A Century of Radiotherapy

Radiotherapy has long been an invaluable tool in the battle against various cancers, particularly brain tumours. Today, visiting a radiotherapy centre is a highly recommended course of treatment the world over. It is possible to chart the evolution of this area of medicine throughout the 20th century, and a fascinating journey it has certainly been.

In 1895 X-rays were first discovered by German-Dutch physicist and mechanical engineer Wilhelm Conrad Röntgen, a breakthrough for which he was later awarded the first ever Nobel prize for physics in 1901. Not long after this achievement the fields of radiation oncology and radiotherapy were born.

Before the negative effects of prolonged exposure to radiation became more widely understood, radiotherapy was used in the treatment of many conditions. In the early 20th century it was a standard treatment for tuberculosis. 

Around this time some of the most brilliant and pioneering work in the field of radiation was being undertaken by married physicists Marie and Pierre Curie. The former would become the first woman to win a Nobel prize, alongside her husband and colleague Henri Becquerel, in 1903 for the development of the theory of radioactivity.

There followed throughout the century several phases and eras in the development of radiotherapy. The Orthovoltage era, generally regarded as spanning from 1930 to 1950, saw advances in brachytherapy. This term denotes radium based interstitial radiation, and it allowed physicians to specifically target tumours more effectively than ever before.

After this came the Megavoltage era from 1950 to 1980. During this time advanced studies were undertaken in order to further the evolution of treatment for deep tissue cancers. Innovative therapeutic devices and approaches such as Cobalt teletherapy were discovered here, and significant progress was made in the development of proton beam therapy.

Today physicists and their colleagues are looking closely at what the next step in radiotherapy will be. That very question was posed at the recent ESTRO 2022 conference held in Copenhagen, Denmark.

Several experts from across the globe stepped up to argue for different approaches for the future. These included automation and robotics, inter-fraction adaptation and faster delivery of radiotherapy in shorter periods of time.

Meanwhile, in the United States, guidelines for the treatment of brain metastases by radiotherapy have recently been updated by the American Society for Radiation Oncology. Vinai Gondi, M.D., from the Northwestern Medicine Cancer Center and Proton Center in Warrenville, Illinois was one of the main participants in updating evidence-based recommendations.

“With the emergence of novel radiotherapy techniques and technologies, brain-penetrating drug therapies and neurosurgical interventions, modern management of brain metastases has become increasingly personalized, complex, and multidisciplinary,” Gondi was quoted as saying.

In terms of medical science, the practice of radiotherapy is quite young. Throughout the 20th century many advances have been made, and looking ahead to the future one can only imagine where the technology will go and how the practice will evolve. No doubt it will be a fascinating second century for what has become one of the most widely practised forms of care in the world.