Superficial Radiotherapy Research Articles

Experimental ileotubal anastomosis in the sow

A technique for restoring luminal patency in occluded Fallopian tubes is described using the sow as an experimental animal. The procedure involved the unilateral construction of an ileotubal conduit following superficial irradiation of the ileal part of the conduit. Healing occurred without scarring and there was evidence that tubal epithelium was replacing irradiated intestinal epithelium. Pregnancy occurred in one of the experimental sows but ended in abortion. A bilateral conduit operation would appear to offer a field for further experimental study.

RADIATION CANCER OF THE SKIN.

The World literature, while replete with cases of radiation dermatoses, contains a paucity of reports of the more serious sequelae of such cutaneous injuries. Until 1942, approximately only 125 cases of occupational cancer and 63 of therapeutic carcinoma resulting from radiation had been reported from all countries (16, 19, 21, 24). The 36 cases of Cannon, Randolph, and Murray (5) comprise the largest series of radiation cancers. The present reported series includes 59 examples of roentgen and radium carcinoma of the skin resulting from post-irradiation dermatitis. Newly imposed standards of protection and education in precautionary measures have not prevented adventitial x-ray exposures in the dental and medical professions, therapeutic sequelae in patients, and beta-ray burns in workers engaged in atomic energy and medical research programs. The extended employment of x rays, radium, and radioactive substances in medicine for diagnostic and therapeutic purposes and their applicability in industry and governmental projects enhance the hazard. We continue to see patients with radiodermatitis and radiocarcinoma in both clinical and office practice. Twice as many cases of roentgen dermatitis were observed at Massachusetts General Hospital in the decade 1948-1957 as in the preceding ten years (5). In the average fluoroscopic examination of the gastrointestinal tract, including spot-films, it is estimated that the patient receives in the neighborhood of 67 R. In a dental film, 1 to 4 R are received. Thus, with a complete oral x-ray study utilizing 12 to 16 films, the total dose received could amount to 12 to 64 R. When repeated diagnostic procedures are performed, the multiplication of the roentgen factors involved becomes sufficiently alarming to warrant a plea for caution (11). Source of Exposure Our 59 patients may be divided into two groups: (a) 28 in whom radiation cancer developed as a result of adventitial exposure and (b) 31 with radiation cancers of the skin following exposure to deep or superficial x-ray therapy administered for benign dermatoses or malignant tumors (Table I). In those instances resulting from therapeutic x radiation the history usually showed some 6 to 12 superficial radiation exposures given within a period of six months to a year. In 2 patients, there was a history of a single superficial therapeutic exposure for benign dermatitis. One radiation cancer subsequently developed after a single radium application to a small hemangioma of the skin. Those patients engaged in the professional use of x rays and radium had spent from two to forty-three years in association with these modalities, the average being twenty-two years. Incidence In a review of 700 cases of radiodermatitis collected from the literature, the overall incidence of cancer was 24 per cent (7, 11, 13, 14, 21).

A 24 CURIE STRONTIUM 90 UNIT FOR WHOLE-BODY SUPERFICIAL IRRADIATION WITH BETA RAYS.

The design and construction of a 24 c 90Sr-90Y unit for whole-body superficial irradiation are described and the results of dosage measurements reported. The effective half-value thickness of the β-ray beam is 2 mm, and a dose of 200 rads can be delivered to an area 188 cm long by 53 cm wide in a time of about 18 minutes. Shorter lengths of the body can be treated in correspondingly shorter times.

Effects of x-ray therapy on basel cell carcinoma. I. A histologic study of serial biopsy specimens.

Improvements in radiotherapy of skin cancer can be achieved through fuller knowledge of the biologic effects of radiation. This preliminary study attempts to reach a better understanding of the basic effects by a careful analysis of histopathologic changes following conventional superficial roentgen irradiation of 3 lesions of basal cell carcinoma. The changes were observed in multiple specimens from each tumor removed by biopsy at intervals during and after the periods of therapy. Material and Methods Biopsy specimens of each tumor were taken before x-ray therapy was instituted, before each treatment was given, and at intervals after completion of each course of treatment. Tumors 1 and 2 were in the same patient, a 74-year-old man. Tumor 1, which he asserted had been present only 6 months, was an ulcerated tumor of the helix and posterior surface of the left ear, measuring 3 cm. in diameter. Four millimeter punch biopsy specimens were

Sézary Syndrome— A Malignant Reticulemic Erythroderma

Seven cases are presented of an exfoliative erythroderma with intense pruritus, edema, pigmentation, superficial lymphadenopathy, hepatomegaly, leonine facies, alopecia, dystrophic nails, and hyperkeratosis of the palms and soles. A cutaneous infiltrate of atypical mononuclear cells is present in this condition and is associated with an increased leukocyte count and with an abundance of these atypical cells in the peripheral blood. The cell is characterized by a large, convoluted nucleus with a narrow rim of cytoplasm frequently containing numerous vacuoles in a necklace-like arrangement around the nucleus. Within these vacuoles is an intensively PAS-positive, diastase-resistant neutral mucopolysaccharide. Patients with this disease remain in good general condition for a long time. Treatment with superficial irradiation, steroids, and cytotoxic agents yields only temporary relief. Death occurs approximately 5 years after the first symptoms have been noted.

Whole body superficial irradiation with strontium 90 beta rays. A report of cases treated with a moving couch technique.

A moving couch technique for giving whole-body surface irradiation with strontium 90 β rays is described. Details of the first cases treated by this method are presented, together with some considerations on dosimetry.

Practical radiation protection.

The possibility of harmful genetic effects from radiation is discussed. The view is expressed that the contribution to gonad exposure from superficial radiotherapy has probably been overstated. The prudence of taking every precaution to reduce dosage is underlined. The dose measured at the approximate gonad area in the treatment of a series of dermatological patients is listed. Simple and easily applied methods by which this dose can be reduced to low or unmeasurable values are set out. The most important of these are the covering of the table with lead, the use of lead aprons, and the posturing of the patient. The application of these measures by physicians carrying out diagnostic procedures, with accruing protection to their patients and themselves, is pointed out. Mention is made of the value of the routine use of a dosemeter. (auth)

Half-value depth and fall-off ratio as functions of portal area, target-skin distance, and half-value layer.

The purpose of this communication is to present, in convenient form, values for the half-value depths and fall-off ratios corresponding to the entire range of radiation qualities, portal areas, and target-skin distances likely to be encountered in clinical roentgen therapy. Compilation of these data is believed to be useful for several reasons. First, these parameters have proved extremely useful in specifying superficial radiation beams, and it is thought that a graphic comparison of the data will facilitate treatment planning for superficial lesions. Second, though these values have seldom been considered in the planning of intermediate or deep therapy, they do provide, in some measure at least, an index of the distribution of radiation of higher energy in tissue. It is believed, therefore, that the data will enable the student to visualize readily the effect of changing kilovoltage, external filter, portal size, and target-skin distance on the distribution of radiation within a patient's tissues. Third...

The reactivity of the x-irradiated ovary of the rat.

SUMMARY 1. The ovaries of adult rats were directly X-irradiated by means of a superficial irradiation apparatus, the rest of the body being screened with lead. A dose of 4400 r produced complete sterilization. None of the animals developed radiation sickness. 2. The sterilized ovary does not undergo compensatory hypertrophy after unilateral ovariectomy, nor does it increase in size in response to exogenous gonadotrophin. 3. After irradiation, short periods of vaginal cornification recur at increasingly irregular intervals; after a minimum of 5 days and usually within 40 days, the vaginal smear becomes continuously cornified. After the period of cornification, which lasts from 2 to 14 weeks, and during which the animals will not mate, the smears become similar to those seen in spayed animals. 4. In sterilized animals the uterus is smaller than normal, but as long as 26 weeks after treatment is still significantly larger than that of spayed controls. 5. These indications of oestrogenic effects continue after bilateral adrenalectomy. They cease after removal of the X-ray sterilized ovaries. 6. Changes in the weight of the body, thymus and spleen after X-irradiation are similar to, but less rapid than, those occurring after ovariectomy. The increase in the weight of the pituitary is greater than that after ovariectomy. The adrenal glands do not decrease in size, as they do after bilateral ovariectomy. 7. The pituitaries of X-ray sterilized animals contain more gonadotrophin than do those of control-operated litter-mates, and about the same amount as do those of spayed rats.

Effect of high-intensity x-radiation on velocity of nerve conduction.

ArticleEffect of High-Intensity X-Radiation on Velocity of Nerve ConductionHerbert B. Gerstner, John S. Orth, and Everett O. RicheyHerbert B. GerstnerFrom the Department of Radiobiology, United States Air Force School of Aviation Medicine, Randolph Air Force Base, Randolph Field, Texas, John S. OrthFrom the Department of Radiobiology, United States Air Force School of Aviation Medicine, Randolph Air Force Base, Randolph Field, Texas, and Everett O. RicheyFrom the Department of Radiobiology, United States Air Force School of Aviation Medicine, Randolph Air Force Base, Randolph Field, TexasPublished Online:31 Dec 1954https://doi.org/10.1152/ajplegacy.1954.180.1.232MoreSectionsPDF (859 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Download PDF FiguresReferencesRelatedInformation Cited ByFeasibility of cerium-doped LSO particles as a scintillator for x-ray induced optogenetics27 April 2021 | Journal of Neural Engineering, Vol. 18, No. 4Treatment Planning Factors Associated with Long-Term Outcomes of Gamma Knife Surgery in Patients with Trigeminal NeuralgiaWorld Neurosurgery, Vol. 151Can Radiation-induced Cranial Nerve Palsy be a Warning Sign of Radiation Myelitis?Neurosurgery Quarterly, Vol. 25, No. 2The Physiological Effects of Radiotherapy on Oral TissueJournal of Prosthodontics, Vol. 1, No. 1Case report: Partial relapse of Bell's palsy following superficial radiotherapy to a basal cell carcinoma in the templeClinical Radiology, Vol. 37, No. 4Behavioral Effects of Ionizing RadiationsElectrophysiologic Responses of Sciatic Nerves Exposed to 200-kV X-Rays and 47.5-MeV ProtonsRADIATION BIOCHEMISTRY OF MISCELLANEOUS ORGANSThe Effects of Ionizing Radiation on the Nervous SystemULTRASTRUCTURAL CHANGES IN THE SENSORY NERVE FIBRES IN THE SKIN OF THE FROG (RANA TEMPORARIA) AFTER CIRCUMSCRIPT IRRADIATION WITH Po210α-PARTICLES (5,3 MeV)18 August 2009 | Acta Pathologica Microbiologica Scandinavica, Vol. 54, No. 2Effects of Irradiation with Low-energy X-rays on Resting- and Action-potentials of Skeletal- and Heart-muscle Fibres3 July 2009 | International Journal of Radiation Biology and Related Studies in Physics, Chemistry and Medicine, Vol. 4, No. 6General Biology: The Adult OrganismEffects of Irradiation of Nerve on Muscular ResponseNature, Vol. 184, No. 4687THE RADIORESISTANCE OF PERIPHERAL NERVESome Biological Aspects of Experimental Radiology A Historical ReviewPhotoreversal of ultraviolet injury to frog and crab nervesJournal of Cellular and Comparative Physiology, Vol. 49, No. 2 More from this issue > Volume 180Issue 1December 1954Pages 232-236 Copyright & PermissionsCopyright © 1954 by American Physiological Societyhttps://doi.org/10.1152/ajplegacy.1954.180.1.232History Received 26 July 1954 Published online 31 December 1954 Published in print 31 December 1954 Metrics

RADIOACTIVE STRONTIUM THERAPY OF THE EYE

BETA irradiation of the eye remains relatively unemployed because of inconvenience, practical difficulties, and, in some instances, potential radiation hazard to the operator or to the patient's lens, or occasionally to both; but, because this form of superficial radiation therapy is both safe and effective when used properly in the conditions for which it is indicated and since it has no therapeutic equivalent in some instances, the continuing search for an improved ophthalmic applicator has led to the use of artificially radioactive isotopes. Radioactive strontium (Sr 90 ) was chosen for the source material by Friedell and his associates, 1 who were the first to use this fission product in an applicator for ophthalmic use. Following the lead of this laboratory model, commercial physicists recently developed a clinical model, the RA-1 Medical Applicator. 2 The effects of clinical treatments with new applicators of this type are certain to be somewhat unpredictable

Thorium X treatment of skin epithelioma, keratoses, and delayed radiation changes.

Epitheliomas, as well as keratoses and superficial radiation injuries, can be successfully eradicated by applying thorium X in solution or in an ointment, the effect being due apparently to the intense ionizing properties of the alpha particle. Unsatisfactory sequelae such as ugly scarring, keloid formation, depigmentation, telangiectasis, or other untoward radiation effects have not been observed to date. Thorium X should not be confused with thorium or thorium compounds. The thorium paste used by Bulkley (1) did not contain thorium X but thorium oxide in combination with other chemicals. The action of this paste was mainly a caustic one, not dependent on its radioactive qualities. History Due to scarcity of radium in Germany, investigators turned to mesothorium as a source of radiation energy. As early as 1912 independent reports by Bickel (2) and Pappenheim (3) appeared in the German literature. Both referred to the oral administration of thorium X in the treatment of anemia and leukemia. The following year Naegeli and Jessner (4) reported on the efficacy of the external application of thorium X in the treatment of psoriasis, neurodermatitis, lupus erythematosus, and lupus vulgaris. Further work dealing with the local application of thorium X in chronic dermatoses was carried out by Fabry (5, 6, 7), Jadassohn (8), Nagelschmidt (9), Pinkus (10), and Prosser Thomas (11). In reporting his experiences with thorium X in the treatment of nevus flammeus (port-wine mark) and various dermatoses, Prosser Thomas indicated that he had also successfully treated several of the flat, cicatrizing superficial basal-cell lesions. He is therefore to be regarded as the pioneer in the treatment of skin epithelioma by this means. Except for the workers listed above, all those reporting on the use of thorium X have described its application in needles with various filtration, simulating radium and radon therapy technics. When thorium X is thus enclosed in a metal sheath, the beta and gamma factors only are utilized, and as some 99 per cent of the energy emitted is in the form of alpha particles, immeasurably larger amounts are necessary to produce any biological effect. The needles used contained 500 μc. (micocuries) or 0.5 mc. of thorium X per centimeter of length, on the basis of Halber-staedter's (12) researches in 1923. Alpha rays from radon have been utilized by Uhlmann (13), Low-Beer and Stone (14), and others. They kneaded radon gas into a vaseline base to treat post-irradiation skin injuries and have reported good results. The concentration of radon ranged from 17 to 34 μc. (50–100 e.s.u.) per gram of vaseline. Uhlmann contended that the healing effects observed were due to stimulation of the epithelial cells as a result of alpha particle bombardment.

DERMATITIS CAUSED BY DIETHYLENE GLYCOL IN TOBACCO

P. H., a white man, aged 39, an aviator, complained of a dermatitis of the left index and middle fingers of six weeks' duration and of the left upper lip of four weeks' duration. Two months before, he had been in a hospital for a period of six months because of fracture and amputation of one thigh. He stated that there was no personal or family history of allergy. The eruption was pruritic. It consisted of pinpoint to pinhead size vesicular and scaling lesions on an erythematous base. The borders were ill defined and gradually faded into the normal skin. Wet dressings of solution of aluminum acetate were prescribed for two days, and this was followed by a single fractional dose of superficial x-ray irradiation and zinc ointment U. S. P. Two weeks later the eruption on the fingers was greatly improved but that on the lip remained unchanged. In

Irradiation of Tumors, with Special Reference to Radiosensitive Tumors

THIS brief review is based on the experience of nearly eight years, during which we have irradiated certain types of tumors with superficial and deep X-ray. Most of the experience was obtained in the treatment of cases observed both by Dr. Bloodgood and the author, and the diagnosis was based on clinical, X-ray, or microscopic evidence and not infrequently on all three. Dr. Bloodgood published a thorough review of radiosensitive tumors in Radiology in March, 1930. The present review is chiefly of tumors considered inoperable, most of them large and either inaccessible or not easily accessible by operation. As a rule, the more malignant the tumor the more radiosensitive it is likely to be; for example, lymphosarcoma and certain other types of sarcoma—embryonal cell sarcoma. There are some exceptions, which will be mentioned later in the case reports. Of the curable types of tumor, basal-cell cancer is well known to yield to irradiation, and since this type of cancer frequently attacks the skin superficial irradiation is usually sufficient to bring about a cure. Basal-cell cancer is mentioned simply to call attention to the fact that irradiation as well as surgery will produce a cure, and also that it falls in the radiosensitive group. When properly treated either by X-ray or surgery, it seldom recurs. Fibromas or fibrosarcomas belong to a type of tumor more or less radiosensitive, and, while some of them will yield to irradiation and the patient remain clinically well for five years or more, others are only temporarily benefited, recur, and have to be surgically removed. Tumors of this type, therefore, fall in the group of moderate curability and it is always advisable to try irradiation before operation. Such a tumor is somewhat slow-growing and not infrequently involves the nerve sheath. One case of fibromyxoma of the antrum and nares and another case of fibromyxosarcoma involving the antrum and ethmoidal region, treated with the deep X-ray, are up to the present time clinically well at two and two and a half years, respectively. These, with a few other cases, are taken from a large number of various types of tumors treated in the past eight years, and are reported because they present points of unusual interest. No attempt has been made in this study to make it embrace a complete review of radiosensitive tumors. Case Reports Case 1. This case is extremely interesting as being an instance of a markedly radiosensitive tumor which proved highly malignant. The patient, H. J. R., white male, aged 56, consulted Dr. Bloodgood in April, 1930, about a growth on his forehead, which had been present for about ten or eleven months. When first noticed it approximated the size of the end of the index finger. It has slowly grown to the present size, occasioning no actual pain, no headaches. The patient feels a little uneasiness there, and cannot wear a hat on account of pressure.