X-Rays and Radium in the Treatment of Tumors of the Conjunctiva

Abstract

IN a former paper, published in “Revista de Radiologia y Fisioterapia,” 1935, and based on 120 cases of cutaneous epithelioma and 12 cases of epithelioma of the conjunctiva, treated with x-rays of different wave lengths, gamma rays, and beta rays, I presented the following conclusions: 1. In working with oscillatory electromagnetic waves of from 1.0 to 0.16 Ångstrom units for the destruction in general practice of cutaneous epithelioma, no optimum wave length was found, the use of which could be preferred to that of others of the series. In other words, the same results may be obtained with x-rays as with radium under the specified conditions. 2. On the other hand, in comparing oscillatory electromagnetic rays with beta corpuscular rays, the conclusion is reached that in all this group of radiations, including the moderately penetrating gamma rays in the middle of the gamma-ray scale, the beta rays, which are the least used in present-day practice, are the most active. More recently I have had the opportunity to test the practical value of these conclusions due to the following circumstances: In a case of epithelioma of the conjunctiva, cured 14 years ago with x-rays of 0.2 Ångstrom unit, a glaucoma developed a few months after the irradiation. Since then I have used a capsule of beta rays (10 milligrams) and a 0.2 mm. silver filter in all ophthalmic cases, with the result that no complications have followed any of these treatments. It is supposed that the small penetration of the beta rays has allowed such satisfactory results without complications involving deeper tissues, such as the ciliary body and the crystalline lens. Two years ago, on checking the impermeability of my radium containers, I found that the capsule had a microscopic defect, impossible to locate exactly, which allowed the emanation to escape. In order to correct this, I was obliged to seal hermetically the entire capsule in a 0.3 mm. silver filter. This resulted in the disadvantage that the filter absorbed nearly all the beta rays, and the intensity was thereby reduced from 15 r to 3.2 r per minute. Figs. 1-A to 2-B, inclusive, show two of the 12 cases of conjunctival epithelioma cured with the original capsule. The case shown in Figures 3-A and 3-C was cured with the capsule after it was hermetically sealed in the silver filter. On comparing the details of procedure in Groups I and II, it will be noted that the dosage in Group II is three and a half times that in Group I. Furthermore, three months of almost daily applications were necessary for complete cure, and the patient complained of pain five months after the beginning of the treatment, in spite of the fact that, clinically, the eye was normal. No other patient has suffered prolonged discomfort.