Evolving Clinical Cancer Radiotherapy: Concerns Regarding Normal Tissue Protection and Quality Assurance

Abstract

Radiotherapy, which is one of three major cancer treatment methods in modern medicine, has continued to develop for a long period, more than a century. The development of radiotherapy means allowing the administration of higher doses to tumors to improve tumor control rates while minimizing the radiation doses absorbed by surrounding normal tissues through which radiation passes for administration to tumors, thereby reducing or removing the incidence of side effects. Such development of radiotherapy was accomplished by the development of clinical radiation oncology, the development of computers and machine engineering, the introduction of cutting-edge imaging technology, a deepened understanding of biological studies on the effects of radiation on human bodies, and the development of quality assurance (QA) programs in medical physics. The development of radiotherapy over the last two decades has been quite dazzling. Due to continuous improvements in cancer treatment, the average five-year survival rate of cancer patients has been close to 70%. The increases in cancer patients’ complete cure rates and survival periods are making patients’ quality of life during or after treatment a vitally important issue. Radiotherapy is implemented in approximately 1/3 to 2/3s of all cancer patients; and has improved the quality of life of cancer patients in the present age. Over the last century, as a noninvasive treatment, radiotherapy has unceasingly enhanced complete tumor cure rates and the side effects of radiotherapy have been gradually decreasing, resulting in a tremendous improvement in the quality of life of cancer patients.

Difference in dose‐volumetric data between the analytical anisotropic algorithm, the dose‐to‐medium, and the dose‐to‐water reporting modes of the Acuros XB for lung stereotactic body radiation therapy

“…The field of radiation oncology has rapidly evolved over the last three decades due to the advances in diagnostic radiology that allows for better tumor volume definition during treatment planning, and the development of new irradiation techniques such as intensity‐modulated radiotherapy (IMRT) and stereotactic body radiation therapy (SBRT), making possible a better optimization of dose distribution around the planning target volume (PTV) (1) . Those advanced techniques require a high and verified accuracy in dose calculation to ensure that the prescribed dose is actually delivered to the tumor with good sparing of the surrounding normal tissues.…”

Long-Term Results of IFRT vs. ISRT in Infradiaphragmal Fields in Aggressive Non-Hodgkins’s Lymphoma Patients—A Single Centre Experience

“…These tumours, induced via radiotherapy, mostly arise with a latency of at least 5-10 years [59,60] The toxicity of RT can be reduced through dose reductions, volume reductions, and the optimization of using IMRT (intensity-modulated radiotherapy). IMRT and VMAT (volumetric modulated arc therapy) are more effective than 3D-CRT in terms of target coverage, dose homogeneity, and reducing toxicity to normal organs [61][62][63]. IMRT/VMAT techniques were not available at the time at our institution.…”

Role of Radiotherapy in Metastatic Renal Cell Carcinomas: An Evolutionary Journey in a Misunderstood Histological Type

“…However, a paradigm shift has occurred in the field of RT, spurred by technological advancements that allow for precise tumor targeting and the delivery of a higher biological RT dose to the tumor, while sparing normal tissues. This represents a significant improvement over past methods [15]. Ning et al [16] studied 2 human RCC cell lines (Caki-1 and A498) and reported that the α/β ratio of RCC cells ranged from 2.6 to 6.9 Gy, which is lower than the dose delivered to most radiosensitive tumor types (α/β ratio of approximately 10 Gy).…”