Milford D. Schulz

The role of radiation therapy in the management of carcinoma of the sigmoid, rectosigmoid, and rectum.

Cancer of the colon is one of the more frequent types of cancer in man. Carcinomas of the sigmoid, rectosigmoid, and rectum account for approximately two-thirds of all such cancers (1). These tumors are almost always adenocarcinomas of varying degrees of differentiation. In contrast to adenocarcinomas elsewhere in the gastrointestinal tract, the prognosis, especially in early cases, is quite favorable; favorable enough, indeed, to place this tumor in the category of so-called curable cancer, along with cancer of the cervix, larynx, breast, lip, and a few others. Cure is accomplished by surgical removal. There are, however, a considerable number of patients whose lesions are unresectable because of local or distant spread of the disease. It is obvious, therefore, that a search for any therapeutic means which might benefit this group is more than justified. Under certain circumstances some of the tumors and their local spread in the pelvis are quite amenable to vigorous radiation therapy (2–6). From 1940 to...

Management of Locally Recurrent Carcinoma of the Nasopharynx

The management and the radiotherapeutic results of carcinoma of the nasopharynx have been fairly extensively reviewed in the past few years (1–3). It is generally agreed that radiotherapy is the treatment of choice, and surgery, other than a tissue biopsy, has little to offer. When the disease is localized to the nasopharynx (T1 and T1) (4), a cure rate of over 50 per cent has been accomplished. Even in patients with metastatic disease in the neck (N1 and N2) , lout of 3 may survive free of disease for five or more years following irradiation (5–8). That nasopharyngeal carcinoma may recur at the primary site after a long period of freedom from disease and that patients may survive with the disease five or more years (3, 8) following radiotherapy have not been emphasized. The purpose of this report is to present the problems of locally recurrent carcinoma of the nasopharynx and its management by radiation therapy. Thirty-five cases of nasopharyngeal carcinoma recurrent at the primary site were obtained fro...

Carcinoma of the eyelid; analysis of 301 cases and review of the literature.

THE treatment of carcinoma of the eyelid presents many problems not encountered in the treatment of similar lesions elsewhere about the face and other body surfaces. A satisfactory cosmetic result ...

The Results of Radiotherapy in Cancer of the Lung

My part in this symposium on cancer of the lung has to do with survival of patients treated by radiotherapy. This I propose to fulfill by presenting, en grosse, material which we have seen at the Massachusetts General Hospital during the period extending from 1940 to 1953. During this period we have recorded on our register 772 patients with histologically proved cancer of the lung. All patients have been followed to death or are known to be alive. One hundred and forty-eight patients, or 19 per cent of the total number, for one reason or another received no treatment at all; 385 or 50 per cent received only x-ray treatment. This latter group includes all patients in whom operation amounted to no more than a biopsy, as well as those who were deemed unsuitable for any surgery at all. It will be recognized that this represents a group which is essentially incurable at the onset. All patients in whom the disease was localized and resectable, who were in good enough physical condition to withstand surgery—wit...

Radiation Therapy Records and Record Keeping

It must have been early indeed that the need for accurate records of therapeutic applications of ionizing radiation to patients was recognized. The first recorded reference (1) in Radiology was in 1929, but even this begins with an apology for the presumption of “again introducing the subject of records.” Ever since, it has been the constant effort of radiologists to keep their records abreast of existing information. This is good, for it is largely because of these records, by means of which a valid estimate of what was accomplished by the method could be made, that the specialty has developed to its present status. Radiation therapy in this country is just now getting out of knee pants. It stands at the threshold of an era of development which will take it out of what has in a large part been an empirical art and put it into a position permitting a more real appreciation of what happens as a biochemical or biophysical event. In order to take maximal advantage of these developments, the need for complete...

Radiotherapy in advanced and incurable malignant disease.

I consented to participate in this symposium on the management of the patient with advanced or incurable cancer if I might be allowed to preach a small sermon rather than make a formal presentation. This is because I believe that the management of a patient with a malignant disease from which he is not going to get well—or has little likelihood of getting well—is at least as much a matter of point of view and plan of action as it is a matter of technic and end-result, perhaps more. I shall not discuss in detail indications and conditions in which radiotherapy is useful. This we all know or it is available to us in standard texts. I should rather approach this from the standpoint of general principles. Oliver Wendell Holmes is quoted as saying that, while one of the physicians functions is to assist in the coming in, another is to assist in the going out. A radiologist has ordinarily little to do with mans coming in, but he often can have much to do with his going out, especially when the going out is th...

On Vacular Nevi

“We are fain to borrow other Mens Eyes” observed Thomas Browne long years ago. A look at the radiologic literature over the years dealing with the management of vascular nevi, however, would cause one to wonder if this be always true, or if for that matter sometimes we are ever willing to give our own eyes a chance. Perhaps it is just that the management of vascular nevi occurring in todays and recent yesterdays children is so often a facultative scotoma. In the considerable welter of articles appearing in the English radiologic literature, abstracts as well as originals, scarce any but deal with how to do something to the poor innocent who happens to have in addition to a vascular birthmark a distraught parent and sometimes, to complicate matters, a medical advisor of the “we must do something now” type. That this common birthmark is in most instances a passing thing having a well defined period of growth, more or less rapid, and then spontaneously regressing is rarely mentioned and, rarelier still, a...

Laurence L. Robbins, M.D.

The newly installed President of the Radiological Society of North America, Dr. Laurence L. Robbins, is one of the youngest men to hold this distinguished office in recent years, yet he brings to it a wealth of experience and a background of distinguished accomplishments in radiology rarely acquired by men years his senior. Larry Robbins was born in a parsonage in Burlington, Vermont, forty-seven years ago and received his early schooling in his native state. He attended Ohio-Wesleyan College and took his B.S. and M.D. degrees from the University of Vermont. A rotating internship at the Mary Fletcher Hospital preceded his training in radiology, which was begun at that hospital under Dr. A. B. Soule, Jr., and completed in 1941 under Dr. George W. Holmes at the Massachusetts General Hospital. Immediately following completion of his residency he was appointed staff radiologist and in 1946 succeeded to the position of Radiologist-in-Chief at the Massachusetts General Hospital. He is an associate clinical prof...

Laurence L. Robbins, M.D.: President of the Radiological Society of North America

The newly installed President of the Radiological Society of North America, Dr. Laurence L. Robbins, is one of the youngest men to hold this distinguished office in recent years, yet he brings to it a wealth of experience and a background of distinguished accomplishments in radiology rarely acquired by men years his senior. Larry Robbins was born in a parsonage in Burlington, Vermont, forty-seven years ago and received his early schooling in his native state. He attended Ohio-Wesleyan College and took his B.S. and M.D. degrees from the University of Vermont. A rotating internship at the Mary Fletcher Hospital preceded his training in radiology, which was begun at that hospital under Dr. A. B. Soule, Jr., and completed in 1941 under Dr. George W. Holmes at the Massachusetts General Hospital. Immediately following completion of his residency he was appointed staff radiologist and in 1946 succeeded to the position of Radiologist-in-Chief at the Massachusetts General Hospital. He is an associate clinical prof...