Ionizing radiation for treatment of benign conditions.

Ionizing radiation has been used much more frequently in the past than at the present in the treatment of benign conditions. As progress continued in the medical sciences, the use of radiotherapy narrowed considerably due to better understanding of the nature of ionizing radiation and its potential complications. Other agents have replaced ionizing radiation in some areas, but there are still conditions that benefit from this treatment. This article reviews the basic principles that should be observed in treating benign conditions with radiotherapy.

Detection of a brain metastasis from osteosarcoma with 99mTc-methylene diphosphonate bone scanning.

99mTc-methylene diphosphonate (MDP) bone scintigraphy demonstrated localization in an intracranial metastasis of osteogenic sarcoma. This unusual case suggests that bone scintigraphy may have diagnostic value in the early diagnosis of metastatic ossifying lesions.

Prolactin-secreting tumors.

A case of galactorrhea induced by hyperprolactinemia has been reported. This patient had bronchogenic carcinoma, undifferentiated, spindle-cell-type, and underwent a pneumonectomy followed by postoperative irradiation of the mediastinum. The initial surgical resection, followed by irradiation, returned the abnormal levels of prolactin secretion to normal. Although subsequent determinations could not be made, this case supports evidence from earlier reports that galactorrhea-induced hyperprolactinemia may occur concomitantly as a paraneoplastic syndrome with this rare form of carcinoma.

Evaluation of postexcisional strontium 90 beta ray therapy for pterygium.

During a ten-year period, 211 patients with a diagnosis of pterygium were treated in the University of Texas Medical Branch by a combined effort using a strontium 90 beta ray applicator immediately after surgical excision. Only one patient developed recurrence. No complications were observed during the first year of follow-up.

The complications of full-pelvic irradiation with particular emphasis to external beam therapy.

62 Patients with uterine carcinoma of cervix treated with high-dose large-volume full-pelvic irradiation given through co-axial-opposing pair portals over the anterior and posterior pelvis. Of these patients, 29 also received a single course of intracavitary radium supplementary to external beam irradiation. Only the severe complications which required surgical intervention have been analyzed, In the group of 33 patients who received only external irradiation, 4 developed such complications (12.1%).The overall incidence of those complications was about 19.3%. It is concluded that the treatment with hidh-dose large-volume full-pelvic irradiation technique, utilizing two opposing parallel pelvic portals, carries an incidence of morbidity 3-4 times the acceptable level and should be discouraged. Alternative techniques are discussed.

A short course - low dose preoperative irradiation of endometrial carcinoma. Preliminary report.

This is a preliminary and comparative report of a randomized prospective study in which 14 unselected women with a proven histological diagnosis of endometrial adenocarcinoma were subjected to a course of external irradiation treatment with total 1,500 rad mid-pelvic dose delivered on five consecutive days followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. Surgery was performed within 1 week after the completion of radiation therapy. At the same time, 15 additional patients with identical histological diagnosis were treated with the conventional external irradiation technique of 5,000 rad delivered in 5 weeks followed by surgery 6 weeks later. The stage indicates no significant differences between these two radiotherapeutic modalities in regard to survival rate, recurrences or complications. The short course-low dose approach markedly reduces the cost and overall treatment time.