RADIATION THERAPY IN NEOPLASTIC DISEASE
Recent innovations in radiotherapy of various forms of cancer are reviewed, and new techniques for treating radiation sickness and injury are outlined. When larger areas of skin are treated with high dosage levels, the erythematous reaction may regress to a wet reaction with denudation. Aqueous 1% gentian violet produces a protective cover which may be soaked off two or three times daily,. followed by a new application by nebulizer or cotton applicator. It is most important to prevent additional trauma. This skin reaction will heal in about two weeks, depending upon the area and depth of involvement. Atrophic dry areas should be protected from irritation. Zinc oxide paste provides an economic protection; however, large areas exhibiting atrophy and ectasia may ulcerate repeatedly. If there has been much vascular damage, adequate excision and skin grafting will probably be necessary. Careful attention must be given to the possibility of metaplasia and transformation into squamous cell carcinoma. The epithelial lining of the oropharynx and esophagas, when included in treatment fields, may develop mucositis near the end of treatment, but the peak reaction usually develops after treatment is completed. This may be easily observed in the oropharynx as a pseudomembranous reaction which looks very much like a monilia infection. This temporary reaction will not require intensive treatment and will respond to warm, normal saline irrigation. The mucous membrane reaction of the esophagus usually develops after approximates 4000 r. Thus, near the end of the 4th wk of treatment, complaints of difficulty in swallowing are expected. There is no effective treatment. Fluoroscopic examination usually does not show a detectable abnormality. The peak reaction may occur 10 days after treatment is completed, and then gradually subsides during the next three weeks. For relief from nausea and vomiting, antiemetics, vitamin B preparations, and antihistamines may be used. Yeast tablets and wine have proved very satisfactory, and a glass of wine diluted to half with water 30 min before noon and evening meals promotes appetite. If the white blood count remains above 2000 and the hemoglobin above 10 g, it is not necessary to be concerned about the hematologic picture. However, if the count falls below these levels, special consideration is required and daily hemoglobin and white blood cell determinations should be done. As a treatment policy, it is recommended that radiation be continued as long as the white blood count remains above 1000 and hemoglobin above 10 g. When hemoglobin falls below this level, transfusion is indicated. The radiation effect is dependent upon the level of tissue oxygenation. With a large field, peripheral white cell counts usually drop in about two weeks. Proctitis, a frequent complication of uterine cancer irradiation, may respond to oil enemas; however, the most effective treatment now seems to be cortisone suppositories. Sedation coupled with narcotics may have to be used for dysuria, which usually does not appear at doses >4000 r. This becomes a rather serious problem in connection with treatment of carcinoma of the bladder, but is rarely a problem in treatment of the uterine cervix. Relief from burning, urgency and frequency can usually be obtained with phenazopyridine. If retention and infection complicate the discomfort, methenamine mandelate may be used safely in combination for its antibacterial action. For postradiation vaginitis, a regimen of gentle irrigation with warm (100 deg F) water, hydrogen peroxide or sodium perborate, and normal saline assists healing. (BBB)
- Research Organization:
- Univ. of Kansas, Kansas City
- NSA Number:
- NSA-17-035366
- OSTI ID:
- 4671697
- Journal Information:
- GP, Journal of the American Academy of General Practice (U.S.) Changed to American Family Physician - GP, Vol. Vol: 26; Other Information: Orig. Receipt Date: 31-DEC-63
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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AMINES
ANTIHISTAMINICS
BLADDER
BLOOD PLASMA
BLOOD VESSELS
BORATES
CANCER
CARCINOGENESIS
CORTISONE
DRUGS
ESOPHAGUS
FLUORESCENCE
FUNGI
HEMOGLOBIN
HYDROGEN PEROXIDES
INFECTIONS
LEUCOCYTES
MANDELIC ACID
NARCOTICS
OILS
OXYGEN
PERACIDS
PHARYNX
PROCTITIS
PYRIDINES
RADIATION DOSES
RADIATION EFFECTS
RADIATION INJURIES
RADIATION PROTECTION
RADIATION SICKNESS
RADIOTHERAPY
SKIN
SODIUM COMPOUNDS
SOLUTIONS
STEROIDS
TISSUES
TRANSFUSIONS
TRANSPLANTS
URINE
UTERUS
VITAMIN B GROUP
VITAMINS
WATER
ZINC OXIDES