RADIATION

THERAPY
P C S 4 0 7 RY E R S O N U N I V E R S I T Y, W I N T E R 2 0 2 1
D R . J A M E S G R Ä F E , P H D, M C C P M
CANCER STATISTICS
 HISTORICAL PERSPECTIVE
Nobel Prize Winners
▪ 1895: Wilhelm Röntgen discovers X–rays (November 8th)

▪ 1896: Henri Becquerel discovers radioactivity

▪ 1897: Marie Curie discovers radium

(http://www.nobelprize.org/)
8 YEARS LATER (1903)
Dr. Charles L. Leonard

• “The results obtained by the use of the Rontgen rays seems to … have
demonstrated their power to alter the character of malignant cells, to
prevent their spread and development,…The Rontgen treatment applied as a
palliative in many hopeless, operatively impossible cases, has resulted
frequently in cures, that, if not permanent, have at least restored the patient
to health and given months and even years of usefulness….”

(From Perez and Brady, 2008)

IMAGINE ALL THE POSSIBILITIES
THAT X-RAYS HAVE CREATED
 EARLY TREATMENTS
▪ low penetrating radiation was generally used
▪ Would treat until the erythema dose was observed (skin reddening;
“sunburn”)

( E.J Hall, 2006)

 KILOVOLTAGE MACHINES

(Khan, The Physics of Radiation Therapy, 2014)

❑Big part of radiation therapy until about the 1950s (XSTRAHL-300, at TBCC)

❑voltage up to about 300 kVp

60 C O THERAPY

❑First unit was invented in 1950 by

Harold E Johns, Saskatchewan
❑First Treatment on November 8th
1951, London ON
❑Produced in nuclear reactors
❑Typical source size is 1-2 cm in
diameter
❑Source of gamma-rays
60 C O

(Perez and Brady, 2008)

LINEAR ACCELERATORS “LINAC”

www.varian.com www.elekta.com
www.varian.com
 PROTON THERAPY
• Protons stop in tissue at a given depth determined by their energy
 BRAGG PEAK

(Smith, 2009)

(Schulz- Ertner & Tsujii, 2007)

(H, Suit et al., 2003)
WHAT IS ONE OF THE GREATEST
ADVANCES IN RADIATION THERAPY?

Being able to see and target what we want to treat.

• Many advances in radiation therapy parallel the

advances in medical imaging.
IMAGE GUIDED RADIATION THERAPY
(IGRT) Target and OAR delineation/contouring

Varadhan, Raj, Grigorios Karangelis, Karthik Krishnan, & Susanta Hui." JACMP, 14.1
(2013)

Beam design and dose calculation Maximize dose to tumor and minimize dose to
health tissue
WANG, Jia-Zhu et al. JACMP, [S.l.], v. 11, n. 2, apr. 2010. ISSN 15269914.
NEXT UP

Interactions of Ionizing Radiation