Trends in radiation oncology: a review for the nononcologist
Maurie Markman, MD
Anuradha Koka, MDAddress reprint requests to A.K., Department of Radiation Oncology, T28, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.
Roger M. Macklis, MD
Fifty percent of cancer patients will undergo radiation therapy for either cure or palliation. This paper reviews the basic principles, practice, and future trends.KEY POINTS
Newer machines produce higher voltages and permit treatment of deeper tumors than earlier ones did.
How to deliver a higher radiation dose to the tumor without harming surrounding, normal tissue is the topic of ongoing research. Current practice is to divide the radiation dose into daily treatment fractions and to use multiple coplanar fields. Future practice likely will use smaller, more frequent doses and noncoplanar fields, planned with the help of computed tomography and stereotaxy.
Whereas brachytherapy once required operators to handle radioactive sources directly, radiation oncologists can now implant brachytherapy catheters, which are after-loaded by automated devices that permit a higher dose to be delivered.
Technological innovations are permitting more patients to be treated, and treated more effectively.