Radiation Therapy Timeline

By ilianag10

  • Discovery of X-ray photon (Wilhelm Conrad Roentgen)

    Discovery of X-ray photon (Wilhelm Conrad Roentgen)
    -Roentgen called it "X-ray", with "x" being the algebraic symbol for an unknown quantity
    • Within a year, the application of X-rays to diagnosis and therapy was established as part of the medical profession
    • In 1896, electrotherapist Emil Grubbe irradiated a woman with breast cancer, and after a year, several researchers noticed the palliative effects of x-rays on cancer
    • 3 years later radiation was used to treat cancer, and began with radium and relatively low-voltage diagnostic machines

  • Brachytherapy

    Brachytherapy
    • Marie Curie introduced the concept of radioactivity in 1898 along with the discovery of radium
    • First used by French doctors Desnos and Minet, they independently used radium encased in silver to treat prostatic hypertrophy
    • First technique used, a catheter containing 10–50 mg of radium in a silver tube through the urethra or rectum for 12 sessions of 20–120 min with 2–4 days of intervals between treatments

  • External beam radium device development

    External beam radium device development
    • Gioacchino Failla develops the first external-beam radium therapy device, known as a “radium element pack” or a “radium bomb"
    • Was used to treat cancers located in the chest, brain, and abdomen
    • One method involved packing a radium source in a lead box with a hole in it; the box would be placed above the body with the hole positioned over the tumor

  • Standard radiation dosing tables developed

    Standard radiation dosing tables developed
    • Physicist Edith Quimby at Memorial Hospital developed many of the dosing tables used in radiation therapy for several years
    • Typically range from 45 to 60 Gy for the treatment of breast, head, and neck cancers
    • Doses are divided into multiple smaller doses that are given over a period of one to two months
    • Dose for each patient depends on the location and severity of the tumor

  • Proton beam theraphy

    Proton beam theraphy
    • The idea of using proton for the treatment of cancer was first suggested in 1946 by physicist Robert R. Wilson, Ph.D.
    • The first attempts to use proton radiation to treat patients began in the 1950s
    • Source: Protons are extracted from hydrogen atoms and accelerated to almost the speed of light using a cyclotron
    • Advantages include the ability to more precisely target the tumor cells and spare healthy tissue

  • Linear Accelerator development

    Linear Accelerator development
    • First patient treatment began in 1953 in London, at Hammersmith Hospital, with an 8 MV machine built by Metropolitan Vickers and installed in 1952, which was the first dedicated medical LINAC
    • Uses microwave technology to accelerate electrons in a part of the accelerator called the "wave guide," then allows these electrons to collide with a heavy metal target to produce high-energy x-ray
    • High energy x-rays are shaped as they exit the machine to conform to the shape of the patient's tumor

  • Intensity-modulated radiation therapy (IMRT)

    Intensity-modulated radiation therapy (IMRT)
    • Brahme, the Swedish medical physicist, introduced Intensity Modulated Radiation Therapy in 1982. He proposed to change the present shape of a collimator into a multi-leaf collimator
    • IMRT refers to a specific technique of linear accelerator-based radiation therapy where beams are modulated in such a manner to produce highly conformal dose distributions
    • Actual IMRT was applied to clinical practice in 2000
    • it takes slightly more time to plan than external beam radiation therapy

  • IGRT

    IGRT
    • May involve a variety of 2D, 3D and 4D imaging techniques
      • The energy can come from X-rays, protons or other sources
    • High-quality images are taken before each radiation therapy treatment session. The images are used to increase the accuracy and precision of the radiation treatment

  • Conformal radiation therapy (CRT)

    Conformal radiation therapy (CRT)
    • In 2001, conformal radiotherapy had become the standard radiotherapy modality
    • Uses CT images and special computers to very precisely map the location of a cancer in 3 dimensions
    • The patient is fitted with a plastic mold or cast to keep the body part still and in the same position for each treatment
    • The radiation beams are matched to the shape of the tumor and delivered to the tumor from several directions.

  • MRI-linac

    MRI-linac
    • This technology combines linear accelerator (LINACs) with MRI, referred to as MRI-guided radiation therapy
    • Provides real-time imaging and quality control given the ability to monitor anatomic structures and positions while treatments are delivered
    • The first installed unites, is Unity by Elekta (Stockholm, Sweden) and MRIdian by ViewRay (Ohio, USA)
    • In 2017, Elekta’s Unity performed the first treatment in humans in a small cohort of patients with spinal metastases