The late results of surgical treatment of lung cancer.
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Biomedical subjects
Publications and source records attributed to W P Scott.
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A spacer/injector needle for 125I and other radioactive sources is described. Exposure is minimized by speed, distance, and (in the case of 125I) the low energy of the source shielded within the needle. Afterloading can easily be performed using small trocars. A readily attached plunger gives the needle a syringe (injection) action, while a rapid seed loader reduces loading time as well as the number of needles required when loading is carried out in the operating room.
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A convenient method of interstitial radiation therapy can be quickly and easily accomplished using absorbable Vicryl-125I sutures which offer these general advantages: long shelf life, 60 day half-life; low energy, 28 kilo electron volts, permitting patients to leave the hospital; good geometric and anatomic distribution of 125I seeds which remain in place after implantation; less radiation exposure to the operating and attending personnel due to this low energy plus the reduced exposure time provided by quick implantation; removal unnecessary, reducing exposure time; implantation using minor surgical equipment; dosage determination easily calculated; hospitalization, from the standpoint of radioactivity, unnecessary.
A simple technique of permanent radioactive implantation, originally developed for the increasing number of unresectable lung tumors, utilizes absorbable polyglactin sutures ("Vicryl") containing low intensity, long half-life 125I seeds.
Permanent and removable interstitial implantation techniques using absorbable and unabsorbable sutures are described. Most of these techniques can be performed in the clinic easily and quickly with basic instruments: needle holder, needle book, and hemoclips. Specifically, Ir192 (74-4 day half life, 300-610 keV, and 6.0 cm. hvl in tissue) nylon ribbon and I125 (60 day half life, 27-35 keV, and 2.0 cm. hvl in tissue) Vicryl sutures are described. A major advantage of the I125 over the Ir192 see (other than the fact that it can be permanently implanted and needs less radiation protection) is that the patient does not remain highly radioactive for as long a period due to hte extremely low I125 energy and may be allowed to leave the hospital. Both nuclides have the advantage of a long shelf life, making their use practical and economically feasible.
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