THE AIMS of preoperative radiotherapy have been well publicized and are summarized as follows:
With an "operable" tumor, malignant cells implanted at the operative site or spilled into the blood stream at the operation may be less likely to recur locally or metastasize.
A tumor which would be ordinarily regarded as being on the border line of operability may be converted into an operable situation by the sterilization of the peripheral cells.
The experimental evidence for the latter statement is that the radiosensitivity of the cells is partly dependent on their oxygenation and, because the centers of malignant tumors tend to be anoxic, they are relatively radio-resistant. Therefore the peripheral cells which are well oxygenated respond better than the central cells. The hypothesis is that a course of radiotherapy could leave a central nidus of viable malignant cells which have been protected by their anoxic state and will
Batley F. Fallacies of Preoperative Radiation. Arch Otolaryngol. 1968;87(5):456–460. doi:10.1001/archotol.1968.00760060458002
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