The Present and Future of Radium Teletherapy: (Section of Radiology)

The problems before the radium teletherapist are those ordinarily dealt with by the deep-X-ray therapist. There is, unfortunately, only one method available for the solution of many of these problems, that of trial and error. This paper records errors and attempts to rectify them.The problems are:-(1) To construct apparatus that can safely be used by the workers. (2) To ascertain with precision the site and extent of the tumour. (3) To obtain a depth-intensity and dose of cancericidal order without damage to the skin or intervening and surrounding tissues. (4) To measure and record the dose received by the tumour. (5) To ascertain the best total duration and spacing of component parts of the total dose. (6) To find means for increasing differentially the sensitivity of malignant cells. (7) To safeguard the patient's general health.Unless there be any advantage in the use of short waves, there is no permanent field for teletherapy.THE COMBINATION OF LONG AND SHORT WAVES APPEARS TO US TO OFFER ADVANTAGES: (1) Permitting continuance of irradiation when one type ceases to be effective; (2) safeguarding the skin; (3) perhaps offering a biological superiority.The immediate future calls for:-(1) Improvements in apparatus. (2) Agreement as to the best unit applicable alike to gamma and X-irradiation. (3) Further exploration of means for measuring dose received. (4) Accumulation of data as to effective dose in relation to tumours of different organs and different histological type. (5) Better grouping of clinical classes. (6) More universal co-operation with physicists. (7) Concentration of control of both forms of treatment in the same hands.