Vaidya, Jayant; (2024) Principles of cancer treatment by radiotherapy. Surgery 10.1016/j.mpsur.2023.12.001. (In press).

Text Vaidya_2023 accepted version of Principles of cancer treatment by radiotherapy for Surgery.pdf - Accepted Version Access restricted to UCL open access staff until 17 January 2025. Download (764kB)

Abstract

Radiotherapy (or radiation therapy) uses ionizing radiation to selectively kill cancer cells, especially for solid tumours. Like surgery, it is meant to be a ‘local’ treatment, although its beneficial systemic (abscopal) effects are being discovered. It is most commonly used in addition to surgery (adjuvant, e.g. breast), but its role in the neoadjuvant setting in combination with chemotherapy for some cancers (e.g. rectum) is also established. In early stages of some cancers, it can be the definitive treatment, avoiding surgery and enabling organ preservation (e.g. larynx), while in late stages, it can provide excellent palliation (e.g. bone metas- tasis). Radiotherapy can be delivered at various energy levels (kiloVolts, megaVolts), with various subatomic particles (e.g. electrons, protons, and high-energy electromagnetic radiation). The traditional bulky equipment (e.g. linear accelerator) needs to be housed in an underground bunker and complex imaging improves precision and reduces radiation to normal tissues. Fractionated regimens spanning several days reduce individual doses. Radiotherapy during surgery achieves the highest precision and immediacy (e.g. TARGIT-IORT for breast cancer) and is proven to reduce deaths by avoiding scattered irradiation to vital organs (e.g. heart or lungs).

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