APPLICATION OF RADIOACTIVE SUBSTANCES IN MEDICINE IN THE USSR
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CIA-RDP80-00809A000700230228-2
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Publication Date:
July 21, 1955
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REPORT
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APPLICATION OF RADIOACTIVE SUBSTANCES ZN
MEDICINE IN THE USSR
Meditsinskiy Rabotnik, Vol 18, No 20
Moscow, 1 Mar 55
Docent I. Lagunova
Director Institute
of Roentgenology and
Radiology imeri V. M.
Molotov
Radiant energy was originally applied for therapeutic purposes at
the time of the discovery of X-rays and rays emitted by radium in the
last decade of the 19th century.
As technology and physics developed, an increasing number of sources
of radiation was found and used. Zn addition to the natural radioactive
elements, radium and mesothorium, artificial radioactive substances,
particularly the radioactive isotopes of cobalt, gold, phosphorus, iodine,
sodium, etc., have been applied during recent years. Radium and mesothorium
belong to the group of metals. These elements emit a mixed alpha, beta,
and gamma radiation. Only the hardest gamma rays emitted by these sources
of radiation are used for therapeutic purposes.
To obtain hard gamma radiation, it is necessary to filter out the
soft alpha rays and beta rays. This is achieved by using filters made of
gold and platinum. Notuithstara3ing the filtration, the radiation of each
of the radioactive metals mentioned is characterized by an inhomogeniety,
i.e., by the fact that every photon does not have the same energy, a
condition which is responsible for some peculiarities as far as the
biological action exerted by the radiation is concerned.
The inhomogeniety of the radiation is particularly characteristic for
mesothoriua. As far as the artificial radioactive isotope cobalt 60 is
concerned (the half-life of this element amounts of 5.3 years), it yields
gamma radiation which has an almost homogeneous energy of photons equal
to 1.1-1.3 Me V. The beta particles emitted by cobalt 50 have an energy
which is so small that the beta rays ar^_ completely absorbed by filters
made of metals which have a medium atomic weight, for instance, ^ickel.
Thus, as far as the possibility of obtaining homogeneous gamma
radiation for therapeutic purposes is concerned, radioactive cobalt
compares favorably with natural radioactive substances.
The homogeneity of the radiation eiaitted by radioactive substances
is particularly significant in the treatment oi' various paticologlcal
processes, especially of malignant tumors. When pathological formations
which are located deeply in the body are irrediatecl, the soft components
of the radiation are absorbed by tissues which lie ir, the path of the ray
bundle, primarily by the skin and the subcutaneous cellular tissue. This
brings about an undesireable reaction which is occasionally quite acute,
so that severe injuries may result. When the hard homogeneous radiation
emitted by radioactive cobalt is used, the reaction of the surrounding
tissues will be considerably less pronounced than in the case of radium
or mesothorium although the biological action on the tumor remains the
same. Another advantage of radioactive cobalt is that it can be obtained
in any desired quantity needed for therapeutic purposes. Radioactive
cobalt is cheap, simple in use, and does not require expensive filters
made oP gold or platinum.
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In addition to solid radioactive cobalt, colloidal solutions ofof ra d1o_
active gold and solutions of salts containing radioactive phoephorua are
used Por therapeutic purposes. Gold and phoephorua belong to the so-called
? short-lived radioactive elements, i.e., they have a short half-life (2,73
days is the case of gold and 14.3 days is the case of phosphorus). Gold
yields gamma radiation and beta radiation vhile phosphorus emits only beta
rays.
All radioactive substances, both natural and artificial ma
the most diverse diseases and applied by the moat diverse methods.
eases that can be treated vlth radioactive substances comprise b ood diseases
such as er hr The dis-
Yt emia, leukosee, and myeloaes; skin diseases such as eczemas,
neurodermites, and psoriasis; and pre-cancer conditions of the skin and of
the mucous membrances, 1. e., Bovena disease, leukoplakla, hyperkeratosis,
etc. Radioactive substances are videly used in the there
flamation processes and particularly in the treatment of mall _
Want tumors located in various PY of various in-
y, beginning vith superficial
tumors (center of the akin) and pending with tumors vhich are locatedndeeplyg
in the body (cancer oP the lungs or cancer of the esophogus).
At the Scientific Institute of Roentgenology and Radiology imeni V,
tov, several methods of radium therapy are being developed and videl a
Pathological processes Molo-
radium there , Primarily malignant tumors, are being aub,Jectedptoitele-
raya, namelyPradium, mesothoriume andreobaltubstances vhich emit hard gamma
almost exclusively for this ur ~ can be used. Cobalt is used
p pose at present.
Teleradium therapy is carried out by means of special equipment manu-
factured at present by the USSR industry. This equipment consists of the so-
called teleradium installations or gamma installations, i.e., CUT-CO-20 and
GUT-CO-400 (gamma ray teleradium installations containin
deei 8 9uantities of radio-
active cobalt equivalent to 20 g and 400 g of radium, respectivel
8nations correspond to the size of the char Y~? The plaht
in the installation. The equipment in questiongisocolloquisllyereferredctouasd
radium cannons. At present, all ontological inetitutiona in the USSR have the
possibility of using this equipment. The use of the powerful teleradium ap-
paratus CUT-CO-400 makes it possible to exert an action on the focus of an
affliction vhich may be located at a depth of 10-15 cm from the surface of the
skin. Depending on the depth of the location of the tumor, various focal dis-
tances are used, i.e., the distance from the center of radiation to the surface
of the body of the patient ie varied appropriately. With the aid of a
GUT-CO-400, patients suffering from tumors of the lun a
and of the eaophogus are treated. B PParatus
y means of the same apparatus, deeply lo-
Gated sarcomas of soft tissues and of the bones and cancers of thedfemaleum,
genital organs can be aub,jected to therapy,
used for theatreatment o~-tu0mo~stlocatedsnealetheheig?acedofothesskin,n~or in-
stance cancer of the ~av or of the throat and metastases in the 1
of the neck, the arm pit, and the groin. Tlie there
to treatment with the GUT-CO_ YmPh nodes
the model GUT-CO-400.
20 model can also be carriedoouttvith thecaidiofe
The extensive application of teleradium therapy at our institute has made
it possible at present to treat successfully patients with tumors of a type
for vhich no effective therapy existed previously. Tvo case histories follow:
treatmentPatithe Bnstitutene iiechad beenesub~ectedutoesurgeryaataotheremedical
inetitutiona, after which a rapid recurrence of the original condition. A
huge tumor covered the whole right side of the face. This tumor closed one
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eye, and obstructed the nseal passages, thus interfering with respiration
through the nose. Another surgical operation was out of the question. The
patient was subjected to teleradium therapy. Ae a result, the tumor re-
gressed; vision of the eye and respiration were restored. The patient re-
gained ability to work. There was no recurrence of the condition during a
year and a half.
A fluorographic investigation disclosed that Patient T had a neg-
lected case of lung cancer. Surgical interference was impossible in this
case for technical reasons. Application of teleradium therapy resulted in a
regression of the tumor, and the patient regained ability to work. After the
treatment, Patient T was under observation for 2 years. No recurrence of
the condition was observed.
Zn addition to teleradium therapy, we use the surface application method.
This method is used in the treatment of tumors which are located either on the
surface of the body or at shallow depths in the subcutaneous cellular tissue.
By this method, cancer of the skin, melanomas, angiomsa, recurrences of cancer
of the lactic gland in the scar after the removal of the cancer, cancer of the
lips, and metastases located superficially (in the skin and in the lymph nodes)
can be treated.
In the surface application method, preparations of radium, mesothorium,
or cobalt are used. During recent years, cobalt has been used more extensively
than any other element for this purpose. The preparations are sealed in small
tubee made of platinum, gold, or nickel. The tubes which contain the radio-
active substance are inserted in a definite order into the applicator (i.e.,
s molding which conforms to the contours of the tumor) made of a plastic mass.
This mesa consists of a mixture of wax and paraffin wax to which sawdust has
been added. The dose of radiation, the intensity ~+f the radiation, and the
time during which the molding is applied to the patient are determined by
means of tables which were drawn up at the institute in 1948.
Phosphorus in the form of sodium phosphate can also be used in the eur-
face application method. However, phosphorus is used only for the treatment
of processes of an inflammatory or tumor type which occur at the very surface.
In other words, capillary angiomas of the skin, eczemas, nei~rodermitee, psori-
asis, and similar conditions are treated.
The procedures of using phosphorus in the surface application method of
therapy have been developed at our institute by Prof. A. V. Kozlova, who re-
ported on the results of applying this method at the International Congress
of Radiologists in Rome which was held in April 1954. In this type of applica-
tion, the calculation of the dose and of the intensity of the radiation is done
according to a special formula 3eveloped by our institute in cooperation with
the Leningrad Institute of Roentgenology and Radiology.
The intratissue method of radiotherapy is carried out by inserting radio-
active needles directly into the tissue of the tumor to the required depth.
The needles are placed at definite distances from each other. The needles
used are filled either with radium, mesothorium, or cobalt. This method is
of considerable advantage ea compared with the methods of external irradiation,
because it enables us to exert action directly on the tumor while it subjects
the surrounding normal tissue to the least possible damage.
The intratissue method is particularly effective when it is used in com-
bination with surgery. When it is not possible to remove the tumor by surgical
means or when the tumor has not been removed completely by surgery, the tumor
or its site can be treated by inserting radioactive needles along the periphery.
The intracavity method differs from the intratissue method in that the radio-
active needles are introduced into the natural cavities formed by such organs
as the uterus, esophagus, urethra, mouth, etc. This method is usually supplmiented
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by external irradiation. The intratumor method is distinguished by the f
that there are introduced i
act
nto the tumor solutions of radioactive substances
which decay rapidly. The auoatances used may be a colloidal solution of gold
or a suspension of the chromate of radioactive phosphorus [sic]. These solu-
tions, on infiltrating the tumor, remain there until the radioactive elements
have decayed completely. During this time, they destroy the afflicted tissues.
A considerable group of so-called radium-resistant tumors has existed;
i.e., tumors which are not very sensitive to the action of radiant energy ap_
plied in the doses available at present and by the methods now at our disposal.
It`ie apparent that these radium-resistant tumors can be eub,jected to deatn:c_
tion under the action of higher doses of radiation, which in direct treatment
of the tumor by radioactive substances may reach an intensity of one million
roentgens,
In the application of radiant energy for therapeutic purposes it must be
remembered that the greatest obs?acle has been the action of the radiation not
only on the tumor but also on the normal tissues surrounding it. Tissues were
damaged to such a considerable extent that irreverelble changes occasionally
occurred in them as a result of the treatment. All this resulted in great harm
to the patients and led to functional disturbances in some organs. For in-
stance, pneumosclerosls occurred after irradiation of tumors of the chest;
also scarification of various tissues as well as atrophy of the akin and of
the mucous membranes. Furthermore ulcers, that did not heal occasionally re-
sulted. Injuries to normal tissues brought about in the process of therapy
often formed an obstacle to the completion of therapy by radiation.
For many years, work has been carried out at the Institute [by Prof A, V.
Kozlova] of measures which would prevent injury to normal tissues in connec-
tion with radiation therapy. Thus, when the method of external radiation is
used, a number of auxiliary measures are applied which contribute to an in-
cresae in the ratio between the sensitivity of normal tissuee to radiant energy
and the sensitivity of tumor tissues to this energy. Among these measures are
the novocain block, the tying up of blood vessels which nourish the area of the
althoughoitlhaspyieldedndefiniteoresultss~didrnotAsolveathenproblemecompletely~
Only by using the intratumor introduction of radioactive substances in the form
of solutions from which the dissolved substances combine directly with the tis-
sues of the tumor so that they act solely upon them, can this problem be re-
solved in a satisfactory manner.
The personnel of our institute is occupied in work on the development of
such methods. At the same time, we are continuing to perfect the methods of
the application of radiant energy that have al:?ead}? been developed and are
being used in the therapy of various diseases. We also seek new ways of using
this energy not only for therapeutic purposes, but also for diagnosing cor-
rectly various diseases and investigating complicated processes of metabolism
that occur in the human body.
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