Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radiation therapy may be curative in a number of types of cancer if they are localized to one area of the body. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery to remove a primary malignant tumor. Radiation therapy is synergistic with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers. The subspecialty of oncology concerned with radiotherapy is called radiation oncology. A physician who practices in this subspecialty is a radiation oncologist.
External beam radiation therapy (EBRT) describes the use of a collimated beam of ionizing radiation from outside the body to treat a disease. As follows:
Radionuclide therapy uses radioactive substances called radiopharmaceuticals to treat medical conditions, particularly cancer. These are introduced into the body by various means and localise to specific locations, organs or tissues depending on their properties and administration routes. This includes anything from a simple compound such as sodium iodide that locates to the thyroid via trapping the iodide ion, to complex biopharmaceuticals such as recombinant antibodies which are attached to radionuclides and seek out specific antigens on cell surfaces.
Megavoltage X-rays are produced by linear accelerators ("linacs") operating at voltages in excess of 1000 kV (1 MV) range, and therefore have an energy in the MeV range. The voltage in this case refers to the voltage used to accelerate electrons in the linear accelerator and indicates the maximum possible energy of the photons which are subsequently produced. They are used in medicine in external beam radiotherapy to treat neoplasms, cancer and tumors. Beams with the voltage range of 4-25 MV are used to treat deeply buried cancers because radiation oncologists find that they penetrate well to deep sites within the body. Lower energy x-rays, called orthovoltage X-rays, are used to treat cancers closer to the surface.
In medicine, proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate diseased tissue, most often to treat cancer. The chief advantage of proton therapy over other types of external beam radiotherapy is that the dose of protons is deposited over a narrow range of depth; hence in minimal entry, exit, or scattered radiation dose to healthy nearby tissues.
Radiosurgery is surgery using radiation, that is, the destruction of precisely selected areas of tissue using ionizing radiation rather than excision with a blade. Like other forms of radiation therapy, it is usually used to treat cancer. Radiosurgery was originally defined by the Swedish neurosurgeon Lars Leksell as "a single high dose fraction of radiation, stereotactically directed to an intracranial region of interest".
Nordion Inc., a Sotera Health company, is a health science company that provides Cobalt-60 used for sterilization and treatment of disease (radiotherapy).
Harold Elford Johns was a Canadian medical physicist, noted for his extensive contributions to the use of ionizing radiation to treat cancer.
Cobalt-60 (60Co) is a synthetic radioactive isotope of cobalt with a half-life of 5.2713 years. It is produced artificially in nuclear reactors. Deliberate industrial production depends on neutron activation of bulk samples of the monoisotopic and mononuclidic cobalt isotope 59
Co
. Measurable quantities are also produced as a by-product of typical nuclear power plant operation and may be detected externally when leaks occur. In the latter case the incidentally produced 60
Co
is largely the result of multiple stages of neutron activation of iron isotopes in the reactor's steel structures via the creation of its 59
Co
precursor. The simplest case of the latter would result from the activation of 58
Fe
. 60
Co
undergoes beta decay to the stable isotope nickel-60. The activated nickel nucleus emits two gamma rays with energies of 1.17 and 1.33 MeV, hence the overall equation of the nuclear reaction is:
Radionuclides which emit gamma radiation are valuable in a range of different industrial, scientific and medical technologies. This article lists some common gamma-emitting radionuclides of technological importance, and their properties.
Fast neutron therapy utilizes high energy neutrons typically between 50 and 70 MeV to treat cancer. Most fast neutron therapy beams are produced by reactors, cyclotrons (d+Be) and linear accelerators. Neutron therapy is currently available in Germany, Russia, South Africa and the United States. In the United States, one treatment center is operational, in Seattle, Washington. The Seattle center uses a cyclotron which produces a proton beam impinging upon a beryllium target.
Intraoperative radiation therapy (IORT) is radiation therapy that is administered during surgery directly in the operating room.
Particle therapy is a form of external beam radiotherapy using beams of energetic neutrons, protons, or other heavier positive ions for cancer treatment. The most common type of particle therapy as of August 2021 is proton therapy.
Radiobiology is a field of clinical and basic medical sciences that involves the study of the action of ionizing radiation on living things, especially health effects of radiation. Ionizing radiation is generally harmful and potentially lethal to living things but can have health benefits in radiation therapy for the treatment of cancer and thyrotoxicosis. Its most common impact is the induction of cancer with a latent period of years or decades after exposure. High doses can cause visually dramatic radiation burns, and/or rapid fatality through acute radiation syndrome. Controlled doses are used for medical imaging and radiotherapy.
Intraoperative electron radiation therapy is the application of electron radiation directly to the residual tumor or tumor bed during cancer surgery. Electron beams are useful for intraoperative radiation treatment because, depending on the electron energy, the dose falls off rapidly behind the target site, therefore sparing underlying healthy tissue.
Alpha particles, also called alpha rays or alpha radiation, consist of two protons and two neutrons bound together into a particle identical to a helium-4 nucleus. They are generally produced in the process of alpha decay, but may also be produced in other ways. Alpha particles are named after the first letter in the Greek alphabet, α. The symbol for the alpha particle is α or α2+. Because they are identical to helium nuclei, they are also sometimes written as He2+
or 4
2He2+
indicating a helium ion with a +2 charge. Once the ion gains electrons from its environment, the alpha particle becomes a normal helium atom 4
2He.
The history of radiation therapy or radiotherapy can be traced back to experiments made soon after the discovery of X-rays (1895), when it was shown that exposure to radiation produced cutaneous burns. Influenced by electrotherapy and escharotics — the medical application of caustic substances — doctors began using radiation to treat growths and lesions produced by diseases such as lupus, basal cell carcinoma, and epithelioma. Radiation was generally believed to have bactericidal properties, so when radium was discovered, in addition to treatments similar to those used with x-rays, it was also used as an additive to medical treatments for diseases such as tuberculosis where there were resistant bacilli.
Neutron capture therapy (NCT) is a type of radiotherapy for treating locally invasive malignant tumors such as primary brain tumors, recurrent cancers of the head and neck region, and cutaneous and extracutaneous melanomas. It is a two-step process: first, the patient is injected with a tumor-localizing drug containing the stable isotope boron-10 (10B), which has a high propensity to capture low energy "thermal" neutrons. The neutron cross section of 10B is 1,000 times more than that of other elements, such as nitrogen, hydrogen, or oxygen, that occur in tissue. In the second step, the patient is radiated with epithermal neutrons, the sources of which in the past have been nuclear reactors and now are accelerators that produce higher energy epithermal neutrons. After losing energy as they penetrate tissue, the resultant low energy "thermal" neutrons are captured by the 10B atoms. The resulting decay reaction yields high-energy alpha particles that kill the cancer cells that have taken up enough 10B.
A radiotherapy accident in Columbus, Ohio, also known as the Riverside radiation case, occurred as the result of an incorrectly calibrated cobalt teletherapy unit, occurred between 1974 and 1976, leading to 10 deaths.
