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May, 1968 CANCER OF THE VOCAL CORDS—CAVENAUGH ET AL. 213 there is no limitation of movement of the true vocal cord as seen on indirect laryngoscopy. It is our belief that limitation of motion, no matter how small the lesion, implies a much more serious prognosis than even the most extensive lesion, provided that mobility of the true vocal cord is maintained in the latter. Method of Treatment Until June, 1964, it was our policy to give patients five treatments per week, delivering approximately 1000 r tumor dose per week for six weeks. Since 1964 we have continued to deliver the same weekly dosage over the same six-week period, but have reduced the number of treatments to three per week. This schedule has been particularly convenient for the patients since it allows them to continue regular employment during the period of treatment. More importantly, we have observed no change in the severity of mucosal reactions with the altered schedule, nor in the overall results. The patient undergoing irradiation therapy is examined at frequent intervals by both the otolaryngologist and the radiotherapist. The repeated examinations allow an interruption of treatment in the occasional patient whose mucosal reaction is more severe than was expected and for the delivery of addi- tional radiation to the patient whose response is less pronounced than desired. A second point of emphasis in our treatment is the practice of "skimming" the beam anteriorly to the skin profile (Fig. 1). We feel that this is most important with the cobalt 60 apparatus in order to avoid the low-dose penumbra area. The implications of this policy in treating lesions of the anterior comissure are obvious. The cords lie completely within the high-dose area of the beam, and no part can be underdosed in the penumbra. Clinical Data and Results The age distribution of the patients is shown in Table 1. As one would expect, most of the patients are between 50 and 70 years Table 1 Age Distribution of Patients Age No. Patients •years) 21-30 2 31-40 2 41-50 10 51-60 11 61-70 18 71-80 10 Total 53 of age when first seen. Our youngest patient was 24 years of age. The sex distribution as shown in Table 2 reveals the expected preponderance of males. Table 2 Sex Distribution No. Male 50 Female 3 Total 53 To compare the results of the two treatment schedules, we divided the patients into two categories: those treated before June, 1964, when our policy of giving three treatments per week went into effect, and those treated after that date. The cut-off date
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1968 |
Identifier | NCHH-17-029 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 29 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-029.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-029 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 213 (images) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1968 |
Identifier | NCHH-17-029-0317 |
Form General | Periodicals |
Page Type | all; all images; chart/table; all images; diagram; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | ncarolinamed29v11968medi_0317.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 29 |
Issue Number | 5 |
Page Number | 213 |
Health Discipline | Medicine |
Full Text | May, 1968 CANCER OF THE VOCAL CORDS—CAVENAUGH ET AL. 213 there is no limitation of movement of the true vocal cord as seen on indirect laryngoscopy. It is our belief that limitation of motion, no matter how small the lesion, implies a much more serious prognosis than even the most extensive lesion, provided that mobility of the true vocal cord is maintained in the latter. Method of Treatment Until June, 1964, it was our policy to give patients five treatments per week, delivering approximately 1000 r tumor dose per week for six weeks. Since 1964 we have continued to deliver the same weekly dosage over the same six-week period, but have reduced the number of treatments to three per week. This schedule has been particularly convenient for the patients since it allows them to continue regular employment during the period of treatment. More importantly, we have observed no change in the severity of mucosal reactions with the altered schedule, nor in the overall results. The patient undergoing irradiation therapy is examined at frequent intervals by both the otolaryngologist and the radiotherapist. The repeated examinations allow an interruption of treatment in the occasional patient whose mucosal reaction is more severe than was expected and for the delivery of addi- tional radiation to the patient whose response is less pronounced than desired. A second point of emphasis in our treatment is the practice of "skimming" the beam anteriorly to the skin profile (Fig. 1). We feel that this is most important with the cobalt 60 apparatus in order to avoid the low-dose penumbra area. The implications of this policy in treating lesions of the anterior comissure are obvious. The cords lie completely within the high-dose area of the beam, and no part can be underdosed in the penumbra. Clinical Data and Results The age distribution of the patients is shown in Table 1. As one would expect, most of the patients are between 50 and 70 years Table 1 Age Distribution of Patients Age No. Patients •years) 21-30 2 31-40 2 41-50 10 51-60 11 61-70 18 71-80 10 Total 53 of age when first seen. Our youngest patient was 24 years of age. The sex distribution as shown in Table 2 reveals the expected preponderance of males. Table 2 Sex Distribution No. Male 50 Female 3 Total 53 To compare the results of the two treatment schedules, we divided the patients into two categories: those treated before June, 1964, when our policy of giving three treatments per week went into effect, and those treated after that date. The cut-off date |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-029.pdf |
Document Sort | all; nchh-17 |
Article Title | Treatment Of Early Carcinoma Of The Vocal Cords |
Article Author | P . Cavanaugh; G. B. Ferguson; T R. C. Jordan; W. R. Hudson; B. T. Worde; M. Raben; H. Connell |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-029 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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