RESULTS FROM TOURNIQUET ANOXIA AND HYPERBARIC OXYGEN TECHNIQUES COMBINED WITH MEGAVOLTAGE TREATMENT OF SARCOMAS OF BONE AND SOFT TISSUES

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Abstract
1. Results are reported for cases of advanced and recurrent sarcomas of bone and soft tissues treated with 4 mev. roentgen rays under conditions of circulatory arrest produced by a tourniquet and in hyperbaric oxygen at 4 ATA, respectively. 2. The treatments have been administered to an initial series of 60 cases. Distant metastases were demonstrated in 19/60 (32 per cent) before treatment and a majority of cases treated were recurrent after surgery or roentgen-ray therapy. 3. The crude cumulative survival rate at 12 months differed for the two modalities, being 12/20 (60 per cent) in the tourniquet group and 7/22 (34 per cent) in the hyperbaric group, respectively. The difference is attributable to the stage of disease treated in the various groups. 4. Regression and sterilization rates of tumors produced were high with both anoxic and hyperbaric techniques, a pessimistic estimate of 70 per cent tumors resolving after the treatments which produced both acceptable levels of tissue reactions and tolerance. Absence of tumor was proven at autopsy or at amputations in 6 cases in the tourniquet group and in 10 cases in the hyperbaric group. 5. Dose fractionation regimens and calculations are described, and techniques and complications are discussed. 6. These results are compared with "conventional" radiotherapy results, and it is concluded that the "oxygen effect" provides the scope for improving over-all results of radiation therapy in this group of tumors.

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