Intralymphatic Radiotherapy: Preliminary Results of a New Method. Note I

Abstract

Liposoluble contrast media, used in lymph nodes x-ray examination, have some specific features, when compared with idrosoluble contrast media. They rarely diffuse through the lymphatic walls, they produce an intense and homogeneous opacity of the lymph nodes and they remain in the lymph nodes for several months. For these reasons, it was thought to substitute the iodine of the liposoluble contrast medium with I¹³¹, and to use this radioactive material for therapy in primary and secondary malignant growth of lymph nodes. Since October 1961 a series of 30 patients was treated, 22 with malignant lymphomas of various type, 8 with metastases from carcinoma of the uterus or malignant melanomas of the legs. The radioactive contrast medium was injected into the feet following the technique suggested by Kinmonth. This tecnique allowed the irradiation of lymph nodes from the inguinal to the lumbo-aortic included. Favourable results were obtained: a marked and durable reduction of the diseased lymph nodes was observed in most cases. The long permanence of the contrast medium in the lymph nodes allowed to follow the size and shape of lymph nodes up to 6 months after injection. No signs of bone marrow damage were observed. The intralymphatic radiotherapy has advantages in respect of the transcutaneous radiotherapy: 1) Irradiation of the lymph nodes from inside, without damage of other tissues; 2) simultaneous irradiation of lymph nodes in different locations, giving a high dose to each lymph node, but a low total body dose; 3) Continuous irradiation; 4) Single inoculation of the radioactive material, even without hospitalization. The limitations of the method are due to the impossibility to reach all the lymph node districts and the lymph nodes completely obliterated by carcinoma metastases, which are by-passed. As these preliminary results suggest, the intralymphatic radiotherapy is best indicated in malignant lymphomas.