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In a previous paper 1 evidence was presented that patients with chronic leukemias treated by a comprehensive program termed titrated, regularly spaced total body irradiation were able to spend over 80% of their leukemic life spans at their normal occupations and recreations. The number of patients involved, the period of observation, and the methods of analysis used did not permit a statement at that time that life was prolonged by this method of treatment. In the present paper a much larger series of patients is reported over a longer period of time, and the data have been analyzed by Tivey, 2 using a modification of the "maximum likelihood method" of Fisher, 3 Boag, 4 and Lea. 5 Evidence is presented in this paper that survival time is significantly prolonged by this program of therapy. METHOD OF THERAPY The method of therapy was described in a previous paper 1 and is

Total-body irradiation has been utilized to treat disseminated malignant tumors for more than thirty years (1, 2). In general, massive single doses (3, 4) have proved unrewarding, whereas several investigators (5, 6) have observed significant responses with fractionated dosage schedules in the chronic leukemias. In August 1964, a study to evaluate fractionated total-body irradiation was initiated at the National Cancer Institute. The preliminary results with leukemia and generalized lymphoma patients will be reviewed in this paper. Clinical Material and Results The diagnoses in 19 consecutive patients are summarized in Table I. All patients were irradiated with 2 MeV x rays from a Van de Graaff accelerator at a target-to-skin distance of 340 cm. Treatments were given alternately from the left and right sides to increase the homogeneity of the absorbed dose. The delivered doses expressed in this report were measured in air at the midline of the patient with a rate dose of 6.1 R per minute for all treatment...

In previous investigations it has been demonstrated that in various animal species increasing doses of x-rays in the form of total body irradiation produce an increasing mortality rate (1, 2). Data concerning the influence of dose fractionation on the lethal effect produced in mice by total body irradiation are presented in this paper. The influence of dose fractionation on the biologic effect of x-rays has been the subject of a large number of investigations. From the accumulated evidence it appears that fractionation usually decreases the effect of a given dose administered in one exposure. In certain tissues and organs with high reproductive capacity, however, as, for example, the testis (3) and malignant tumor tissue (4), the effect of the fractionated dose was found to be more pronounced. The mammalian body is composed of tissues known to react differently to dose fractionation. A study of its influence on the organism as a whole appears, therefore, of special interest. Methods A total of 253 white m...

The influence of dose fractionation upon the lethal effect of total body roentgen irradiation on mice has been previously reported (1). The present paper describes the change in effect of the absolute lethal dose LD100 of x-rays in mice, with fractionation into single doses of various sizes and when different over-all exposure times are employed. MethodsA total of 220 white male Swiss mice were used in this experiment. Twenty of these served as unirradiated controls. The irradiation factors employed were as follows: 200 kv.p., 10 ma., 0.25 mm. Cu and 1.0 mm. Al total filtration, corresponding to a half-value layer of 0.75 mm. Cu. The intensity of the radiation was 23.4 r/min. and the target-skin distance was 50 cm. A field 20 × 20 cm. was employed, and the set-up for the exposures was the same as in our previous experiments (2).The doses used were as follows: 1,000 r was given to 63 mice in a single exposure. 1,000 r was given to 40 mice, using 100 r daily on ten consecutive days. 1,000 r was given to 33 ...

In the past few years there has been a rapidly growing interest in the problems of radiation protection in cases of exposure of large areas of the human body. In addition, much work has been done in the field of organ transplants, particularly with respect to the management of leukemia with bone-marrow transplants. It is of interest to note that more success has attended the studies on experimental animals than on man. It is postulated that one of the problems in evaluating the efficacy of total-body irradiation of man has been the difficulty of obtaining a fairly uniform dose of radiation throughout the entire volume of a patient. Certainly a system which provided such a uniform energy deposition would eliminate a variable in the ultimate evaluation of total-body irradiation. It is the object of this paper to describe a physical system designed and constructed with this in view and to report the initial results of the dosimetry connected with it, as well as the problems encountered. The irradiation chamb...

During the past fifteen years we have been engaged in a systematic investigation of the effects of total-body irradiation, using a variety of small laboratory animals, including goldfish, mice, and guinea-pigs. These studies have demonstrated a positive relationship between increase of the administered x-ray dose and the percentage mortality (1–3). We have also been able to show that the lethal effects of total-body irradiation upon fish or mammals can be used advantageously for the study of numerous problems in medical radiation biology, such as depth dose determination (4), the influence of dose fractionation (5, 6), and the pharmacological analysis of the acute radiation syndrome (7, 8). The use of the lethal effect of total-body irradiation in recent years, in laboratories all over the world, brings to the fore the problem of the reproducibility of this effect. In this paper there will be presented pertinent data on mice, collected during the years 1949–53. Procedures and Methods A total of 586 male w...