Radiation Therapy

Radiation Therapy

Technology advancements in radiation therapy have allowed treatment to be tailored to a patient's tumor type, size, and location to minimize the risk of damage to healthy tissue, improve survival, and minimize potentially serious side effects.

While radiologists once drew up treatment plans with a wax pencil on X-ray films, they now construct intricate, computerized treatment plans based on 3-D images of the tumor and can vary both the shape and intensity of radiation beams. One of the earliest radiation techniques, brachytherapy, now offers effective treatment for prostate, cervical and other tumors by directly implanting small radioactive sources temporarily or permanently into tumors via remote-operated equipment.

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1999

Chemoradiation shown conclusively to benefit patients with advanced disease

Chemoradiation shown conclusively to benefit patients with advanced disease

A major clinical trial confirms the value of giving carboplatin chemotherapy and standard radiation therapy together to patients with advanced oropharynx cancer. While the approach, called concurrent chemotherapy, causes more side effects than radiation treatment alone, patients receiving the concurrent therapy lived almost twice as long as the patients receiving radiation alone.

Giving radiation to the chest twice-daily increases survival for small cell lung cancer

Giving radiation to the chest twice-daily increases survival for small cell lung cancer

A study finds that twice-daily radiation to the chest, together with chemotherapy, prolongs survival compared with once-daily radiation and chemotherapy in patients with small cell lung cancer that has not spread. Investigators showed that 26 percent of patients in the twice-daily group survived at least five years, compared with 16 percent in the once-daily group.

Simultaneous chemotherapy and radiation proven most effective for stage III non-small cell lung cancer

Simultaneous chemotherapy and radiation proven most effective for stage III non-small cell lung cancer

Researchers find that giving chemotherapy and radiation during the same treatment period, an approach known as concurrent chemoradiation, results in better survival for patients with stage III non-small cell lung cancer (disease with limited spread in the lungs and surrounding tissue) than the standard practice of waiting to give radiation therapy until after chemotherapy was completed. This finding echoes similar findings reported for small cell lung cancer in earlier years.

Cranial radiation reduces risk of small cell lung cancer spreading to the brain

Cranial radiation reduces risk of small cell lung cancer spreading to the brain

Radiation to the head is proven to significantly cut the risk that small cell lung cancer will spread to the brain, and thus improves survival. This result is initially shown in patients with earlier stage small cell lung cancer, and is later also proven effective in patients with advanced disease, who have an even higher risk of developing brain metastases.

1998

NCI recommends chemotherapy-radiation combination for invasive cervical cancer

NCI recommends chemotherapy-radiation combination for invasive cervical cancer

The National Cancer Institute issues an alert recommending that physicians consider adding chemotherapy to radiation therapy for women being treated for invasive cervical cancer (cancer that has spread within the cervix or pelvis). This updated approach is based on several randomized trials showing that women lived longer when treated with both radiation and chemotherapy, compared to those treated with the prior standard of radiation or surgery alone.

New radiotherapy technique enables precise targeting of tumors near sensitive tissue

New radiotherapy technique enables precise targeting of tumors near sensitive tissue

Doctors begin using intensity modulated radiation therapy (IMRT), a highly advanced radiation technique, to precisely target tumors that lie close to vital organs and other sensitive tissue that must be protected from radiation. IMRT uses sophisticated software and complex new machinery to vary both the shape and intensity of radiation. One of the clearest benefits has been in the treatment of head and neck cancers; IMRT allows doctors to minimize radiation exposure to the spinal cord, optic nerve and salivary glands, reducing side effects without compromising tumor control.

1997

New chemo-radiation therapy offers alternative to surgery for advanced disease

New chemo-radiation therapy offers alternative to surgery for advanced disease

The introduction of combination therapy - using both radiation and cisplatin chemotherapy together – offers an important new treatment alternative for patients with advanced bladder cancer who are older or otherwise unable to undergo bladder surgery. The strategy provides tumor shrinkage, limits nearby cancer growth, and enables many patients to retain normal bladder function – a key quality of life benefit.

In 2012, a Phase III study confirms the benefits of this approach, using the chemotherapy drugs fluorouracil and mitomycin. Researchers demonstrate this regimen improves survival, with no significant increase in side effects.

1993

Simultaneous radiation and chemotherapy boosts survival for small cell lung cancer

Simultaneous radiation and chemotherapy boosts survival for small cell lung cancer

Researchers demonstrate that starting radiation therapy together with chemotherapy dramatically improves the effectiveness of treatment for patients with early-stage small cell lung cancer, compared to starting radiation later in the course of treatment. This new approach is found to significantly delay cancer progression and improve survival.

1991

Combining chemotherapy and radiation prolongs survival for non-small cell lung cancer

Combining chemotherapy and radiation prolongs survival for non-small cell lung cancer

Two studies show that treatment programs involving both radiation and chemotherapy are more effective than either approach alone for patients with "stage III" non-small cell lung cancer (including patients with larger tumors that may or may not have limited spread within the lungs and in nearby lymph nodes). This two-pronged treatment approach soon becomes the standard of care for this disease.

1990

Combination chemoradiation first emerges

Combination chemoradiation first emerges

Researchers report successful results of a new approach for head and neck cancer therapy – so-called "chemoradiation." This approach involves giving cisplatin chemotherapy and radiation together (concurrently), rather than one after the other (sequentially). The two-pronged approach helps prevent the spread of advanced squamous cell cancers of the head and neck to other parts of the body and causes greater tumor shrinkage, compared to radiation therapy alone.

Several years later, another trial finds that a similar approach – combining radiation with both cisplatin and fluorouracil chemotherapy – helps reduce the size of tumors enough so that patients can eventually undergo surgery to remove them. This approach is proven to significantly extend survival and reduce the risk of recurrence.

Shift to 3-D radiation treatment plans increases precision, safety of therapy

Shift to 3-D radiation treatment plans increases precision, safety of therapy

Thanks to the integration of powerful computers into medicine, doctors are able to dramatically improve radiation therapy by creating 3-D treatment plans. These plans require highly complex calculations and vastly more computing power than earlier, two-dimensional treatment plans. Thanks to this advance, radiation can be targeted at tumors from multiple angles, with beams of varying power, in ways that minimize the damage to healthy, surrounding tissue.

1985

Chemotherapy plus radiation effective as adjuvant therapy
Gamma Knife therapy introduced for treating brain tumors

Gamma Knife therapy introduced for treating brain tumors

After nearly two decades of research, doctors begin using a non-invasive technique known as Gamma Knife to treat certain brain tumors. Also called stereotactic radiosurgery, the approach utilizes precisely focused radiation waves to disrupt cancer cell function and replication, while leaving the brain tissue surrounding the tumor largely untouched. Gamma Knife may also be combined with other forms of cancer therapy, including surgery. The approach continues to be refined today.

1981

Chemotherapy plus radiation effective for patients who cannot be treated surgically

Chemotherapy plus radiation effective for patients who cannot be treated surgically

Adding the chemotherapy drug 5-fluorouracil to standard radiation is shown to boost one-year survival from 10 percent to 40 percent for patients with locally advanced inoperable pancreatic cancer (disease that has spread to nearby tissues but cannot be surgically removed). The findings show the benefits of combining different treatment approaches for this stage of disease.

1977

Many women can opt for breast-conserving surgery

Many women can opt for breast-conserving surgery

Studies show that a procedure called lumpectomy – involving the removal of only the tumor, and not the entire breast – followed by radiation therapy is as effective as mastectomy for women with early-stage breast cancer. The finding helps dramatically reduce the physical and cosmetic side effects of breast cancer treatment and enables women to recover more quickly after surgery and return to their normal lives.

Radiation established as standard treatment for glioblastoma

Radiation established as standard treatment for glioblastoma

Radiation therapy becomes a mainstay of treatment for glioblastoma, a highly aggressive form of glioma, based on data showing it extends median survival from 3 months to about 9 months. This is the first time a treatment is proven effective against any brain cancer. Today, radiotherapy is used alone or with chemotherapy, both before and after surgery, and in patients with inoperable tumors.

1970

Increased use of radioactive "seeds" to target prostate and other cancers

Increased use of radioactive "seeds" to target prostate and other cancers

Studies suggest that an approach called brachytherapy extends the lives of patients with prostate cancer, compared to surgical removal of the prostate and surrounding tissue. In this approach, tiny radioactive sources or "seeds" are implanted directly into the prostate gland, delivering a high dose of radiation directly to the tumor while leaving healthy tissue beyond the prostate relatively unaffected.

Brachytherapy has been used since the early 1900s, but became less common after the widespread adoption of external beam radiation. With refined techniques and conclusive data on its effectiveness, the approach once again becomes a central part of treatment for prostate, cervical and other cancers.

1965

First use of radioactive isotope for treatment of inoperable liver cancer

First use of radioactive isotope for treatment of inoperable liver cancer

Investigators report the first use of the radioactive isotope Yttrium 90 (Y90) for the treatment of inoperable liver cancer, for which previously there were no treatment options.

For this therapy, the Y90 is chemically bound to a glass or resin bead called a microsphere. The microsphere is then implanted into the liver, providing radiation therapy directly to the nearby tumor and surrounding tissue with a goal of shrinking tumors or stalling their growth.

Today, treatment with Y90 is known to be particularly effective in certain patients, such as those with mild liver cirrhosis whose tumors invade nearby large blood vessels.