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Category: DIRECT LARYNGOSCOPY IN DISEASES OF THE LARYNX
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Radium and the therapeutic roentgenray are today our
only effective means of retarding the progress of esophageal malignant
neoplasms. No permanent cures have been reported, but marked temporary
improvement in the swallowing function and prolongation of life have
been repeatedly observed. The combination of radium treatment applied
within the esophageal lumen and the therapeutic roentgenray through
the chest wall, has retarded the progress of some cases.
The dosage of radium or the therapeutic ray must be determined by the
radiologist for the particular individual case; its method of
application should be decided by consultation of the radiologist and
the endoscopist. Two fundamental points are to be considered, however.
The radium capsule, if applied within the esophagus, should be so
screened that the soft, irritating, beta rays, and the secondary rays,
are both filtered out to prevent sloughing of the esophageal mucosa.
The dose should be large enough to have a lethal effect upon the
cancer cells at the periphery of the growth as well as in the center.
If the dose be insufficient, development of the cells at the outside
of the growth is stimulated rather than inhibited. It is essential
that the radium capsule be accurately placed in the center of the
malignant strictured area and this can be done only by visual control
through the esophagoscope (Fig. 95)
Drs. Henry K. Pancoast, George E. Pfahler and William S. Newcomet have
obtained very satisfactory palliative effects from the use of radium
in esophageal cancer.