Thirty two pre-operatively irradiated lung tumors were studied histologically and changes induced in tumors by irradiation were described as well as healing process of the irradiated tumors. Ionizing radiation affects primarily the individual tumor cells, leading them to degeneration and lysis. Reparative granulomata of various types are formed probably secondarily, in which radiation injured cells and cellular debris play a most important part. The coagulation necrosis of the center of the tumor nests and that involving the tumor stroma are not due to the direct effect of the fractional irradiation.
Clinical impression of the results of radiotherapy was evaluated with the proposed histological grading of irradiated tumors, and paradoxical cases were presented.
Radiation dose required to destroy much of the tumor is larger with increasing size of the tumor and at least 6, 000-7, 000r is necessary for the lung tumors of average size.
Surgical resection of the tumor, if indicated, should be performed within two weeks after completion of radiotherapy, since regrowth of the tumor is most likely to occur with inadequate radiotherapy when surgery is delayed.
Histological structures and other factors influencing the biological effectiveness of radiation have been discussed.
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