The reirradiation of recurrent bronchogenic carcinoma with external beam irradiation

Symptomatic local failure following thoracic irradiation for bronchogenic carcinoma presents a clinical challenge to the Radiation Oncologist. We retrospectively evaluated the efficiency of reirradiation with external beam radiation of 30 patients. The median dose of initial irradiation was 6,000 cGy in 6 weeks. The median time following initial irradiation to recurrence was 12 months. The median dose of retreatment was 3,030 cGy in 3 weeks. Of the symptomatic patients, 88% and 70% subjectively responded to initial irradiation and to reirradiation, respectively. Retreatment toxicity included radiation esophagitis (6 patients), dry desquamation (4 patients), and symptomatic radiation pneumonitis (1 patient). Based on this study, doses of external beam radiation in the range of 2,000-3,000 cGy in 2 to 3 weeks appear safe and effective in reirradiating recurrent bronchogenic carcinoma.

Unexpected frequency of idiopathic costochondral pain

A study of the records of patients seen in a two-year period in a private gynecologic practice and a one-year period in the emergency department of a general hospital was prompted by the incidence of chest wall pain diagnosed as costochondral pain. The study revealed 76 women in the former practice and 156 men and women in the latter with this condition. Physicians need to understand this symptom complex and be aware of the frequency of its occurrence in patients presenting with chest pain and fearing breast cancer or cardiac disease. Costly, intensive investigation can be avoided when careful, deep palpation of the costochondral junction discloses pain traversing the rib under the breast, leading to a diagnosis of idiopathic costochondral pain.

The importance of cauterization to maintain a healthy cervix. Long-term study from a private gynecologic practice

A total of 13,897 patients from a private gynecologic practice were retrospectively analyzed with special regard to the benefits obtained from hot linear cautery. This has been performed as an office procedure since 1937, providing unique long-term follow-up. The exposed cervical transitional zone and mild, atypical, or dysplastic cervical cytology were so treated in 6,364 patients. A significantly higher percentage of carcinoma in situ and invasive disease was found in the noncauterized cervices. With the trend of cervical intraepithelial neoplasia (CIN) toward development at an earlier age in today's population, the importance of office cauterization in preventing cervical cancer becomes apparent.