Ακτινολογία σημειώσεις 2

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 Radiotherapy- fundamental principles and methods Dr. Tatiana Hadj ieva , MD, PhD Pro fessor , Uni vers it y Radi oth erapy Cli ni c Medi cal Uni vers it y Sof ia

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Σημειώσεις ακτινολογίας. Ραδιολογία. Πυρινική Φυσική. Ραδιοθεραπεία

Transcript of Ακτινολογία σημειώσεις 2

Professor ,
financial announcements after the
type– preliminary report’ 28.12.1895 
Dr. Emil Groube,
I radical irradiation course for skin cancer-  
basocellulare nasi – 99 fractions
Mainly treatment of neoplasms ( and non-
malignant disease) using
with other modalit ies
Exploration of radiobiological and
physical basis of RT
students and post-graduated fellows
External beam RT
measured dose
in the
extended period
lower
External beam RT
X- ray tube
external beam therapy
circular and l inear accelerators – LINACS
End of 60-s –teleradiotherapy – wide distr ibut ion
with a leading role USA, England and France
 
 
Claude Regaud , Henri Coutard
External beam RT
animals
Becquerel & Curie
Paris, radium tubes into the tumour ;- Treatment
duration -hours and days
Intracavitary Curietherapy  - 1903 Doederlein,
cervix.
 
External beam RT
Brachytherapy Brachy “ Short distance” -
placing sealed RA source close to or in the contact with target tissue
Different techniques for RAS implantation
 Surgical methods ( interstitial, intracavitary, intraluminal,mould CTH )
Temporary or permanent implant
 
Interstitial Curietherapy
 
Non
 
the mouth
with permanent implant
 
Dose (Gy)
   V   o
External beam RT
Pancreatic cancer
Stomach cancer
Rectal cancer
having
avoids mutilating action of the surgery 
 
treatment
131I
medication in disseminated malignomas
treatment
biological matter
DNA -target
Reparation of sublethal damages
Mitotic cell death – death during mitosis
Interface cell death –rare process
 
 break of DNA 
Narrow therapeutic ratio ( Gain) requires precise
planning !!!
with minimal
tissue
dissgerminomas
SCC (G1-G3 – Ca cutis,  colli uteri, ORL; adenocarcinomas
Radioresitant tumours-  mesenhymomas- bone and soft tissue sarcomas,
some epithelial blastomas (adenosquamous or mucoepidermoid type)
 
Normal tissue radiosensitivity
Early effects – during and up to 3 m after RT. Reversible
symptoms, do not limit the dose
Late effects –
Tissue with low tolerance to radiation – hemopoetic
sys\tem, reproductive organs, lens, spinal cord, liver, lung
Tissue with high tolerance to radiation- bones, muscles,
nerves
dose-volume histograms
nephrotoxicity, Adriablastin-cardiotoxicity
2- moderate –25%
3- strong –50%
5- fatal 100%
Non reversible
of breast
Implementation of radiations with different energy therefore
with different tissue penetration
Radiation with different LET- dif ferent RBE
RBE
2. Radiobiological approach
Chemo-radiation
Hyperthermia and RT  Augmentation of the normal t issue tolerance to
radiation
2. Radiobiological approach
radiation
2. Radiobiological approach
radiation
2. Radiobiological approach
radiation
Bonner et al. N Engl J Med 2006; 354:567-78.
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