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September 27, 1965

Can Irradiation Destroy Metastatic Pelvic Lymph Nodes?

JAMA. 1965;193(13):1102-1103. doi:10.1001/jama.1965.03090130030007

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That irradiation is ineffective in the control of nodal metastases from cervical carcinoma is a cherished belief of some authorities, particularly those who prefer surgical treatment. This belief, however, is largely based on experience with the older methods of x-ray treatment, methods which are inadequate by modern standards. Today, an increasing amount of evidence indicates that, with apparatus now available, a cancerocidal dose of irradiation can indeed be delivered to the pelvic nodes.

The opinion that irradiation was ineffective was formed from two observations: (1) Pelvic nodes excised after irradiation treatment sometimes contain metastatic foci; (2) The first sign of recurrence was often a palpable pelvic node for patients who were treated by irradiation and who did not have any kind of surgical treatment. The inference was that the radiosensitive primary lesion was destroyed, but the nodal disease was not radiosensitive, and therefore, was not destroyed.

There was, also, evidence,

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