In a prospective study, 14 patients with primary non-oat cell lung carcinoma were treated with intraoperative Iodine125 (I125) implantation of the lung tumor via lateral thoracotomy or median sternotomy. Staging mediastinal node dissection was performed in each case. Patients were selected when wedge or segmental resections were not technically feasible, such that lobectomy or completion pneumonectomy would have been required or pulmonary function studies were poor. Doses ranged from 8,000 cGy at the periphery to 20,000 cGy at the center. With a minimum 12 month follow-up, mean and median survivals were 16.7 and 15.1 months, respectively. Local control was achieved in 10 of 14 patients (71%) with all local failures occurring in pathologic stage III patients. When separated according to tumor size, local control was obtained in six of seven tumors of less than 3 cm and four of five tumors of 3-5 cm. Both cases with masses greater than 5 cm failed locally. There was one operative mortality and two postoperative complications. All other patients were discharged within one week of surgery. There was no radiation pneumonitis. I125 lung brachytherapy is an excellent alternative treatment for T1 and T2 tumors when medical conditions preclude curative resection.
Aberdeen when I was there a few years ago. Handling for radiography is probably less risky than direct inspection. By excluding from radiological examination the five cases of acute epiglottitis the Glasgow workers have excluded the five cases in which neck radiographs would have been diagnostic, so it is not surprising that Goel concludes that neck radiographs were unhelpful. References Gocl KM. Are neck radiographs necessary in the management of croup syndrome'? Arch Dis Chlild 1984;59:908. 2 Illingworth RS. Comnmnoni sytnptoins of disease in children. 7th
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