Letter Concerning “The Value of a Multi-Perforated Screen in Deep X-Ray Therapy”

Abstract

In the issue of Radiology as indicated above, Liberson has made “A Preliminary Report on a New Method of Delivering Multiple Erythema Doses without Permanent Injury to the Skin.” The thought and the method are not new. I described practically the same method in 1909. This was published in the “Journal de Radiologie” (de la Sociétè Belge de Radiologie), Tome 3, page 18.5, in the French language, and shortly thereafter in the German language, in the “Fortschritte auf dem Gebiete der Röntgenstrahlen.” The title was “Theorie einer Methode, bisher unmöglich anwendbar hohe Dosen Röntgenstrahlen in der Tiefe des Gewebes zur Therapeutischen Wirksamkeit zu Bringen ohne schwere Schädigung des Patienten, zugleich eine Methode des Schutzes gegen Röntgenverbrennungen überhaupt” (“Theory of a Method by which a Therapeutic Effective Dose can be Delivered into the Deeper Tissues without Injury to the Patient, at the Same Time Furnishing a Method of Protection against Radiodermatitis Superficially”). My second publication followed in the same year in “Münchener medicinischen Wochenschrift,” 1909, No. 45, with the title “Zur Röntgentiefenthcrapie mit Massendosen” (“Conceming Deep Roentgen Therapy with Massive Doses”). My third publication may be found in “Strahlentherapie,” Band 1 (1912), page 12, with the title “Röntgentiefentherapie mit Metallnetzschutz. Praktische Erfolge” (“Deep Roentgen Therapy with Wire Netting”). At that time the title of my publication was similar to the title of the article by F. Liberson, and, it may be observed, dealt with a similar method, at least, with the same principle though with modified details. The principle of Liberson's method and mine is also briefly as follows: If one wishes to deliver three to five erythema doses into a deeplying tumor, one is apt to produce an injury to the skin which is difficult or impossible to heal. If, however, one utilizes a metallic mesh, or multi-perforated lead screen on the skin during the treatment, one may obtain in the perforations of the screen severe injury or burning, but under the metal wire or protected lines, the skin will remain practically uninjured, and from these lines, or small protected areas, healing of the injured skin can take place. By this means, the irradiation of the tumor area is not thereby interrupted, but homogeneously irradiated if one irradiates on each occasion with the focus of the tube shifted a millimeter or a centimeter in four different directions. Furthermore, in connection therewith, I have recommended tubes with broad focus, I have recommended tubes with broad focus, and I have also stated that herewith filters may be combined.