Radiation myelitis: can diagnosis be unequivocal without histological evidence?
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Biomedical subjects
Publications and source records attributed to R Abadir.
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The testes of rats were treated by x rays, or ultrasound. 2000 rads single dose of x ray led to tubular atrophy, which was defined as destruction of all spermatogenic cells but Sertoli cells. Ultrasound of 1 W/cm2 for 15 min led to tubular necrosis, which was designated as complete disorganization of the seminiferous tubules with disappearance of spermatogenic as well as sertoli cells. The possibility of male castration by ultrasound is raised.
Localized carcinoma of the prostate was treated in 20 patients by pelvic lymph node dissection, radioactive iodine implant and external radiotherapy. Treatment was well tolerated. Pelvic lymph node involvement was present in 35% of the patients. Well-differentiated cancers were essentially in small prostates (3 cm), stages T1 or T2. They had a lower possibility (10%) of metastasis to only one pelvic lymph node. None had more than one lymph node involved. Moderately or poorly-differentiated cancers occurred in larger prostates (4 cm or more), stage T3. They had a high likelihood (60%) of pelvic node involvement.
Twenty-six patients with superior pulmonary sulcus (Pancoast) tumors were evaluated. Twelve patients were treated with high dose radiotherapy with NSD over 1 900 rets and 10 with NSD less than 1 900 rets. Four patients were treated with combined radiation and surgery. High dose radiotherapy resulted in relief of pain in all patients but apparently did not change survival. Low dose radiotherapy offered relief of pain to only half the patients. Distant metastasis was noted in 30% of patients (15% to brain, 3.8% to liver), rib destruction in 65% and supraclavicular nodes in 19%. Only 4 patients went to surgery and 2 died during operation. We thus conclude that Pancoast tumor is essentially an inoperable disease.
Hyperthermia induced from microwave 30 watts for 5 minutes or from ultrasound 1 watt/cm2 for 5 minutes as well as x-rays were destructive to the testes of rats. The combination of x-ray and hyperthermia enhanced the destructuve effect regarding the degree of reduction of spermatogenesis as well as the number of tubules affected.
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Thirteen patients with intrathoracic metastasis were treated with radiotherapy. Response was obtained in 75% (9/12) of cases and was complete in 50% (6/12). There was extrathoracic metastasis at time of radiotherapy in six patients. Complete disappearance of intrathoracic metastasis occurred only in patients without extrathoracic metastasis; only three of six had primaries known to be radiosensitive (Wilms' tumor and Ewing's sarcoma). In three patients the intrathoracic metastasis progressed after radiotherapy and all had extrathoracic metastasis. It is concluded that radiotherapy is an effective modality of treatment of intrathoracic metastasis and that favorable response is associated with the absence of extrathoracic metastasis rather than the known radiosensitivity of the primary.
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A case of desmoid tumor of 17 years' duration associated with cystosarcoma phyllodes of 17 months' duration is presented. Good initial response to radiation therapy of the desmoid tumor was shown. Poor response of cytosarcoma phyllodes to radiation therapy was noted. A comparison between the similarities and differences of the two tumors is presented.
The spread pattern was studied in 48 autopsied cases of irradiated, apparently localized lung cancer. Disease was found in the upper abdomen in 52%, in the brain in 8.7%; in the bones in 20.8%; and confined to the thoracic cavity in 27%. Radical irradiation controlled 38% locally. The pattern of metastasis in these irradiated lung tumors did not seem to differ from that of unirradiated lung cancers reported elsewhere.
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