Gustave Kaplan

Nitrogen Mustard as an Adjunct to Radiation in the Management of Bronchogenic Cancer

It is generally agreed that pulmonary resection offers the patient with bronchogenic carcinoma his best chance for cure. Unfortunately, most cases are inoperable when first seen. Of the 400 patients with bronchogenic carcinoma seen at the Veterans Administration Hospital in the Bronx (N. Y.) in the past four years, 90 per cent came too late for surgery. At the Hines Veterans Hospital, 95.4 per cent of 1,057 such patients admitted from 1937 to 1947 were already beyond any attempt at salvage by surgical resection (1). This distressing picture is reflected in other hospitals and clinics. It may be estimated that in 1949 there were in this countrya bout 28,000 new patients with bronchial cancer, compared to 10,000 in 1939 (34). Unless treated by irradiation, inoperable bronchogenic carcinoma runs its lethal course rapidly and inexorably, complicated by distressing signs and symptoms, both local and systemic. Of 584 non-irradiated inoperable patients, not one survived more than one year after the onset of the ...

Treatment of Bronchogenic Cancer with Conventional X-Rays According to a Specific Time-Dose Pattern

This is A report of 43 patients with advanced nonresectable cancer of the lung who received conventional x-ray therapy according to an abbreviated time-dose pattern and showed subjective and objective improvement. Inoperable carcinoma of the lung is essentially an incurable disease either because of its local extension to vital structures (1) or because of distant metastasis. Experience has shown that when a dose of radiation sufficient to eradicate the local disease is delivered, irreparable changes in the surrounding normal lung tissue may be produced. While the morbidity secondary to these changes is incapacitating, it would be a small price to pay were the disease cured. However, with the frequent incidence of local extension and/or distant spread, both of which mitigate against cure, one should be circumspect in delivering high dosage to the lung. There is little doubt that irradiation can induce a significant degree of palliation in a great many patients. This should be accomplished with a dose that...

Malignant fibrohistiocytoma (fibroxanthoma). Case report.

Abstract A case of malignant fibrohistiocytoma (fibroxanthoma) is presented. Metastases to the lungs, bone, and soft tissues occurred. The lesions in the lungs and left thigh responded favorably to 60Co therapy. This is a relatively rare condition, occurring in approximately 1% of fibroxanthomas. There are no definite histological features which may indicate malignant changes.

Improvement of osseous changes in the sella turcica following irradiation for a pituitary tumor; a case report.

Changes in the size and structure of the sella turcica following roentgen therapy for a pituitary tumor have only rarely been observed. Pancoast, Pendergrass, and Schaeffer (6) have stated, “The bone in the dorsum sellae is seldom, if ever, regenerated after it has been destroyed by pressure. On the other hand, if the dorsum sellae is destroyed by an infiltrating growth, regeneration may occur, as is evidenced in a few instances on record.” Von Poswick (7) reports a case of recalcification of the sella turcica after roentgen therapy, but in this instance the sellar involvement was secondary to a malignant growth. Decrease in the size of the sella after irradiation in pituitary gigantism has been reported by Hurxthal (4), and 8 cases in which an enlarged sella diminished in size following roentgen therapy are cited by this same writer and his associates in another communication (5). All of this latter group were acromegalics; in 1 of the cases, the decrease was a result of operative procedure plus irradiat...

Unusual manifestations of carcinoma of the nasopharynx. A case report

A case of carcinoma of the nasopharynx which occurred in a 21‐year‐old Negro man is reported. He developed metastasis in the left humerus which simulated a primary bone tumor. This was studied by biopsy, angiography, and a strontium‐85 scan. He subsequently complained of pain in the right humerus. Angiography and strontium‐85 scan revealed metastasis in the bone before x‐ray verification. X‐ray therapy induced prompt pain relief.

Results of radiation therapy in vascular anomalies of the central nervous system.

There are few published studies in the English and American literature (2, 4, 5, 7, 9, 12, 13, 17) reporting the use of irradiation as primary form of treatment or as an adjunct to surgery in the management of vascular anomalies of the central nervous system. In most of the cases reported, a critical evaluation of the contribution of radiation was not possible. Descriptions of treatment factors were either omitted or inadequately recorded. The purpose of this report is to present an evaluation of our own experience in the use of roentgen therapy as an adjunct to surgery in the treatment of these pathologic entities, which are responsible for such distressing and disabling symptoms as headaches, vomiting, vertigo, epilepsy, hemiplegia, and impotence. The vast majority of these lesions cannot be completely extirpated by surgery. In most instances only surgical decompression is possible. Postoperative roentgen therapy was therefore employed in an attempt to induce an endarteritis, diminishing the size of the...

Gonadal exposure incident to roentgen therapy.

Because of its genetic effect, there has been much concern about gonadal exposure to man-made radiation. Geneticists (1) feel that there is no threshold dose below which mutations are not produced. Low doses are mutagenic, and all doses, however distributed, are cumulative. At the present time, diagnostic radiology is the major contributor to gonadal exposure of the populace. To the individual, however, exposure from radiotherapy is greater than that from any other source. The scope of the problem from the point of view of roentgen therapy is emphasized in the study made for the National Academy of Sciences by Laughlin and Pullman (2) who estimated that the number of x-ray treatments given by radiologists to persons under thirty in the year 1955 was 1.9 million. To this figure must be added the number of treatments given by dermatologists. Clark (3) estimated that 25 per cent of treatments in all age groups are for nonmalignant ailments. The remaining 75 per cent are for malignant diseases, where genetic ...