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RadThera
intro to radthera
| Question | Answer |
|---|---|
| ________ is the emission and propagation of energy through space or a material medium. ________: Travel of energy through a medium (eg, space). Radiation travels through the air to the patient's body | Radiation Propagation |
| Treatment that means additional treatment given after the main treatment to help prevent cancer from coming back. | Adjuvant treatment Radiation is given after the primary cancer treatment (usually surgery) to destroy any remaining cancer cells and reduce the risk of recurrence. |
| A clinical modality dealing with the use of ionizing radiations in the treatment of patients with malignant neoplasia (and occasionally benign diseases) | Radiation therapy |
| Aim of radiation therapy: To deliver a precisely measured _____of radiation to a defined tumors volume with as minimal damage as possible to surrounding healthy tissue. | dose |
| We use ____ as a unit of measurement It measures the absorbed radiation dose in tissue, which directly determines the biological effect on tumors and normal cells. | Gy (Gray; absorbed dose) |
| The goal is the _____________ _____. To achieve maximum tumor control with minimum normal tissue injury. | Therapeutic ratio Therapeutic ratio = Tumor ↑ / Tissue ↓ |
| It is the discipline of human medicine that deals with the generation, conservation, and dissemination of knowledge related to causes, prevention, and treatment of cancer, involving special expertise in therapeutic applications of ionizing radiation. | Radiation oncology |
| Radiation ________ = the field/doctor that decides Radiation ________ = the treatment that is given | oncology therapy |
| Radiation oncology is both a ___ and a ___? | Clinical and scientific, research-based Medical specialty and a science |
| Radiation is combined with chemotherapy to improve effectiveness, especially for advanced cancers. | Concurrent chemoradiation |
| What is radiation oncology? | Clinical and scientific endeavor Cancer Ionizing radiation Biological and physical basis Professional training |
| (History of Medical Applications of Accelerators) Wilhelm Conrad Röntgen (1845–1923) discovers X-rays | 1895 |
| (History of Medical Applications of Accelerators) On what date did Röntgen announce his discovery of X-rays and demonstrate it with a photograph of a hand? | 23rd January 1896 |
| (History of Medical Applications of Accelerators) Who was the colleague whose hand Röntgen photographed to demonstrate X-rays? | Albert von Kölliker |
| (History of Medical Applications of Accelerators) Who conducted the first treatments of tissue with X-rays in 1897 at the University of Vienna? | Leopold Freund |
| (History of Medical Applications of Accelerators) Why wasn’t early radiation therapy very effective for deep cancers? | Doctors didn’t yet know how to safely use megavoltage radiation, which is now essential for precise, deep-tissue treatment. |
| (History of Medical Applications of Accelerators) Who received the first Nobel Prize in Physics in 1901? | Wilhelm Conrad Röntgen |
| (History of Medical Applications of Accelerators) Who performed the first X-ray treatment of carcinoma in Sweden in 1899? | Stenbeck and Sjogren |
| (History of Medical Applications of Accelerators) What significant institute did Vinzenz Czerny found in 1906? | Institute for Experimental Cancer Research in Helderberg |
| (History of Medical Applications of Accelerators) In which decade were industrially manufactured X-ray apparatus with a high voltage of 150 kV introduced? | 1920’s |
| (History of Medical Applications of Accelerators) Who invented the first linear accelerator (kV) in 1930? | Rolf Wideroe |
| (History of Medical Applications of Accelerators) Was the first linear accelerator used for cancer treatment? | No, it was for science only (specifically for physics) |
| (History of Medical Applications of Accelerators) Who developed the first linear accelerator for therapy in England in 1949? | G.R. Newberry |
| (History of Medical Applications of Accelerators) Which companies developed compact linear accelerators in the 1950s and later with energies up to 25 MeV and above? | Varian, Siemens, GE, Philips, and others |
| (History of Medical Applications of Accelerators) ________ LINAC: First-generation, low-energy, less precise, manual ________ LINAC: High-energy, computer-controlled, precise, image-guided | Stanford Modern |
| (Wilhelm Conrad Roentgen) Discovered X-rays while studying ________ _____ in a gas discharge tube. | cathode rays |
| (Wilhelm Conrad Roentgen) He observed that another type of radiation was produced that could be detected outside the tube. This radiation could penetrate opaque substances, produce ___________, blacken a photographic plate, and ionize a gas. | fluorescence |
| (Wilhelm Conrad Roentgen) He also noted that these X-rays could be used to image _____. Roentgen characterized and validated his findings in a technical report within ___ weeks. | bones 6 |
| He discovered Radioactivity and he is also the Father of Radioactivity | Antoine Henri Becquerel, 1896 |
| Becquerel thought the phosphorescent materials, such as some _______ ____, might emit penetrating X-ray-like radiation when illuminated by the bright sunlight | uranium salts |
| Who isolated the first known radioactive elements, Polonium and Radium, in 1898? | Marie Curie and Pierre Curie |
| Which country is Polonium named after? | Poland |
| In which year did Marie Curie and Pierre Curie share the Nobel Prize in Physics with Becquerel? | 1903 |
| Which medical student in Chicago, Noted peeling of his hands on exposure to X-rays, and first used radiation to treat a woman named Rose Lee with recurrent carcinoma of the breast? | Emil Grubbe |
| How many doctors did Emil Grubbe instruct in the medical use of X-rays? | 7,000 |
| How many surgeries did Emil Grubbe undergo due to multiple cancers caused by radiation exposure? | More than 90 |
| Becquerel's doctoral students showed him that rays could be measured using ionizing techniques, and radiation intensity is _________ proportional to the amount of uranium in a substance | directly |
| Who argued in the 1920s-1930s that the differential effect of X-rays on cancer and normal tissues could be best obtained by giving the treatment slowly? | Claude Regaud |
| What principle did Claude Regaud demonstrate that is now the heart of many treatment programs in Radiation Oncology? | Fractionation |
| (Important Limitations of Early Radiotherapy Machines) Tumors located deep inside the body could not be treated effectively. Radiation would lose energy before reaching the tumor. | Inability to produce high-energy, deeply penetrating beams. |
| (Important Limitations of Early Radiotherapy Machines) To deliver enough dose to the tumor, the skin and surface tissues received too much radiation. This caused burns, erythema, and other side effects. | It was difficult to treat deep-seated tumors without excessive skin reactions. |
| What did early advocates of Radiation Therapy rely on instead of external beams? | Placement of radioactive sources in proximity or even within the tumor (Brachytherapy) |
| Who suggested to Danlos that a radioactive source could be inserted into a tumor? | Pierre Curie |
| What effect did radiation have when inserted into a tumor in early brachytherapy? | Radiation caused the tumor to shrink |
| Where were early 20th century techniques for brachytherapy pioneered? | Curie Institute in Paris by Danlos |
| What does Brachytherapy mean? How is brachytherapy delivered? | “Short distance” radiation Place the radiation source directly in or near the tumor |
| Early method: Developed because external beams were not strong enough | Brachytherapy |
| A radiologist who had a keen interest in newer advances related to the field was appointed as Director of the Holt Radium Institute (1931) | Ralston Patterson |
| Significance under Ralston Patterson's leadership: ___ – radiation therapy became systematic and standardized rather than experimental. _____ _____ – doses of radiation were calculated precisely, improving safety and effectiveness. | More protocol-based treatments Scientific dosimetry |
| She, a wife of Ralston Patterson, started research work at the Christie Hospital (1938) and became a world-renowned pioneer in biological dosimetry, childhood cancers, and anti-cancer drug treatment methods. | Edith Patterson |
| A medical physicist at Holt Radium Institute, developed the Manchester System for radium therapy along with Patterson. | Herbert Parker (1932) |
| His techniques enabled physicians to arrange radium needles or tubes in configurations that would maximize the radiation dose to the tumor while minimizing it to healthy tissue. | Herbert Parker (1932) |
| A system that was the most comprehensive and widely used system in the field of radiotherapy. A dosimetry and treatment planning system for radiotherapy that became the most comprehensive and widely used in its time. | Manchester System |
| Following initial interest in brachytherapy in Europe and the US, why did its use decline in the middle of the 20th century? | Radiation exposure to operators from the manual application of the radioactive sources |
| What device in the 1950s-1960s reduced the risk of unnecessary radiation exposure to operators and patients? | Remote afterloader |
| What, together with 3D imaging modalities, computerized treatment planning systems, and delivery equipment, made brachytherapy safe and effective today? | Advancements in radiotherapy |
| A Canadian medical physicist sent a request to the National Research Council (NRC) asking them to produce Cobalt-60 isotopes for use in a cobalt therapy unit prototype. | Dr. Harold E. Johns |
| This isotope emits high-energy gamma rays with deep tissue penetration, a half-life of 5.27 years, and allows accurate, effective treatment of deep-seated tumors. | Cobalt-60 |
| What milestone occurred on October 27, 1951, at Victoria Hospital? | 43-year-old cervical cancer patient treated |
| A megavoltage treatment capable of producing high-energy, deeply penetrating beams, allowing for the very first time treatment of tumors deep inside the body without excessive damage to the overlying skin and other normal tissues. | Linear Accelerator (LINAC) |
| These two developed the 1st medical linear accelerator at Stanford University, San Francisco | Dr. Henry Kaplan – radiation oncologist Edward Ginzton – physicist/engineer |
| The first patient to be treated using the machine was a 2-year-old child named ______ ______ with retinoblastoma. Treatment was highly successful. For more than 40 years, this patient remained free of disease with good vision. | Gordon Isaacs |
| [Clinical Radiation Generators (Types Of Kilovoltage Therapy) ] Very superficial skin lesions | Grenz-ray Therapy – <20kV |
| [Clinical Radiation Generators (Types Of Kilovoltage Therapy) ] for tumors not deeper than 1 – 2mm | Contact Therapy – 40 to 50kV |
| [Clinical Radiation Generators (Types Of Kilovoltage Therapy) ] (tumors 5mm in depth | Superficial Therapy – 50-150kV |
| [Clinical Radiation Generators (Types Of Kilovoltage Therapy) ]\ Lesions 2-3 cm in depth - Start of Cobalt-60 | Orthovoltage Therapy – 150-500kV |
| [Clinical Radiation Generators (Types Of Kilovoltage Therapy) ] Cobalt to LINAC | Supervoltage Therapy – 500-1000kV |
| [Clinical Radiation Generators (Types Of Kilovoltage Therapy) ] Standard of care in Rad Thera LINAC | Megavoltage Therapy – >1MV (LINAC) |
| What were limitations of early LINACs? | Bulky, limited gantry motion, flexible treatments only |
| The early accelerators, the first one, was initialized at Hammersmith in ______. In _____, the patient was treated at Stanford University in the United States. | 1952 1956 |
| What is a feature of 2nd Generation Teletherapy units? They were built between ____ and _____. | Isocentric units, rotate 360 degrees around gantry axis 1962 1982 |
| What advancement improves precision and accuracy of dose delivery in 2nd Generation Teletherapy? | 360-degree rotation Considered as “almost” modern LINAC Computer-controlled machines |
| A form of radiation therapy where the fields used are designed such that the radiation dose is mostly delivered to the tumor, while the surrounding tissues receive little to no radiation dose in 1990s. | 3-D Conformal Radiotherapy |
| A form of radiation therapy that attempts to deliver a tumoricidal dose to the tumor while minimizing the damage to the surrounding healthy tissues. | 3-D Conformal Radiotherapy |
| A form of radiation therapy that has precision targeting: With the help of CT simulation (Multiplanar imaging) and CT is used because it is much faster (though you can also use MRI and other modalities with # imaging) | 3-D Conformal Radiotherapy 3-dimensional information about the patient's body is supplied by the CT-simulation process. CT-based planning + beam shaping + 3D dose calculation |
| An advance form of 3D conformal radiotherapy (3DCRT). It uses sophisticated software and hardware to vary the shape and intensity of radiation delivered to different parts of the treatment area. | Intensity Modulated Radiotherapy (IMRT) |
| Intensity Modulated Radiotherapy (IMRT) is also called ____ _______. Because the treatment plan is designed by specifying the desired dose to the tumor and constraints for normal tissues, the software calculates the beam arrangements. | Inverse planning |
| IMRT is particularly useful in which cancers? | Head and Neck cancers |
| A form of radiation therapy that is rapidly growing in popularity primarily due to the widespread adoption of the new linear accelerators, which function both as treatment and imaging machines. | Image-Guided Radiation Therapy (IGRT) |
| A form of radiation therapy that uses advanced linear accelerators (LINACs) that can function as both: Treatment machines (delivering high-energy radiation) and Imaging devices (using X-rays, CT, or cone-beam CT) | Image-Guided Radiation Therapy (IGRT) Images are taken right before or during treatment to adjust patient positioning. |
| Which IGRT imaging type is 2D, provides quick alignment, but is limited to 2D tumor visualization? | kV Planar |
| Which IGRT imaging type is 2D, uses the treatment beam for alignment and bony anatomy verification, but has poor soft tissue contrast? | MV Imaging (MG) |
| Which IGRT imaging type is 3D, allows accurate tumor and organ visualization, and enables dose escalation, but has longer imaging time and higher dose than 2D? | Cone-Beam CT (CBCT) |
| Which IGRT imaging type is 3D + time, tracks tumor motion with very precise targeting, but requires advanced software and longer planning? | 4D Imaging |
Created by:
yulyae