[Results of radio-surgical treatment of primary malignant lymphomas of the digestive tract].

In 29 patients treated in the Department of radiotherapy of the University Hospital, Lausanne, between 1963 to 1978, 18 of these lesions were localized in the stomach (1 was confined to the oesophago-gastric region), 10 in the small intestine and 1 in the rectum. The patients comprised 18 men and 11 women; the majority (21 out of 29) were over 50 years of age. Using the former histological classification, 13 patients had lymphomas of the lymphocytic type (in which 1 was a Brill-Symmers), 13 had reticulum cell sarcomas and 3 had mixed type. 28 patients had previously undergone surgery: 7 had had extensive surgery, 15 resections were classified as macroscopically tumour free by the surgeons though histologically the end of the surgical specimens was sectioned through tumour and/or regional lymphatics were positive, and 6 patients had undergone exploratory laparotomies. Radiotherapy was carried out using high energy machines in 28 of the 29 patients (i.e. telecobalt therapy and a betatron) and in the remaining patient a 200 kV conventional therapy machine was used. 21 patients received radical radiotherapy (in 15 patients the irradiation was confined to the tumour bed and the regional lymphatic ganglia, 1 patient was treated over the whole abdominal cavity using various parallel opposing portals, and 5 patients were treated by the moving-strip technic). In 8 patients the treatment was considered incomplete. The patients who were treated radically received doses of 4000-4500 rads in 5 weeks to the tumour bed and the regional lymphatic ganglia, and 2000-2500 rads in 5 weeks when the moving-strip technic was used and when the whole abdominal cavity was treated. Seven patients also received chemotherapy involving either one drug or in some cases multiple drug therapy. The best survival figures were in patients treated radically by both surgery and radiotherapy regardless of histology. The only prognostic factor was the initial extent of the disease.