Principles of Radiation Therapy
Radioactivity was first described by Henri Becquerel and Pierre and Marie Curie in the late 1890s. Wilhelm Roentgen discovered x-rays in 1895, and subsequent physics and biology research revealed the therapeutic properties of radiation. X-rays were first
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Abigail L. Stockham, Ehsan H. Balagamwala, Roger Macklis, Allan Wilkinson, and Arun D. Singh
Contents
10.7
Charged Particle Therapy.........................
96
10.1
Introduction ................................................
89
10.8
Brachytherapy ............................................
97
10.2 10.2.1 10.2.2 10.2.3
Basic Principles .......................................... Dual Nature of Radiation ............................. Radioactive Decay ....................................... Ionizing and Nonionizing Radiation ............
90 90 90 90
10.9
Summary.....................................................
97
References .................................................................
97
10.3 10.3.1 10.3.2 10.3.3
Teletherapy Sources ................................... Cobalt-60 Unit ............................................. Linear Accelerator ....................................... Cyclotron .....................................................
91 91 91 91
10.4 10.4.1 10.4.2 10.4.3
Radiation Parameters ................................ Radiation Dose............................................. Relative Biological Effectiveness ................ Cobalt Gray Equivalents ..............................
92 92 92 92
10.5 10.5.1 10.5.2 10.5.3 10.5.4
Treatment Parameters ............................... Target Volume .............................................. Total Dose .................................................... Fractionation ................................................ Tissue Tolerance ..........................................
92 92 93 93 93
10.6 10.6.1 10.6.2 10.6.3 10.6.4 10.6.5
Teletherapy Techniques ............................. External Beam Therapy ............................... Conformal Radiation Therapy ..................... Three-Dimensional Conformal Therapy ...... Intensity-Modulated Radiation Therapy ...... Stereotactic Radiosurgery ............................
93 93 94 95 95 95
A.L. Stockham, MD • E.H. Balagamwala, MD R. Macklis, MD • A. Wilkinson, PhD Department of Radiation Oncology, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA e-mail: [email protected], [email protected] A.D. Singh, MD (*) Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, USA e-mail: [email protected]
10.1
Introduction
Radioactivity was first described by Henri Becquerel and Pierre and Marie Curie in the late 1890s. Wilhelm Roentgen discovered x-rays in 1895, and subsequent physics and biology research revealed the therapeutic properties of radiation. X-rays were first used to treat cancer in 1897. Soon after, the concept of brachytherapy was developed when radium was implanted into tumors for therapeutic effect. Low-voltage x-ray machines were built in the 1920s for the external treatment of superficial tumors. The first cyclotron (used to accelerate heavy particles such as protons, neutrons, and deuterons) was invented in 1932 in California. In 1951, the first clinical cobalt-
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