| Popis: |
1. 1. Roentgen rays were applied first in the human to a gastric cancer by Depeignes in 1896. 2. 2. Because of its inaccessibility for external and interstitial irradiation, the frequency of obstruction of an orifice, and the advanced stage of the disease when diagnosed, irradiation of gastric cancer is extremely difficult. 3. 3. Radiosensitive gastric tumors are rare and usually occur in the proximal half of the stomach. 4. 4. Gastric lymphosarcoma has been found to be radiosensitive. 5. 5. Radium in the 4-gram radium element pack, radon in gold seed, roentgen rays and combinations of these radiotherapeutic agents have been applied in definitely measured doses to 60 cases of gastric cancer. For external irradiation the radium element pack seems preferable to roentgen rays. 6. 6. Roentgen irradiation in fractionated doses to several portals with a crossfiring effect in the tumor provides greater tissue dosage. 7. 7. Preoperative irradiation of operable gastric carcinoma is not advised. In cases where two stage resection is elected, irradiation may be used in the interval. 8. 8. Interstitial radiation with gold radon seeds of gastric cardia cancer has been performed through a gastrostomy stoma or by exposure of the tumor by a costochondral rib flap. This method is supplemental to external radiation. 9. 9. Exclusion of inoperable carcinomas of the distal segment is desirable before radiation therapy is instituted. 10. 10. Prophylactic irradiation of radically resected cases is not a routine procedure in this clinic. 11. 11. Serious complications which may follow radiotherapy include tumor necrosis with fistula formation, peritonitis and hemorrhage from the stomach. Radiation sickness occurs frequently. 12. 12. Palliation has been obtained in some inoperable gastric cancers. |
