Roentgen therapy of intrathoracic neoplasms.

THE RESULTS OF TREATMENT OF CARCINOMA OF THE ESOPHAGUS, WHETHER BY OPERATION OR RADIATION, ARE EQUALLY POOR: At best 3 to 5 per cent 5-year survival in larger series. Likewise, the palliative results as judged from short-term survival after 1, 2, and 3 years are approximately the same. The cause of failure is usually that metastatic deposits are already present in the paraesophageal and mediastinal nodes by the time diagnosis is made. Control of these nodes is impossible either by surgical or by radiation therapy, but in about half of the patients adequate irradiation therapy will be palliative and will satisfactorily re-establish esophageal function, but entail less morbidity than surgical operation. Carcinoma of the lung yields little to radiotherapy. Cure is rare, but specific aims of palliation may be achieved. Anaplastic tumors can be controlled locally by irradiation, but they metastasize so rapidly that the chief aim of radiotherapy is to relieve pulmonary embarrassment due to rapid enlargement of mediastinal lymph nodes. Epidermoid carcinomas and adenocarcinomas may be treated at points of bronchial obstruction by intense irradiation, but diffuse thoracic pain is better palliated by sympathetic nerve block.