Ionizing radiation : Historical

perspective and its use in

cancer patient

Dr.Ritam Joarder

Wave theory of light Particle theory of light

Q u a n t u m

t h e o r y o f

l i g h t

Aristotle

Descartes

Thomas Young

Maxwell

Fresnel

Huygens

Robert Hooke

Democrates

Newton

Plank

Einstein

Faraday

Geissler

WilliamCrookesEugene

Wilhelm Conrad Röntgen: Discovery of X-ray ( November 8 ,1895 )

“First, that I was the

first person exposed

to x-rays who

received sufficient

cumulative effects to

develop x-ray

dermatitis.

Second, that I was

the first person to

apply x-rays to

pathologic lesions on

living human subjects

for therapeutic

purposes.”

1896 : Controversial claims of Emil Grubbe

Treated a woman with breast cancer in 1896

1896 : Victor Despeignes

Treated a case of

gastric carcinoma

with 80 sessions

lasting between 15

and 30 min daily

1896 : Therapeutic use of X-rays

1903 : Authored first textbook of radiotherapy

A five yr old girl with

pigmented hairy

naevus all over her

back treated and

cured , then lived

upto 75 yrs.

Leopold Freund

The Nobel Prize in Physics 1903.......awarded to Antoine Henri Becquerel "in recognition of the extraordinary services he has rendered by his discovery of spontaneous radioactivity"

D i s c o v e r y o f R a d i o a c t i v i t y : 1896

1897 : Discovery of Electrons by

J . J . Thompson

Received

Nobel Prize

in Physics

1906

1898: Discovery of Radium And Polonium

Marie and

Pierre Curie

shared 1903

Nobel prize

in physics

with

Becquerel

1899 : Cure of Skin Cancer

Thor Stenbeck

cured BCC of

Nose with 100

treatments over 9

months in

Stockholm

Tage Sjoegren treated

sq. cell epithelioma

with 50 treatments over

30 months

1899: Discovery of α & β particles ( E. Rutherford )1900: Proposal of Radioactive Decay & Half life

Received Noble prize

in Chemistry 1908 for

“Disintegration

theory “ of elements

Paul Ulrich Villard discovered gamma radiation in 1900, while studying radiation emitted from radium. Villard's radiation was named "gamma rays" by Ernest Rutherford in 1903

1900 : Discovery of γ-rays

1900: Formulation of Quantum theory

Awarded with Noble prize in Physics 1918

1903 : Law of the Photo electric effect

Albert Einstein was awarded with Noble prize in Physics 1921

1903: Noble Prize in medicine for

Neils Ryberg Finsen

Used UV rays to treat Lupus Vulgaris , which also used to treat cancer later on.

.. . I started in to make a number of these lamps, but I soon found that the x-ray had affected poisonously my assistant, Mr. Daily, so that his hair came out and his flesh commenced to ulcerate. I then concluded it would not do, and that it would not be a very popular kind of light, so I dropped it...

1904 : Fluorescent lamp of Edison ~ Death of Clarence Dally

1920s-1930s : Radioactive Quackery

Case of “Radium Girls”

1932 : Death of Eben Beyers

Roentgen therapy Vs Radium therapy

1913: Hot Cathode tube ~ W D Coolidge

• Peak voltage of 140 Kv

with 5 mAmp current

• Max. dose at skin with

rapid dose fall-off with

depth inside tissue

1922: Discovery of Compton Scattering

Received Noble Prize

in Physics 1927

1923 : Grenz Ray therapy ( Gustav Bucky )

< 20kV Voltage

Filtration of 1.0 mm Al

Used to treat skin

lesions

Contact Therapy Or Chaoul Therapy

Papillon technique for Superficial Rectal Cancer

40-50 kV potential

2mA current

SSD 2cm or less

0.5-1.0mm thickness

Al filter

Rapidly decreasing

depth dose in tissue

Superficial Therapy

50 – 150 Kv Voltage

1- 6mm Al filtration

1- 8 mm Al HVL

15- 20 cm SSD

Operated at 5- 8 mA

current

1930s:Orthovoltage therapy or Deep Therapy( Sieman’s Stabilapan )

150-500 Kv voltage 10-20 mA current 50 cm SSD HVL 1-4mm Cu

Disadvantage :High skin doseIncreased absorbed dose in boneIncreased Scattering

Telecurietherapy ( Radium bomb )

Sluys-Kessler Radium bomb

Failla's Radium bombs

Giaocchino Failla

1920s : Radiation dosimetry

R . Sievert E.Quimby

1929 : Invention of Cyclotron

Ernest Lawrence

received Noble

prize in Physics

1939

1931 : Van de Graaff Generator (MIT)

Robert van de Graaff

40 feet high

Electrostatic device

capable of operating

at 5,000,000 volts

2 MeV Clinical

Van de Graaff

X-ray machine

1932 : Discovery of Neutron

James

Chadwick

received Noble

prize in Physics

1935

Irène and

Frédéric Joliot

Curie shared

Noble prize in

Chemistry 1935

1934 : Artificial Radioactivity

1938 : Discovery of Co60

isotope

Glenn T Seaborg

Glenn T Seaborg

shared Noble prize

in Chemistry 1951

with Edwin M

McMillan for

discovery of

transuranium

elements

1940 : Betatron ( Donald W Krest )

20 MeV Betatron created by Krest in University of

Ilionis , USA (originally planned by Achen Widroe)

Originally the principle had been published by Vladimir

Veksler

1945 : Development of Synchrotron

Edwin Mattison McMillan

later shared Noble Prize in

Chemistry In 1951 with Glenn

Seaborg for discovery in

chemistry of transuranium

elements

The Most Shameful day for Mankind

On Monday, August 6,

1945, at 8:15 AM, the

Atomic Bomb “ Little

Boy" was dropped on

Hiroshima by an

American B-29

bomber, the Enola

Gay directly killing

an estimated 80,000

people

1951 : Cobalt Bomb ( H.E.Johns)

First Cobalt 60 machine

in Saskatoon ,Canada

1953: First Linear Accelerator

1956: First pt treated with LINAC

Henry Kaplan Gordon Issac,2yr old pt

of B/l Retinoblastoma

1958 : Computerized treatment planning introduced

:J. Laughlin, T. D. Sterling,

K. C. Tsien, R. Wood

1962 : Electronic portal imaging introduced: S.

Benner

1965: Conformal radiation therapy with multileaf

collimation introduced : S. Takahashi

1968: Gamma Knife introduced :Leksell

1969: First commercial treatment planning

systems :R. Bentley, J. Cox, W. Powers

1968 : Computer-assisted Tomography

Godfrey N. Hounsfield Allan M Cormack

Shared

Noble Prize

in Medicine

1979

Paul C. Lauterbur Sir Peter Mansfield

Shared Noble

prize in

Medicine 2003

for their

discovery

1973 : Zeugmatography

1979 : Concepts of BEV, DVH,

Digital reconstructed radiographs

DVHs were introduced

by Michael Goitein and

Verhey in 1979 in a

publication by Shipley

et al

Brief History of Brachytherapy

1920s : Radium Surface therapy

Radium surface

brachytherapy

treatment of skin

cancer at the

Institut Curie, Paris,

1922

Interstitial implantation

of radon seeds for a

carcinoma

of the rectum, 1929, at

the London Hospital

1920s : Use of needle implants

Dr.Gosta Forssell : Started

radium treatment in Ca Cervix

in 1912

James Heyman :

Published “Stockholm

method in

radiotherapy of

uterine cencer “ in

1924

1910-24 : Stockholm technique

„Intensive, intermittent and intracavitary radium treatment method‟.

1934 : Manchester Dosage System

Ralston Paterson And

Herbert M Parker

developed Manchester

Dosage system for

surface applicators of

radium in 1934

Later revised by Margaret C Tod and W J Meredith

as Dosage System for Cancer of the Cervix in 1938

1978 : Paris System

B Pierquin ; A Deutreix

et al published Paris

system for Interstitial

brachytherapy in 1978

1904 : Earliest intracavitary applicator

Used by Wickham

and Degrais in

Paris from 1904.

Early Concepts of Radiobiology

1906 : Law of Bergonie And Tribondeau

Jean A Bergonie L M Tribondeau

cells tend to be

radiosensitive

if they have

•High division rate

• Long dividing

future

•Unspecialized

phenotype

1911 : Concept of fractionation

Sterilization of ram's testis without excessive skin reactions using fractionated radiation ( Claude Regaud )

1934 : Time –dose factor concept

Henri Coutard showed

that both skin and

mucosal reactions

depended on the dose,

the treatment time

and the no. of

treatment sessions.

Francois Baclesse

1967 : Concept of Dose –volume Relationship

Hypothesized that in

addition to time-dose

factor , irradiation

damage to normal

tissue also depends

upon the volume

irradiated.

Realizing the importance of oxygen

Louis Harold Gray and RH Thomlinson

established the relation of chronic

hypoxia and Radiosensitivity (1955)

1956, the cell-survival assay was

developed by Theodore T Puck and

Philip I Marcus

The ability to quantitate cell killing.

1963 : Variation of Radiosensitivity through the

cell cycle

: Toyozo Terasima and LJ Tolmach

1966 : Potentially lethal damage repair

: LJ Tolmach

1969 : Concept of Accelerated repopulation

: Hermens & Barendsen

John F Kerr

Kerr et al recognized

apoptotic cell death in

the response of

radiosensitive tissues to

ionizing radiation.

1972 : Concept of Apoptosis

Julie Denekamp

1973 : Time course of

proliferation in normal

tissue following

irradiation

G W Barendsen

1982 : Concept of

Biologically effective

dose

1975 : Concept of 4 Rs of Radiobiology

H Rodney Withers

Withers also quantified stem-cell

numbers and survival of normal

cells .

Advances in Radiotherapy

1900 to 1950

Advances in Radiotherapy

1950 to Present

" Martyr‟s Memorial "

On the memorial for “x-ray martyrs” in the garden of

St. George‟s Hospital, Hamburg, Germany, were 169

names inscribed in 1936; in 1959 their number had

increased to 359

TO THE RONTGENOLOGISTS AND RADIOLOGISTS OF

ALL NATIONS,

DOCTORS, PHYSICISTS, CHEMISTS, TECHNICAL WORKERS,

LABORATORY WORKERS AND HOSPITAL SISTERS

WHO GAVE THEIR LIVES IN THE STRUGGLE AGAINST THE

DISEASES OF MANKIND.

THEY WERE HEROIC LEADERS IN THE DEVELOPMENT

OF THE SUCCESSFUL AND SAFE USE OF X RAYS AND

RADIUM IN MEDICINE.

IMMORTAL IS THE GLORY OF THE WORK OF THE DEAD.

This Effort Is Dedicated