[Preoperative irradiation in hypernephroid carcinoma].

Since 1967 we have been using preoperative radiation therapy for hypernephroma as proposed by RICHES. Radiation therapy, to include the para-aortic lymph nodes, is given in 250 rad increments 4 times weekly to a total dose of 3000 rads. After an interval of 3 weeks following the radiation therapy, we are performing the radical nephrectomy. 100 patients were treated by this method in the years 1967-1975: 32 patients were in stage I, 7 in stage II, 50 in stage III and 11 patients in stage IV. In 26 patients more than 5 years have passed since the beginning of the treatment: 46% od these survived. The survival for 3 years is 63, for 1 year after the surgery 80%. The surgical mortality rate is 2%. The object od the preoperative treatment is: 1. Devitalization of growing cells in the periphery of the tumor, thus preventing metastases and local recurrence. 2. Decreasing the size of the tumor and thereby facilitating surgery. In one-third of the cases there is radiologically demonstrable decrease in the size of the tumor mass, probably secondary to obliteration of the dilated veins in the capsule. The delay of six weeks has had no adverse effect on the outcome of the disease.