Cobalt-60* Teletherapy for Complicated Peptic Ulcer
CHARLES H. BROWN, M.D.
Department of Gastroenterology
ROBERT A. HAYS, M.D.
Department of Radiology
ROENTGEN THERAPY to the fundus of the stomach was first used 40 years ago by Bruegel1 in the treatment of peptic ulcer. Palmer and associates2–4 have used irradiation extensively during the past 20 years as one aspect of ulcer therapy that included a strict medical regimen consisting of a bland diet, frequent feedings, antacids, sedation, psychotherapy, and other measures. In 1948 they3 reported follow-up studies on 800 patients, and to date approximately 1200 of their patients with peptic ulcer have received such therapy.2 Their follow-up studies have revealed excellent results, with a low incidence of recurrent peptic ulcer, which have stimulated our interest in the adjunctive use of irradiation in the treatment of complicated peptic ulcer.
Gastric secretory studies are most important in evaluating any treatment for peptic ulcer. It has been repeatedly stressed, “No acid, no ulcer.” Any type of therapy that results in anacidity will be effective ulcer treatment. In 1939, Palmer and Templeton4 reported a transitory reduction in acid secretion in all cases receiving roentgen therapy. In 35 of 88 patients studied, achlorhydria occurred. Ricketts, Kirsner, Humphreys, and Palmer5 found a reduction in volume of gastric sccretion averaging 47.5 per cent, with complete anacidity in 13 of 15 patients with gastric ulcers who had received a depth dose of 1600 r. With their latest technic (Technic A) and with a depth dose of 1600 to 2500 roentgens, 44 (76 per cent) of 58 patients developed achlorhydria, and an additional 6 (11 per cent) had a 50 per. . .