ROENTGENOTHERAPY

From Big Medical Encyclopedia

ROENTGENOTHERAPY [rentgeno-(on a name B. X-ray) + Greek therapeia treatment] — a method of the radiation therapy performed by means of the x-ray emission generated by special medical roentgenotherapeutic devices.

Development and deployment of this method are connected with opening by V. Rentgen in 1895. x-ray emission (see). In R.'s development in our country the big contribution was made by D.F. Reshetillo, M. I. Nemyonov, A. A. Tseitlin, N. V. Lazarev, A. I. Dombrovsky, L. M. Golstein, A. L. Halipsky, Ya. G. Dillon, L. D. Podlyashuk, A. I. Ruderman, etc.

The roentgenotherapy in oncology in a crust, time lost the value a little. It is connected with implementation in a wedge, practice gamma devices (see), betatrons, cyclotrons and linear accelerators (see. Particle accelerators ), generating high energy radiation — gamma radiation (see), bremsstrahlung (see), electronic radiation (see), neutron emission (see), proton radiation (see), etc. that gave the chance to create the best dozny distribution in a tumor and surrounding healthy fabrics. However korotkodistantsionny (short-distance) R. keeps value at treatment various, hl. obr. superficially located, tumors of skin (a carcinoma cutaneum, a bazalioma, Bowen's disease, metastasises of cancer in skin) and boundary mucous membranes (a top and bottom lip, an oral cavity, outside female generative organs, a rectum); at pretumor diseases (a leukoplakia, giperkeratoza), malignant (an angiosarcoma, Kaposha's sarcoma) and benign tumors of a vascular origin (a hemangioma and a lymphangioma).

Rubles will see off in radiological departments. The x-ray emission applied at korotkodistantsionny R. is characterized by the maximum energy of photons to 40 — 45 kev. Radiation is carried out at small distance a source — a surface (see), a cut makes from 15 to 300 mm depending on the nature of a disease and localization patol. process. Korotkodistantsionny R.'s kind is R. which is carried out by the ultrasoft not filtered x-ray emission generated at a voltage of 0 — 12 quarter. Limited penetration (1 — 2 mm) allows to apply it only at the most superficial damages of skin.

Korotkodistantsionny R. can be applied in combination with one of remote methods of radiation therapy or enter the combined treatment.

Radiation is carried out from one or several fields. At malignant tumors single doses make 200 — 250 is glad on each field (2,0 — 2.5 Gr), total 5000 — 6500 is glad (50 — 65 Gr) at a rhythm of 5 fractions in a week. At nek-ry forms of malignant tumors the total dose can be increased.

Local beam reaction is shown in the form of dry or wet radioepidermitis (see) or radioepithelitis (see) also comes to an end in 4 — 6 weeks (see. Beam damages ). In the subsequent are possible local atrophy of skin (see), teleangiectasias (see) a depigmentation of skin (see. Dyschromias of skin ). Induration skin and beam ulcers can arise after R. in a total dose. exceeding 7000 I am glad (70 Gr).

The roentgenotherapy of not tumoral diseases is directed to suppression of inflammatory reaction, oppression of proliferative processes, painful sensitivity, decrease in secretory activity of glands, etc. Decrease in painful sensitivity at R. is connected with a direct impact of ionizing radiation on nerve terminations, sensibilized serotonin and products of proteinaceous disintegration in the center of an inflammation, and also with weakening of inflammatory changes (interstitial pressure, the acidosis, the increased ion concentration of potassium; caused by radiation.

The river of not tumoral diseases shall be carried out according to strict individual indications, at precisely established diagnosis and only at inefficiency of other, not beam methods of treatment.

Rubles will see off at acute and chronic inflammatory, including and purulent, processes independently or in combination with operational treatment and antibacterial therapy. It can be used at nek-ry postoperative complications (an anastomositis. resistant inflammatory infiltrates in the field of a wound, a post-amputating pain syndrome).

The river can be applied also at nek-ry not tumoral defeats of endocrine system (a diencephalic syndrome), the nek-ry nonspecific degenerative and dystrophic and inflammatory processes of the bone and joint device which are followed by a reactive inflammation of soft tissues and the expressed pain syndrome.

Sometimes R. is applied at treatment of keloid cicatrixes, eczemas, neurodermatitises.

R. of not tumoral diseases at children is contraindicated and during pregnancy.

One of philosophy of R. of not tumoral diseases is the aspiration to receive to lay down. effect at radiation by the minimum doses. At acute inflammatory processes the single dose makes 15 — 25 is glad (0,15 — 0,25 Gr), at chronic — 30 — 60 is glad (0,3 — 0,6 Gr), at hyperplastic 100 is glad (1 Gr). Total doses are in range from 50 — 100 is glad (0,5 — 1 Gr) at acute, 150 — 300 is glad (1,5 — 3 Gr) at chronic and till 1000 is glad (10 Gr) at hyperplastic processes.

Depending on a form of a disease radiation is carried out bucketed 3 — 5 days at acute, 1 — 2 day — at chronic and daily at hyperplastic processes (5 fractions a week). The therapeutic effectiveness of R. at not tumoral diseases makes 85 — 98%. A repeated course at an exacerbation of chronic diseases is conducted not earlier than in 6 months

See also Radiation therapy .



Bibliography: Kishkovsky A. N. and Dudarev A. J1. Radiation therapy of not tumoral diseases, M., 1977; Kozlova A. V. Radiation therapy of malignant tumors, M., 1971; P ER e with l e and N I. A. and Sark and - with I N Yu. X. Clinical radiology, M., 1973; Pereslegin I. A., Under - la shch at to E. L. and Ustinova V. F. Current state of a question of radiation therapy of not tumoral diseases, Vestn. rentgenol. and radio-gramophones., No. 2, page 5, 1981; Ruderman A. I. Short-distance roentgenotherapy, M., 1968; Handbuch der medizinischen Radiologie, hrsg. v. L. Diet-helm u. a., Bd 17, B. u. a., 1970; A review of the use of ionizing radiation for the treatment of benign diseases, v. 1 — 2, Rockville, 1977 — 197 8.


I. A. Pereslegin.

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