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Relative values of irradiation and radical hysterectomy for cancer of the cervix
R.EVIEWS
AND
ARSTRACTS
127
Radiosensitive casea are treated with 100 mg. of radium for forty-eight hours. One month Iater they are examined again and if induration persists or if bloody discharge has occurred 30 mg. are applied for eighteen hours. Slightly sensitive cases are treated with 100 mg. for twenty-four hours, repeated at ten- to twelve-day intervals for three weeks; then, after interval of three weeks they are treated twice at three week intervals with 30 mg. for twenty-four hours. Radioresistant cases are started with a aose of 30 mg. for twenty hours with a second dose of 100 mg. eight days later. Three weeks later the radium is reapplied in doses of 12 to 15 mg. every ten to twelve days for two or three months. Certain cases where the distribution of cancerous tissue is irregular are treated by inserting needles with 10 mg. of radium into the indurated areas for a period of twenty-four to thirty-six hours, repeating this exposure eight, fifteen, and in some cases twentyfour days after the first. THOS. R. C~OETHALS. Clark, John Gc., and Block, Frank B.: Relative Values of Irradiation and Radical Hysterectomy for Cancer of the Cervix. The Atlantic Medical Journal, 1924, xxvii, 696-699. The authors draw the conclusion that radium is a palliative remedy of inestimable value in the great majority of hopeless surgical cases and of absolute curative value in a small percentage. While it challenges most favorable comparison with the radical abdominal operation, nevertheless they take no issue with the skillful specialist who still adheres to the radical viewpoint, provided he supplements his operation with postoperative irradiation. As to anteoperative irradiation, they are still doubtful, and await with interest the report from those clinics in which this prophylactic plan is employed. To discard or fail to use this new remedy as an adjunct to surgical measures in the face of such statistics as are now available should lay C. 0. IULAND. the objector open to a charge of criminal negligence. Hernaman-Johnson, Francis:~ The Analgesic Other Painful Disorders. The Practitioner,
Effects of X-rays 1926, cxvi, 314.
in Uaucer
and
Hernaman-Johnson discusses the pain relieving properties of the x-rays in cancer and other painful disorders and points out that they share these properties with other forms of radiation, radiant heat, and ultraviolet light. The relief of pain by heat is so well known a phenomenon that it is accepted as a matter of course, and excites neither incredulity nor wonder. It is generally “ explained ’ ’ by stating that the benefit is due to dilatation of surface capillaries. X-rays also produce capillary dilatation, though not of an obvious type. In neither instance is the explanation adequate, nor is the clinical result either more or less mysterious in the one case than in the other. LiDAIR AND PRoSX?EK. Daels and De Backer: Cervix. Le Progres
A New Tech& for Radium Treatment M&Gal, 1924, No. 38, p. 558.
of Cancer of the
These authors feel that treatment of cervical cancer by x-ray is unsatifaetory because the normal tissues also are subjected to prolonged radiations. It does, however, offer the advantage of radiating the lymphatic tissues of the pelvis en masse, a factor not accomplished when radium is used in the vagina: Therefore, these authors have worked out a technic by which they expose the parametrial lymphaties to radium by the extraperitoneal introduction of radinm tubes. To this method they have given the name of C‘Radium Drainage” or “Radium Wertheim.” The capsules contain 3.3 mg. of radium element, filtered by 0.5 mm. of platinum. Two such capsules are contained in a sheath of 1.5 mm. of platinum. Two sheaths
AND
ARSTRACTS
127
Radiosensitive casea are treated with 100 mg. of radium for forty-eight hours. One month Iater they are examined again and if induration persists or if bloody discharge has occurred 30 mg. are applied for eighteen hours. Slightly sensitive cases are treated with 100 mg. for twenty-four hours, repeated at ten- to twelve-day intervals for three weeks; then, after interval of three weeks they are treated twice at three week intervals with 30 mg. for twenty-four hours. Radioresistant cases are started with a aose of 30 mg. for twenty hours with a second dose of 100 mg. eight days later. Three weeks later the radium is reapplied in doses of 12 to 15 mg. every ten to twelve days for two or three months. Certain cases where the distribution of cancerous tissue is irregular are treated by inserting needles with 10 mg. of radium into the indurated areas for a period of twenty-four to thirty-six hours, repeating this exposure eight, fifteen, and in some cases twentyfour days after the first. THOS. R. C~OETHALS. Clark, John Gc., and Block, Frank B.: Relative Values of Irradiation and Radical Hysterectomy for Cancer of the Cervix. The Atlantic Medical Journal, 1924, xxvii, 696-699. The authors draw the conclusion that radium is a palliative remedy of inestimable value in the great majority of hopeless surgical cases and of absolute curative value in a small percentage. While it challenges most favorable comparison with the radical abdominal operation, nevertheless they take no issue with the skillful specialist who still adheres to the radical viewpoint, provided he supplements his operation with postoperative irradiation. As to anteoperative irradiation, they are still doubtful, and await with interest the report from those clinics in which this prophylactic plan is employed. To discard or fail to use this new remedy as an adjunct to surgical measures in the face of such statistics as are now available should lay C. 0. IULAND. the objector open to a charge of criminal negligence. Hernaman-Johnson, Francis:~ The Analgesic Other Painful Disorders. The Practitioner,
Effects of X-rays 1926, cxvi, 314.
in Uaucer
and
Hernaman-Johnson discusses the pain relieving properties of the x-rays in cancer and other painful disorders and points out that they share these properties with other forms of radiation, radiant heat, and ultraviolet light. The relief of pain by heat is so well known a phenomenon that it is accepted as a matter of course, and excites neither incredulity nor wonder. It is generally “ explained ’ ’ by stating that the benefit is due to dilatation of surface capillaries. X-rays also produce capillary dilatation, though not of an obvious type. In neither instance is the explanation adequate, nor is the clinical result either more or less mysterious in the one case than in the other. LiDAIR AND PRoSX?EK. Daels and De Backer: Cervix. Le Progres
A New Tech& for Radium Treatment M&Gal, 1924, No. 38, p. 558.
of Cancer of the
These authors feel that treatment of cervical cancer by x-ray is unsatifaetory because the normal tissues also are subjected to prolonged radiations. It does, however, offer the advantage of radiating the lymphatic tissues of the pelvis en masse, a factor not accomplished when radium is used in the vagina: Therefore, these authors have worked out a technic by which they expose the parametrial lymphaties to radium by the extraperitoneal introduction of radinm tubes. To this method they have given the name of C‘Radium Drainage” or “Radium Wertheim.” The capsules contain 3.3 mg. of radium element, filtered by 0.5 mm. of platinum. Two such capsules are contained in a sheath of 1.5 mm. of platinum. Two sheaths