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Radio Therapy - Benefits and Uses of Radio Therapy

X-rays or Roentgen rays are rays of very short wave-length (shorter than 100A degree units). They are produced by bombardment of electrodes from a cathode filament to an anode tungsten plate at a high voltage and the resultant X-rays are emitted through a window. The present machines are shock-proof, and ensure a great deal of protection from scattered X-rays. The quantity and quality of X-rays reaching the site at different voltage (kV), milliamperes (mA) and distances are measured and charted for each machine. The unit of Roentgen ray quantity measure is called a Roentgen (r). The epilation or erythema dose is the skin toleration dose (400 r for unfiltered radiation at 90 kV).

Depth, Dose Data (after zoon and zerry Modified)

Epidermis

Hair papilla

Corium

Sweat glands (Eccrine)

Derm. and eczema

Psoriasis

Lichen simplex chronicus

Lichen planus

Folliculitis and acne

Basal cell epithelioma

Squamous cell epithelioma

0.03 to 0.25 mm

2.5 to 3.5 mm

3.0 to 4.0 mm

2.0 to 4.0 mm

0.8 to 2.0 mm

0.7 to 3.0 mm

1.0 to 4.0 mm

0.4 to 2.0 mm

3.0 to 6.0 mm

2.0 to 5.0 mm

3.0 to 10.0 mm

High voltage Betatron has been employed with success in exfoliative dermatitis and intractable erythroderma.

The physio-biological effects of radio-therapy are:

1. Reduction of rate of cell division or even temporary cessation

2. Reduction of secretion.

3. Reduction of sensitivity in nerve endings.

4. Reduction of bacterial and fungal growth.

5. Permanent killing of cells.

Indications for Radiotherapy

 

Disease

Indications

Dosage

Total radiation

A

Benign

 

 

 

1

Acne vulgaris

Chronic pustular or keloid/cystic acne

75 r weekly

1000 r in 6 months

2

Keloid

Not hard, more vascular rather less fibrotic; less than 9-2 months duration

300 r alternate days or weekly

1500 r

3

Ch. Eczema

Chronic, resistant

75 r weekly

800 r

4

Paronychia

Chronic, persistent

75 r weekly

400 r

5

Heemangioma

Strawberry/cavernous

250 r fortnightly or monthly

500-75o r

6

Warts

Periungual, subungual, plantar

750 r monthly

1500 r

7

Lichen simplex chronicus

Marked lichenification long standing, resistant to topical steroids

100 r weekly

800 r

8

Dermal leishmaniasis

One or two areas, resistant to routine therapy

600 r one dose

600 r

9

Pustular psoriasis dyshidrosis

Resistant, recalcitrant

50-75 r weekly

500 r

10

Hypertrophic lichen planus

Recalcitrant cases

100 r weekly

800 r

11

Lymphocy-toma cutis

 

100 r weekly

1000 r

B

Malignant

 

 

 

12

Basal cell epithelioma

Avoid cartilaginous areas, scrotum and eyes

400 r alt. day

3000 r

13

Squamous cell epithelioma

 

500 r alt. day

4000 r

14

Kaposi"s haemorrhagic sarcoma

Skin lesions

100 r weekly

800-1000 r

15

Lymphomas (esp. mycosis fungoides)

 

300 r alt. day

3000 r

Grenz rays are useful in resistant cases of pruritus ani, vulvae, scrotum; dyshidrosis; psoriasis and balano-posthitis.

Definite contra-indications are:

1. Light-sensitive dermatoses, lupus erythematosus etc.

2. Acute eczema.

3. Radio-dermatitis, ulcer, atrophy and epithelioma.



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