and often cervical cancer particularly when there is vaginal involvement or risk CT Compatible MR Compatibility: Conditional for 1.5 and 3 Tesla Flexible design Tandems can be rotated and shifted longitudinally. Optional intrauterine tandems length of 5 and 9cm available Made from titanium and Peek very stable, very light weighted Titanium parts clearly marked with a Ti for easy identification Steam sterilizable (Aluminium sterilization tray is included) Regulatory approval pending Not authorized for use in Canada

25 1.9 GM Universal Endometrial Applicator Set CT Compatible / MR Compatibility: Conditional Qty.* Product # Components of the Applicator Set 1 GM Intrauterine tandems, right and left, 320mm, angle 20 x 60mm length 1 GM Intrauterine tandems, right and left, 320mm, angle 20 x 70mm length 1 GM Intrauterine tandems, right and left, 320mm, angle 20 x 80mm length 1 GM Intrauterine tandem, center, 320mm, straight 1 GM Clamping unit for the endometrial applicator 1 GM Vaginal cylinder with lever, 30mm diameter x 50mm length 1 GM Sterilization tray 1 GM Grub screws for clamping unit (pack of 10) 4 GM Sterilization plugs (pack of 25) 1 GM Allen key, 2.0mm wrench size Required Accessories (choose one afterloader-specific kit) 1 GM Basic accessory kit for intracavitary applicators, VariSource 200 and ix 1 GM Basic accessory kit for intracavitary applicators, GammaMedplus series Optional Components and Accessories 1 GM Intrauterine tandems, right and left, 320mm, angle 20 x 50mm length 1 GM Intrauterine tandems, right and left, 320mm, angle 20 x 90mm length 1 GM X-ray marker BV set I, up to 320mm applicators, coded GM Universal applicator clamping device 1 GM Source guide tube support (GammaMed units only) 1 GM Handle for lever 1 GM Leak stop button (pack of 50), non-sterile *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

26 GM Heyman Packing Applicator Set CT Compatible / MR Compatibility: Conditional Intended for: HDR or PDR intracavitary brachytherapy of the endometrium Afterloader: GammaMedplus ix / GammaMedplus Modality: HDR, PDR 1.10 The Heyman Packing Applicator Set is used to simulate the classical Heyman packing technique for endometrial cancer treatment. The standard set contains capsules which are 4, 6, and 8mm in diameter. The applicator is reusable and can be steam sterilized. For visual coding of individual capsules, there is a set of channel marker clips. Obturators prevent kinks and ease the insertion of the capsules. Suitable for endometrium, corpus- and cavum-uteri Simulates classic Heyman packing technique CT Compatible MR Compatibility: Conditional for 1.5 and 3 Tesla if used without channel markers and mandrins 4, 6, and 8mm diameter capsules ensure optimal packing of the cavum-uteri Stabilizing obturators allow for easy insertion Channel marker clips provide visual coding and easy identification of multiple channels Steam sterilizable

27 1.10 GM Heyman Packing Applicator Set CT Compatible / MR Compatibility: Conditional Qty.* Product # Components of the Applicator Set 6 GM Heyman capsule, 4mm diameter x 17.5mm length, with mandrin 6 GM Heyman capsule, 6mm diameter x 17.5mm length, with mandrin 6 GM Heyman capsule, 8mm diameter x 17.5mm length, with mandrin 1 GM Channel marker clips, coded GM Leak stop buttons, non-sterile, pack of 50 4 GM Sterilization plugs, cream (pack of 25) Required Accessories 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus 1 GM Completer kit for Heyman Packing Applicator Set, GammaMedplus Optional Components and Accessories 1 GM Channel marker clips, coded GM Source guide tube support, GammaMed units only 1 GM Mandrin for 320mm length *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

28 GM Fletcher-style Applicator Set Defined Geometry Intended for: HDR intracavitary brachytherapy of the uterus, cervix, endometrium & vagina Afterloader: GammaMedplus ix / GammaMedplus Modality: HDR 1.11 The Fletcher-style Applicator Set with defined geometry reproduces applicator geometry of the conventional Fletcher-style applicator. The use of three independent probes also allows a non-cylindrical isodose shaping in the cervix area. The design of the colpostat segments prevents tissue protrusion between the segments even with widespread setups. Relative to the vaginal axis, the colpostat probes are curved 60 and the intrauterine probes are curved 30. The intrauterine probes are 3mm in outer diameter to allow for easy insertion. The cervical stopper reduces the risk of perforation. The set contains three sizes of intrauterine probes with additional sizes available. The set works with Smit cervical sleeves to allow for repeated insertion and prevent perforation. A rectal retractor can be attached to allow for rectal dose reduction as well as the use of forceps. Suitable for uterus, cervix, endometrium and vagina Reproduces the applicator geometry of conventional Fletcher-style applicators Three independent probes allow for non-cylindrical dose shaping Flat-edged Colpostat segments prevent tissue protrusion between segments 3mm diameter intrauterine tandem probes allow for easy insertion into cervical channel providing maximum patient comfort Vaginal axis colpostat probes are 60 and intrauterine 30 probes allow for a 90 angle between colpostat segments and intrauterine probe to provide optimal positioning Intrauterine probes equipped with cervical stoppers reduce the risk of perforation Optional Smit cervical sleeves allow easy multible fraction application and provide maximum patient comfort Optional rectal retractor uses a central clamping mechanism that allows for easy use of forceps Steam sterilizable

29 1.11 GM Fletcher-style Applicator Set Defined Geometry Qty.* Product # Components of the Applicator Set 1 GM Colpostat probe, left 1 GM Colpostat probe, right 1 GM Intrauterine probe with stopper, length 40mm, 30 angle 1 GM Intrauterine probe with stopper, length 60mm, 30 angle 1 GM Intrauterine probe with stopper, length 80mm, 30 angle 1 GM Mini colpostats, pair 1 GM Colpostats for 20mm spread, pair 1 GM Colpostats for 25mm spread, pair 1 GM Colpostats for 30mm spread, pair 1 GM Central clamping mechanism 1 GM Allen key, 2.0mm wrench size, for colpostat fixation screws 4 GM Sterilization plugs, cream (pack of 25) Required Accessories (choose one afterloader-specific kit) 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus series Optional Components and Accessories 1 GM Hook forceps, 250mm length 1 GM Forceps clamping mechanism 1 GM Rectal retractor for 3-channel applicators 1 GM Cervical sleeves, 30mm length 1 GM Cervical sleeves, 40mm length 1 GM Cervical sleeves, 50mm length 1 GM Cervical sleeves, 60mm length 1 GM Cervical sleeves, 70mm length 1 GM Cervical sleeves, 80mm length 1 AL Cervical sleeve, 20mm length, single use 1 AL Cervical sleeve, 40mm length, single use 1 AL Cervical sleeve, 60mm length, single use 1 AL Cervical sleeve, 80mm length, single use 1 GM Intrauterine tube with stopper, 30mm length, 30 angle 1 GM Intrauterine tube with stopper, 50mm length, 30 angle 1 GM Intrauterine tube with stopper, 70mm length, 30 angle 1 GM Flexible fixation device for 3 channel applicators 1 GM Fixation strap, 500mm/150mm 1 GM Fixation strap, 1050mm/350mm 1 GM Fixation strap, 1700mm/500mm 1 GM Universal applicator clamping device 1 GM Source guide tube support, GammaMed units only 1 GM Leak stop button (pack of 50), non-sterile 1 GM Sterilization box for Fletcher-style applicators, defined geometry, GM & GM *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

30 GM Titanium Fletcher-style Applicator Set Defined Geometry CT Compatible Intended for: HDR or PDR intracavitary brachytherapy of the uterus, cervix, endometrium & vagina Afterloader: GammaMedplus ix / GammaMedplus Modality: HDR, PDR 1.12 The Titanium Fletcher-style Applicator Set with defined geometry reproduces applicator geometry of the conventional Fletcher-style applicator. The use of three independent probes also allows a non-cylindrical isodose shaping in the cervix area. The design of the colpostat segments prevents tissue protrusion between the segments even with widespread setups. Relative to the vaginal axis, the colpostat probes are curved 60 and the intrauterine probes are curved 30. The intrauterine probes are 3mm in outer diameter to allow for easy insertion. The cervical stopper reduces the risk of perforation. The set contains three sizes of intrauterine probes with additional sizes available. The set works with Smit cervical sleeves to allow for repeated insertion and prevent perforation. A rectal retractor can be attached to allow for rectal dose reduction as well as the use of forceps. Suitable for uterus, cervix, endometrium and vagina CT Compatible Made from lightweight titanium Titanium parts clearly marked with a Ti for easy identification Reproduces the applicator geometry of conventional Fletcher-style applicators Three independent probes which allow for noncylindrical dose shaping Flat-edged Colpostat segments prevent tissue protrusion between segments 3mm diameter intrauterine tandem probes allow for easy insertion into cervical channel providing maximum patient comfort Vaginal axis colpostat probes are 60 and intrauterine 30 probes allow for a 90 angle between colpostat segments and intrauterine probe to provide optimal positioning Intrauterine probes equipped with cervical stoppers reduce the risk of perforation Optional Smit cervical sleeves allow easy multible fraction application and provide maximum patient comfort Optional rectal retractor uses a central clamping mechanism that allows for easy use of forceps Steam sterilizable

31 1.12 GM Titanium Fletcher-style Applicator Set Defined Geometry CT Compatible Qty.* Product # Components of the Applicator Set 1 GM Titanium colpostat probe, left 1 GM Titanium colpostat probe, right 1 GM Titanium intrauterine probe with stopper, length 40mm, 30 angle 1 GM Titanium intrauterine probe with stopper, length 60mm, 30 angle 1 GM Titanium intrauterine probe with stopper, length 80mm, 30 angle 1 GM Mini colpostats 1 GM Colpostats for 20mm spread 1 GM Colpostats for 25mm spread 1 GM Colpostats for 30mm spread 1 GM Titanium central clamping mechanism 1 GM Allen key, 2.0mm wrench size, for colpostat fixation screws 4 GM Sterilization plugs, cream (pack of 25) Required Accessories 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus series Optional Components and Accessories 1 GM Titanium hook forceps, 250mm length 1 GM Titanium forceps clamping mechanism 1 GM Titanium rectal retractor 1 GM Cervical sleeves, 30mm length 1 GM Cervical sleeves, 40mm length 1 GM Cervical sleeves, 50mm length 1 GM Cervical sleeves, 60mm length 1 GM Cervical sleeves, 70mm length 1 GM Cervical sleeves, 80mm length 1 AL Cervical sleeve, 20mm length, single use 1 AL Cervical sleeve, 40mm length, single use 1 AL Cervical sleeve, 60mm length, single use 1 AL Cervical sleeve, 80mm length, single use 1 GM Titanium intrauterine tube with stopper, 30mm length, 30 angle 1 GM Titanium intrauterine tube with stopper, 50mm length, 30 angle 1 GM Titanium intrauterine tube with stopper, 70mm length, 30 angle 1 GM Universal applicator clamping device 1 GM Source guide tube support, GammaMed units only 1 GM Leak stop button (pack of 50), non-sterile 1 GM Sterilization box for Fletcher-style applicators, defined geometry, GM & GM *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

32 AL Titanium Fletcher-Suit-Delclos-style Applicator Set, Flexible Geometry CT Compatible / MR Compatibility: Conditional Intended for: HDR or PDR intracavitary brachytherapy of the uterus, cervix, endometrium & vagina Afterloader: VariSource ix / VariSource 200 / GammaMedplus ix / GammaMedplus Modality: HDR, PDR 1.13 The Titanium Fletcher-Suit Delclos-style Applicator Set is used for high dose and pulse dose rate treatment of the uterus, cervix, endometrium and vagina. Based upon the traditional FSD design, the Titanium Fletcher- Suit-Delclos-style Applicator is manufactured from titanium. The applicator features two colpostats which can be used with interlocking tandems of angles 15, 30 and 45. The tandem s intrauterine section is only 3mm diameter which often permits insertion without total anesthesia even when used without a cervical sleeve. Suitable for uterus, cervix, endometrium and vagina based on the traditional Fletcher-Suit-Delclos design CT Compatible MR Compatibility: Conditional for 1.5 and 3 Tesla Made from lightweight titanium Titanium parts clearly marked with a T for easy identification Interlocking tandems can be used at 15, 30 and 45 3mm diameter intrauterine section fits to flexible cervical sleeves Cervical stoppers reduce the risk of perforation Optional Smit cervical sleeves for easy multible fraction application Steam sterilizable (Aluminium sterilization tray is included)

33 1.13 AL Titanium Fletcher-Suit-Delclos-style Applicator Set CT Compatible / MR Compatibility: Conditional Qty.* Product # Components of the Applicator Set 1 AL Pair of Titanium colpostat tandem (left & right) 1 AL Titanium Intrauterine tandems, angle 15 1 AL Titanium Intrauterine tandems, angle 30 1 AL Titanium Intrauterine tandems, angle 45 1 AL Titanium tandem pivot assembly with locking nut 1 AL Ovoid pair, mini, 16mm diameter 1 AL Ovoid pair, 20mm diameter 1 AL Ovoid pair, 25mm diameter 1 AL Ovoid pair, 30mm diameter 2 AL Titanium cervical stop set screw 1 AL Acetal, cervical stop with titanium CT marker 1 AL Titanium cervical stop 1 AL Titanium Allen wrench, autoclavable 1 AL Titanium locking nut 4 GM Sterilization plugs, cream (pack of 25) Required Accessories (choose one afterloader-specific kit) 1 GM Basic Accessory Kit for Intracavitary Applicators (GYN & ENT), VariSource 1 GM Basic Accessory Kit for Intracavitary / GYN Applicators, GammaMedplus Optional Components and Accessories 1 GM Universal applicator clamping device 1 GM Source guide tube support (GammaMed units only) 1 GM Leak stop button (pack of 50), non-sterile 1 AL Cervical sleeve, 20mm length, single use 1 AL Cervical sleeve, 40mm length, single use 1 AL Cervical sleeve, 60mm length, single use 1 AL Cervical sleeve, 80mm length, single use *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

34 GM Manchester-style Applicator Set Flexible Geometry Intended for: HDR intracavitary brachytherapy of the uterus, cervix, endometrium and vagina Afterloader: GammaMedplus ix / GammaMedplus Modality: HDR 1.14 The Manchester-style Applicator Set reproduces the dosimetry of the conventional Manchester-style applicator. The ovoid design allows for tungsten shielding of the top and bottom for dose reduction to the rectum and/or bladder. The three intrauterine probes are curved 15, 30 or 45 relative to the vaginal axis. The intrauterine probes have a 3mm outer diameter to allow for easy insertion and a cervical stopper to help prevent perforation. An optional rectal retractor allows for rectal dose reduction and the use of forceps which can be easily attached to the central clamping mechanism. Suitable for uterus, cervix, endometrium and vagina Reproduces applicator geometry of Manchester-style applicators Three independent probes which allow for noncylindrical dose shaping Multiple diameters of ovoid pairs allow for easy adaptation to patient anatomy and more flexible dose shaping Ovoid pairs accept tungsten shielding pieces to enable specific shielding above and below ovoids Probes with 3mm diameter intrauterine tandem allow for easy insertion into cervical channel, providing maximum patient comfort Straight vaginal axis colpostat probes Optional rectal retractor available Optional clamping mechanism available Steam sterilizable

35 1.14 GM Manchester-style Applicator Set Flexible Geometry Qty.* Product # Components of the Set 1 GM Manchester-style colpostat probe, left 1 GM Manchester-style colpostat probe, right 1 GM Intrauterine probe, 15 curved, for three channel applicator 1 GM Intrauterine probe, 30 curved, for three channel applicator 1 GM Intrauterine probe, 45 curved, for three channel applicator 1 GM Cervical stopper 2 GM Manchester-style ovoid, 20mm, without shielding 2 GM Manchester-style ovoid, 20mm, double shielded 1 GM Manchester-style ovoid, 20mm, unilateral shielded top 1 GM Manchester-style ovoid, 20mm, unilateral shielded bottom 2 GM Manchester-style ovoid cap, 25mm outer diameter 2 GM Manchester-style ovoid cap, 30mm outer diameter 1 GM Central clamping mechanism 1 GM Disassembly pin for removal of ovoid caps 1 GM Allen wrench, 2.5mm, autoclavable 4 GM Sterilization plugs, cream (pack of 25) 1 GM Leak stop buttons, non-sterile, pack of 50 Required Accessories 1 GM Basic accessory kit for intracavitary/gyn applicators, GammaMedplus series Optional Components and Accessories 1 GM Hook forceps, 250mm long 1 GM Clamping mechanism for forceps 1 GM Rectal retractor for three channel applicators 1 GM Universal applicator clamping device 1 GM Source guide tube support, GammaMedplus only 1 GM Intrauterine probe, straight, for 3 channel applicator 1 GM cm intrauterine probe angled 20, for 3 chan. app. 1 GM cm intrauterine probe angled 20, for 3 chan. app. 1 GM cm intrauterine probe angled 20, for 3 chan. app. 1 GM cm intrauterine probe angled 20, for 3 chan. app. 1 GM cm intrauterine probe angled 20, for 3 chan. app. 1 GM cm intrauterine probe angled 20, for 3 chan. app. 1 GM cm intrauterine probe angled 40, for 3 chan. app. 1 GM cm intrauterine probe angled 40, for 3 chan.app. 1 GM cm intrauterine probe angled 40, for 3 chan. app. 1 GM cm intrauterine probe angled 40, for 3 chan. app. 1 GM cm intrauterine probe angled 40, for 3 chan. app. 1 GM cm intrauterine probe angled 40, for 3 chan. app. 1 GM Flexible fixation for 3 channel applicators 1 GM Fixation strap, 500mm/150mm 1 GM Fixation strap, 1050mm/350mm 1 GM Fixation strap, 1700mm/500mm 1 AL Cervical sleeve, 20mm length, single use 1 AL Cervical sleeve, 40mm length, single use 1 AL Cervical sleeve, 60mm length, single use 1 AL Cervical sleeve, 80mm length, single use *Quantity indicated is the quantity included with the kit. Quantity associated with each part number is one (1) unless otherwise indicated in the product description. C TO ORDER: applicators@varian.com

36 AL Ring & Tandem Combination Applicator Set CT Compatible / MR Compatibility: Conditional Intended for: HDR intracavitary brachytherapy of the uterus, cervix, and cervix channel Afterloader: VariSource ix / VariSource 200 / GammaMedplus ix / GammaMedplus Modality: HDR, PDR 1.15 The Ring and Tandem Combination Applicator Set is indicated treatment of the cervix, cervix channel and uterus. The applicator comes with 32mm diameter rings that can be used in conjunction with interlocking tandems of lengths 20, 40 and 60mm. A optional set of tandems with 80mm length is available. This combination set supplies a complete range of tandem and ring angles 30, 45 and 60. The set also includes two ring build-up caps 5mm and 7.5mm, a rectal retractor, and a aluminium sterilization tray. The applicator set is fabricated from space-age titanium tubing for a light yet rigid appliance with very thin tandem tubing for ease of placement. The fixed geometry further speeds applicator placement and greatly simplifies the treatment planning process. For additional needle implantation, optional ring caps for 1.65mm diameter titanium needles and 2mm plastic needles are available. Suitable for cervix, cervix channel and uterus CT Compatible MR Compatibility: Conditional for 1.5 and 3 Tesla Manufactured from titanium Titanium parts are clearly marked with a T for easy identification Lightweight yet robust Uses reproduction of applicator geometry based on conventional ring and plate style Interlocking tandems in lengths of 20, 40 and 60mm Wide range of tandems and ring angles Includes a rectal retractor to avoid the need of packing Fixed geometry for consistent dosimetry Thin 3mm tandem can often be inserted without anesthesia Includes two build-up caps 5mm and 7.5mm Ring caps for needle implants optional available 80mm tandem length optional Steam sterilizable (Aluminium sterilization tray is included)