Howard Kelly establishes gynecologic brachytherapy in the United States.
OBJECTIVE
Exploration of Howard Atwood Kelly's contributions to gynecologic brachytherapy.


METHODS
Review of contemporary journals, texts, newspaper accounts, and the memoirs of Kelly's associates. Information from unpublished material, including Kelly's handwritten notes and diaries, was culled from the Alan Mason Chesney Archives of the Johns Hopkins Medical Institutions.


RESULTS
Despite European reports of radium's efficacy, gynecologists on both sides of the Atlantic resisted its adoption. The endorsement of radium therapy by America's foremost gynecologist, Howard Kelly, was instrumental in its acceptance. His consummate skill as clinician, investigator, publicist, and entrepreneur established brachytherapy as the primary treatment modality for carcinoma of the cervix and vagina. The technique he pioneered in the second decade of the 20th century, a combination of brachytherapy and megavoltage-equivalent teletherapy, presaged modern practice.


CONCLUSIONS
Principles for the management of female genital neoplasia, outlined by Howard Kelly nine decades ago, remain relevant today.
Aronowitz
Jesse N
JN
Department of Radiation Oncology, University of Massachusetts Medical School, Worcester, MA 01605, USA. Jesse.Aronowitz@umassmemorial.org
Robison
Roger F
RF
D001918:Brachytherapy / Q000266:history*; D005260:Female; D005833:Genital Neoplasms, Female / Q000266:history* / Q000532:radiotherapy*; D006176:Gynecology / Q000266:history*; D049673:History, 20th Century; D006801:Humans; D010820:Physicians / Q000266:history*; D014481:United States