V. Irradiation of Gastric Cancer

Publisher Website
Google Scholar
Abstract
As you will have learnt from previous speakers, some 80 per cent. of cases of gastric cancer are beyond any hope of cure by surgery when first brought to the surgeon (Ogilvie, 1938). Due to the impossibility of a surgical cure in such a vast number of cases, many other forms of treatment, including irradiation, have been tried in the past, but without striking success. Hardly had Röntgen discovered X rays in 1896, when Despeignes applied them to the external irradiation of a gastric cancer. There is no need for me to recall the different forms and combinations of irradiation applied to this viscus from then to the present day. The results of these different methods are too well known to need further repetition here; it should suffice merely to make some general remarks on their limitations and shortcomings. External irradiation fails because of the deep situation of the gastric tumour and its close relation to other vital organs, both factors tending to prevent adequate tumour dosage, and because of the high but variable radio-resistance of gastric cancer cells, possibly increased by infection. This high resistance may be only apparent, owing to limitation of the tumour dose by severe general and skin reactions. Owing to movements of the tumour, accurate centring of the X-ray beam at repeated exposures is difficult to obtain. Livingston and Pack (1941) stated that most patients will not survive long enough to benefit from prolonged external irradiation alone, due to their eventual profound malnutrition.