London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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60
radium and X-rays, 1 ; completely treated by radium alone, 1 ; completely treated
by X-rays, 1 ; too ill for any treatment, 1.
The case of carcinoma of the vulva was incompletely treated by X-rays, being
too advanced for further treatment. The case of sarcoma of the vagina was incompletely
treated by X-rays and died before completion. The case of carcinoma
of the rectum refused further treatment after one application of radium. The
case of recurrent carcinoma of the body of the uterus after operation was completely
treated by X-rays. The case of recurrent carcinoma of the cervix after previous
radium elsewhere received one further application of radium.

The ages of cases of carcinoma of the cervix were :—

30-34 years355-59 years10
35-39 „1060-6412
40-44 „1065-69 „7
45-49 „1170-74 „5
50-54 „1575-805

Radium treatment.—Description of apparatus. 1. Radium containers.

Substance.Content in milligrammes.ShapeDimensions.Material.Thickness of wall.
UterusRadium21 mg. el2 tubes25 mm. x 2.75 mm.Platinum0.5 mm.
VaginaRadium5 mg. el.16 tubes12 mm. x 1.2 mm.Platinum0.5 mm.
2. Internal applicators.
Number.Shape.Dimensions.Material.Thickness of wall.Milligrammes used.
Uterus1Bent tube70 mm. x 7 mm.Silver2.15 mm.42
Vagina2Flat boxes28.5 mm. x 21 mm.Silver1.15 mm.80
Number oftreatmentsInterval of treatments.Duration ofapplication.Dosage at each troatment.
Uterus3One week between 1st and 2nd Three weeks between 2nd and 3rd20 hours42 mg. el. (or 20 hrs.
Vagina3One week between 1st and 2nd Three weeks between 2nd and 3rd20 hours80 mg. el. for 20 hrs.

Average total dosage : 7320 mg. el. hours = 54.9 mulicunes destroyed.
The internal applicators are enclosed in indiarubber bags. Thickness of material, I mm.
Total screenage : in terms of lead, uterus, 3 mm. ; vagina, 2 mm.
X-ray treatment.
The routine treatment given to these patients is as follows :—The whole of the
cavity of the true pelvis is irradiated through 5 or 6 fields, the number used depending
upon the amount of fat and the patient's muscular resistance to displacement of
viscera.
The total dose delivered on the skin of the patient varies, an attempt being
made to deliver 4500 r. to every part of the cavity of the pelvis. Daily treatments
are given, Sundays excepted, each field is treated in rotation and 300 r. given daily.
K.V. is 200, the filter is 4 mm. of tin, 5 mm. of copper and the intensity varies
from 5 to 15 r. per minute, some cases being treated on each of these intensities.
The results of treatment are shown in the following table.