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RADIOTHERAPY
Introduction
Nuclear and isotope techniques are widely used in numerous areas of human
activity and for more than century have prominent application in different
areas including medicine. This paper focuses on radiotherapy which is one of
the applications of gamma rays in medicine.
To start with, a brief understanding of gamma rays should be known first,
including properties and sources of gamma rays. Without an understanding
of gamma rays, the working principle of radiotherapy could not be
demonstrated clearly.
An introduction of radiotherapy is then followed before I go into the details of
the two main approaches in radiotherapy: external beam radiation therapy
and brachytherapy.
Radiotherapy
Radiation therapy is the treatment modality of malignant and benign
diseases, by means of ionizing radiation. Since a wide spectrum of ionizing
radiation is known nowadays, available technological solutions which use
these sources of radiation, are also numerous. There are two major
approaches in radiation therapy: external beam radiation therapy (also
known as teletherapy), where the ionizing radiation comes from external
source outside the body of the patient, and brachytherapy, where the source
of radiation is placed inside the patient, inside the tumor, or in its close
proximity.
The use of radionuclides in the treatment of diseases is long more than a
century, starting with observation of P. Curie that a radium source in direct
contact with skin causes burns. The first application of radium-226, as sealed
sources in radiotherapy occurred in 1915, but this method was abounded in
the middle of the twentieth century, when reactor isotopes (as cobalt)
remote manipulation became available (Magill, 2005). One of the most
important applications of radionuclides in radiotherapy is based on the use of
sealed radiation sources for external beam therapy, the use of implants for
the treatment of prostate cancer, intravascular radiotherapy and use of
radiopharmaceuticals for therapeutic purposes. In addition to these methods,
rapid development and implementation of a wide range of new and effective
techniques, such as radioimmunotherapy and ion beams is expected in near
future (John, 1983).
Brachytherapy
Hundreds of thousands of patients each year is referred to brachytherapy
treatments (in the Greek language brachys means close). In this technique, a
sealed source of radiation is introduced into the body cavity or tissue and its
proximity to the tumor, provides the necessary dose for the tumor and
minimal dose to the surrounding healthy tissue. The radiation of
radionuclides is usually of moderate energy gamma radiation, which allows
homogeneous irradiation of the target and simultaneous protection of normal
tissue. Radiation sources usually have a high specific activity and small size.
With brachytherapy implants, it is possible to achieve successful treatment
with very low energy photons (20 keV, palladium). Common sources include
gamma-emitting radionuclides (iridium-192, cesium-137, iodine-125,
palladium-103) whose radiation has a range of the order of cm in tissues.
Shorter ranges, of order of mm, are achieved using beta-emitting
radionuclides such as strontium-90, rhenium-188 and phosphorus-32 (Magill,
2005; Martin, 2006).
The first patient treatments were performed using radium sources (Levitt,
2006; Devlin, 2007). Development of nuclear physics and radionuclide
Conclusion
Radiotherapy is an excellent example for transfer of modern technologies
and scientific knowledge in daily clinical practice. Based on various properties
of nuclei and radiation, such as the interaction of radiation with matter, radiation
detection, biological effects of radiation and static and dynamic nuclear properties
(magnetic properties, stability, radioactive decay), application of gamma rays bring
on a daily basis immense benefits in the diagnosis and treatment of disease and in
the development of medical science.
References
1) American Association of Physicist in Medicine (A.A.P.M.). (1987). Specification
of Brachytherapy Source Strength. A.A.P.M. Report 21. New York.
7) Levitt, S.H.; Purdy, J.A.; Perez, C.A. and Vijaykumar, S. (2006). Technical Basis
of radiation therapy. (4th ed.). Springer-Verlag. Heidelberg. Germany. p. 3
31.
9) Martin, B. (2006). Nuclear and Particle Physics. John Wiley and Sons Ltd.
10)
Podgorsak, E. (2005). Radiation oncology physics: a Handbook for
teachers and students. I.A.E.A., Vienna.
11)
Podgorsak, E. (2006). Radiation physics for medical physicists. Springer
Verlag. Berlin. Heildelberg.