THE EFFECTS OF IRRADIATION (EXTERNAL AND INTERNAL) ON LYMPHATIC DYNAMICS

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Abstract
Of the 10 patients on whom lymphographic studies were made after the administration of external radiation therapy, none manifested abnormality in lymphatic dynamics. Of the 20 patients on whom lymphographic studies were made after the endolymphatic administration of radioactive isotopes very little effect was observed upon the lymphatic vessels and the dynamics of lymph flow; however, a marked effect upon the lymph nodes occurred. The lymph nodes are radiosensitive and can be destroyed with the usual doses of external and internal irradiation given in clinical practice, the lymphatic vessels are radioresistant and orthodox dosages exert no observed effect upon them as noted in this study. The free transport of administered ethiodol through irradiated regions was observed. No new collateral lymphatic vessels were seen and no obstructive phenomena in the lymphatic system occurred. The concept whereby irradiation would seal off the lymphatic vessels is incorrect. A comparison is made of the effect of surgical extirpation of certain groups of lymph nodes (lymph nodes in the groin and axilla) with the effect of irradiation of these lymph nodes. The alterations in lymphatic dynamics which occur after surgery show that if clinically indicated, a radical excision of the lymph nodes should be performed in continuity with the primary cancer. If an in continuity operation cannot be performed and if one is dealing with a radiosensitive malignant neoplasm, irradiation might be the preferred treatment in that it does not significantly alter the lymphatic dynamics. No significant change in lymphatic vessel structure and function was observed either from irradiation delivered from an external source, or from that administered internally in the form of the endolymphatic injection of radioactive isotopes (I131 ethiodol, Aul98 and Y90 micromicro-spheres).

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