X-ray therapy

Dactinomycin, an antineoplastic dmg, was discovered in 1943 and is made in rather pure form by StreptomjcesparvuUus. Dactinomycin has some bacteriostatic antibacterial and antifungal activity, but high toxicity limits its use to antineoplastic therapy. It may be used alone or with other antineoplastics, with or without surgery and synergistic x-ray therapy. Dose limiting bone marrow toxicity may result in low white cell and platelet count. Intestinal mucosal damage also occurs. Reviews of more detailed chemotherapeutic information are available (217—222). 

It should be noted that the compound alone has no therapeutic effect in malignant tumours. Cases of inoperable carcinoma of the bronchus have been treated2 by a combination of X-ray therapy and compound (VIII). In such cases and also in connexion with malignant tumours of other types, there are indications from preliminary clinical studies, that the intravenous administration of compound (VIII) has a small but useful effect as a clinical radiosensitizer. 

Byfield JE, Barone R, Mendelsohn J, et al. Infusional 5-fluorouracil and X-ray therapy for non-resec-table esophageal cancer. Cancer 1980 45 703-708. 

Shields TW, Higgins GA Jr, Lawton R, et al. Preoperative x-ray therapy as an adjuvant in the treatment of bronchogenic carcinoma. J Thorac Cardiovasc Surg 1970 59 49-61. 

Shore, R.E., Hildreth, N., Woodard, E., Dvoretsky, R, Hemplemann, L., AND Pasternack, P. (1986). Breast cancer among women given X-ray therapy for acute postpartum mastitis, J. Natl. Cancer Inst. 77,689. 

If steroid therapy fails or is contraindicated, irradiation of the posterior orbit, using well-collimated high-energy x-ray therapy, will frequently result in marked improvement of the acute process. Threatened loss of vision is an indication for surgical decompression of the orbit. Eyelid or eye muscle surgery may be necessary to correct residual problems after the acute process has subsided. 

In addition to its many uses in medical and physiological research, radioisotopes are used in therapy, and in agricultural and industrial research. Radioactive cobalt, for example, became available for the treatment of deep-seated cancer. This isotope of atomic weight 60 loses half its radioactivity in about five days and is more than 300 times as powerful as radium. It is taking the place of radium and X-ray therapy in many hospitals. 

Rotmensch J, Whitlock JL, Culbertson S, Atcher RW Schwartz JL (1994) Comparison of sensitivities of cells to X-ray therapy, chemotherapy, and isotope therapy using a tumor spheroid model. Gynecologic Oncology 55 290-293. 

About 14000 patients with the disease ankylosing spondylitis received X-ray therapy between 1935 and 1954 in Great Britain and Northern Ireland. In irradiating the spine, doses of 300-700 rad were received by tissues in the thoracic region. The major radiation-related outcome has been an excess of leukemia due to irradiation of bone marrow progenitor cells within the ribs and vertebrae and, recently, an indication of excess solid tumors in the lungs,... 

Erythema multiforme is a relatively common, acute, self-limited, inflammatory reaction pattern that is often associated with a preceding herpes simplex or mycoplasma infection. Other causes are associated with connective tissue disease, physical agents, X-ray therapy, pregnancy and internal malignancies, to mention a few. In 50% of the cases, no cause can be found. In a recent prospective study of erythema multiforme, only 10% were drug related. 

Supplement vitamin Be deficiency states, impaired absorption, therapy with vitamin Be antagonists, increased requirements (pregnancy, lactation), increased stimulation with exogenic estrogens. X-ray therapy... 

Previous therapies for pre-cancerous and malignant skin lesions involved either local excision or low-voltage X-ray therapy. Modern therapy would favor early biopsy of cancerous or pre-cancerous lesions followed by excision or Mohs micrographic surgery appropriate for the type and location of the lesion. 

Decrease of splenic size and partial or complete disappearance of abdominal discomfort may result from x-ray therapy (Medoff and Bayrd 1954). In one case (WeinSCHENK 1964) long-term administration of B-vitamins, folic acid, methionin, choline and vitamin E was followed by decrease of hepatosplenomegaly (Wein-SCHENK 1965) and this treatment is presently being evaluated in another case. 

There is no way of influencing the course of the acutely progressing disease in infants. Splenectomy for mechanical reasons is rarely indicated. X-ray therapy may favorably infiuence local skin infiltrations (Crocker and Farber 1958). 

If the diagnosis is made relatively early, before the onset of heart and kidney involvement, a patient can be helped. When the adrenal gland becomes enlarged, a cure may be effected by surgery. In a third to a half of the cases where the pituitary gland is involved, x-ray therapy may hall or slow the progress of the disease. 

Californium-252 attracted early attention as a possible therapeutic agent in cancer treatment. The general impression formed from early work was that neutron therapy was inferior to x-ray therapy. More recent studies, however, indicate that neutron irradiation may have advantages over x-rays or y-rays in certain situations. In the period 1976-82, several hundred cancer cases were treated by neutron irradiation supplied by Cf [94]. Although not a cure, Cf neutron therapy appears to have promise in the treatment of pelvic cancer and in brachytherapy (short exposure therapy). Neutrons appear to have particular utility in tumors whose oxygen supply is impaired, and which, as a consequence, are relatively insensitive to x-rays or y-rays. While the applications of neutrons in the treatment of cancer are still experimental, there is a possibility that further clinical studies may well find a use for the neutron-emitting californium isotopes in therapy. 

Exposure to X-rays decreases the viscosity of human joint fluid without increasing the titratable acidity (indicating that the effect is not a result of oxidative degradation) or reducing its susceptibility to bull testis hyaluronidase (426). Because of the wide distribution of hyaluronic acid in the body, this effect was suggested as an important factor in the response of many tissues to X-ray therapy. 

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