The need for careful studies as herein presented demonstrates the ability of irradiation to sterilize pelvic lymph nodes. This is an area of much misconception since the radioincurability of metastatic nodes has often been equated to, or measured by, patient deaths. As metastatic nodal disease is usually a sign of moderately advanced cancer, local control of the primary and regional nodes may often be achieved without halting dissemination. A patient, therefore, may not be treated successfully with metastatic nodes because of death due to distant spread. The failure is not simply that of the inadequacy of local therapy, be it surgery or irradiation, but local therapy is inadequate in that it does not encompass all the disease.
The need to determine the relative value of surgery and radiotherapy in controlling metastatic nodes is an important question to explore. The combining of two full courses of therapy such as radical surgery
Rubin P. Comment. JAMA. 1965;193(13):1106–1107. doi:10.1001/jama.1965.03090130034010
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