A PRELIMINARY CLINICAL REPORT CONCERNING OXYGEN BAROTHERAPY AND MEGAVOLTAGE RADIOTHERAPY
Attempts were made to develop a radiotherapy technique to increase the sensitivity of various types of tumors by exposing the patient to oxygen at high pressure in a specially constructed chamber while undergoing high-voltage x-ray treatment. Results are reported for 110 cases of locally advanced malignant tumors in various sites that have received treatment combining oxygen barotherapy with 4-Mev x-ray therapy, delivering three large fractions of x-ray dosage in a total time of 21 days. Each patient received general anesthesia, bilateral myringotomy, and pressurization of oxygen to 45 lb/in./sup 2/ gauge pressure in a pressure vessel. Cases treated during the first 10 months are reported in relation to their status from 2 months after treatment. Immediate tumor resolution was good but severe radiation reactions required reduction of the dosagn first used. Reduction of the dose to 3 x 1000-rad maximum tumor dose did not significantly alter the sequelae and more recently a maximum tumor dose of 3 x 800 rad was used. The reduced dosage was well tolerated, being no worse than that expected when conventional techniques were used to deliver 6000 to 6500-rad tumor doses in 5 to 6 weeks with 4-Mev x rays. The higher doses in oxygen showed mucosal reactions similar to those seen nt the site of a radon implant producing 6000 to 7000-rad tumor doses in 5 to 7 days but of course involved much larger volumes of tissue. Experience with similar large doses delivered in air, compared with those used with barotherapy, suggests that dose for dose the mucosal reactions were more intense with barotherapy. Animal lab studies lended suppont to this conclusion. Skin reactions, on the other hand, seemed to parallel the dosage received on the skin and not to be aggravated by oxygenation effects. Tumor resolution with the various dosage schemes employed was very satisfactory and often dramatic. Delayed necroses appeared commonly five months after completing treatment in those cases treated with high doses who developed the most intense mucous membrane reactions even though healing was almost complete 2 to 3 months after treatment. The use of antibiotics, conticosteroids, and triiodothyronine did not infiuence progression. Definite local recurrence of tumor within the treated volume was confirmed in only a few cases. In three patients, comparison was possible of the tumor resolution produced by the barotherapy technique with the resolution produced when similar dosage was given in air to a regional metastasis later appearing. The resolution was far superior with barotherapy. Bilateral myringotomy produced temporary deafness, usually unilaterai, in approximately 20% of the cases, and oniy four patients have any residual deafness. It is concluded that the pressure vessel allows treatment of advanced tumors in practically all sites without seriously limiting the application of x-ray fields which would be normally chosen with conventional megavoltage therapy. In the 110 cases local tumor disappearance was noted in 60% to 80%, depending on whether an optimistic or pessimistic view was taken of those cases with still uncertain status. (BBB)
- Research Organization:
- Peter MacCallum Clinic, Melbourne
- Sponsoring Organization:
- USDOE
- NSA Number:
- NSA-18-013585
- OSTI ID:
- 4088762
- Journal Information:
- J. Coll. Radiol. Australasia, Journal Name: J. Coll. Radiol. Australasia Vol. Vol: 6
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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