ENDOLYMPHATIC RADIOTHERAPY IN MALIGNANT LYMPHOMAS - LONG TERM RESULTS

Abstract

The lymphatic vessels of the dorsum of the foot have been used in the past seven years to inject with and without contrast material (Lipiodol, Ethiodol) different radioactive isotopes (¹³¹I, ¹⁹⁸Au, ⁰⁰Y) in the attempt to treat metastatic retroperitoneal adenopathies of lymphomatous or carcinomatous type (l, 8, 12, 13, 15, 16, 17, 19, 26, 27, 28, 31). Due to the relatively simple technique (25, 35) the intralymphatic injection of radioactive isotopes has been tried first by Chiappa in Milan in 1961 (11) and pursued by numerous investigators throughout the world. In our Institutes since September 1961 a large program has been undertaken with the administration of Lipiodol fluid ¹³¹I (endolymphatic radiotherapy) in malignant lymphomas, chronic lymphatic leukemia, carcinomas of testicle, cervix, prostate, urinary bladder, rectum and malignant melanoma (8, 11, 12, 13, 15, 16, 17, 27).

Special attention has been focused on malignant lymphomas and after two and a half years of experimental clinical trials, a therapeutic program including the systematic administration of Lipiodol 131I to all cases with histologically proved malignant lymphomas was started in May 1964 (3, 4). Since very high tissue doses can be delivered with endolymphatic radiotherapy (1, IO, 19, 20), the rationale for its systematic use in all lymphoma patients regardless of the clinical stage, was to see whether the administration of Lipiodol ¹³¹I could satisfactorily meet the requirements of radical, palliative and prophylactic radiotherapy. The principal aim of this report is to analize the experience achieved with 340 malignant lymphomas treated with different doses of Lipiodol ¹³¹I and to discuss the advantages, limits and side effects of endolymphatic radiotherapy. Since a systematic treatment with high doses of Lipiodol ¹³¹I has been started in May 1964, only the three year survival rate is presently available.