Abstract

Because of the extreme technical difficulty and the high mortality incident to resection of the pancreas for carcinoma, few cures may be expected from radical surgical measures. While those carcinomas limited to the body or tail of the pancreas may be favorable for resection, the majority involve the head of the gland and would require a pancreatoduodenectomy for removal, a procedure which has been survived for a long period (nine months) by only one patient (Kausch). It seems evident that surgery can offer definite palliation of symptoms but little toward an ultimate cure in these cases. A review of the literature reveals few references to the use of high-voltage x-rays in the treatment of carcinoma of the pancreas. No reports of irradiation by means of radium element or emanation were found. Richards in 1922 reported favorable results in two cases of carcinoma of the pancreas. In both cases the tumor was found to be inoperable on exploration. Biopsies showed adenocarcinoma. Following courses of high-voltage therapy both patients improved remarkably, being symptom-free ten and twenty months later. No mass could be demonstrated by x-ray following high-voltage therapy. In 1925 Flecker and Cameron in their study of the alteration in blood sugar values after intensive high-voltage roentgen irradiation, mentioned remarkable results with x-rays in carcinoma of the pancreas. In their experimental and clinical work they found a temporary depression of blood sugar values within twenty-four hours of exposure, followed by a return to normal limits within four to eight days. Redwitz reported that he had seen no value in radiation therapy in carcinoma of the pancreas. The effect of high-voltage x-ray therapy on the normal pancreas has been studied experimentally by several investigators. Kmietowicz and Tumidajski observed a decrease in pancreatic secretion with an activation of proferments following irradiation with 2.8 human S. E. D. Ivy, McCarthy and Orndoff in 1924, in studying the effect of roentgen rays on gastric secretion, found a marked fibrous atrophy of the pancreas to 1/6 to 1/7 the normal size, following one human S. E. D.

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