Essentials in roentgentherapy of interest to clinicians; with a consideration of its application in gynecology

1. 1. The problemof radiotherapy will not be completely solved until the biologic factors entering into this equation have been better understood and more directly controlled. 2. 2. Individualization of cancer patients is of prime importance and for this reason surgery and radiotherapy must supplement each other, and change their roles from predecessor to successor, from time to time, according to the mature judgment of the treating clinician. 3. 3. The localistic conception of cancer must be modified, and malignant disease must in the light of recent advances be considered as a gereral affection characterized by a constitutional morphologic inferiority of some tissue. 4. 4. The success of x-ray therapy in malignant disease is not wholly dependent upont the destruction of the tumor cells, but also, to a very large extent, upont the general cellular immunity of the organism, and upon a preservation and stimulation of the forces governing this immunity. 5. 5. Surgery should be given first choice whenever possible. The remoral of the main malignant focus and large metastatic deposits gives the economy a better chance to utilize its reserve of natural immunity in combating the remaining disorganized malignant stragglers, which must still be weakened by postoperative deep roentgentherapy. 6. 6. The administration of deep x-ray therapy requires training and preparation; the possession of an x-ray apparatus does not indicate therapeutic skill. From a gynecologic viewpoint, I may add that modern gynecology demands, besides a thorough preparation and mastery of surgical technic and a comprehensive understanding of the female patient in particular, also a knowledge of the main principles of radiotherapy. 7. 7. Radiotherapy must be administered by, or under the direction and colse supervision of, clinician, in order to obtain the best resutls. 8. 8. It is quite possible that some of the present day views regarding cancer therapy by means of surgery, radium, or x-rays, will undergo may changes. One thing, however, is certain, that the x-rays as one of the most important weapons in combating deep seated malignant foci will never diseappear from our medical armamentarium.