. The American journal of roentgenology, radium therapy and nuclear medicine . ancer sometimes actually shortens thepatients existence. COMBINATION ROENTGEN AND RADIUMMETHOD A combination of the external appli-cation of roentgen radiation with theintraesophageal application of radiumappears to the writer to be the idealmethod. This belief is borne out by ourclinical results which show greatest pro-longation of life, although our results areno better than those reported by Mills ayear ago. We have performed gastrostomyon three-quarters of our patients, and havegiven them by this means alone a m
. The American journal of roentgenology, radium therapy and nuclear medicine . ancer sometimes actually shortens thepatients existence. COMBINATION ROENTGEN AND RADIUMMETHOD A combination of the external appli-cation of roentgen radiation with theintraesophageal application of radiumappears to the writer to be the idealmethod. This belief is borne out by ourclinical results which show greatest pro-longation of life, although our results areno better than those reported by Mills ayear ago. We have performed gastrostomyon three-quarters of our patients, and havegiven them by this means alone a markeddegree of palliation. COMMENT In our own work we prefer the method otgastrostomy under local anesthetic, fol- lowed in ten days by the placing of thethread, and three or four days later by thefirst application of radium. A series ofroentgen applications through four fieldsis then given, if it has not already pre-ceded the operation. On about the twen-tieth and twenty-fifth days further radiumis applied, and a program of watchfulwaiting instituted. In the preparation ot. Fig. ^. This thread is then passed tlirmigh the gastros-tomy tube, which is reintroduced into the openinginto the stomach. Traction upon the thread a — ain the direction of a pulls the inner end of the gas-trostomy tube up to the inferior border of the stric-ture thus preventing sawing of the thread upon thesoft tissues at the cardia. The radiferous capsuleis then drawn down the esophagus into the strictureunder x-ray guidance and the taut thread held inposition by the forceps b clamped on the gastro-stomy tube close to the skin. the radium applicator, whether for use bythe sound or by the thread and gastrostomymethod, it is our custom to use two, and attimes three, capsules, placed end to end,a 100 mgm. in the middle, and a 50 mgm. 864 The Technique of Radiation Therapy of Esophageal Carcinoma capsule on either end. The whole is con-tained in the usual i mm. of brass filterand wrapped with plastic rubber
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