history of radiation therapy or radiotherapy can be traced back to experiments performed immediately after the discovery of x-rays (1895), when it was shown that radiation exposure produces sunburn. Influenced by electrotherapy and escharotics - medical applications of caustic substance - doctors begin using radiation to treat growth and lesions produced by diseases such as lupus, basal cell carcinoma, and epithelioma. Radiation is generally believed to have bactericidal properties, so when radium is found, in addition to treatments similar to those used with x-rays, it is also used as an additive for medical treatment for diseases such as tuberculosis where there are resistant bacilli.
In addition, since radiation is found in hot water springs known for their curative strength, it is marketed as a miracle cure for all types of diseases in the treatment of patents and quack medicines. It is believed by medical science that small doses of radiation will not cause harm and the harmful effects of large doses are temporary.
The widespread use of radium in medicine ends when it is found that physical tolerance is lower than expected and exposure causes long-term cell damage that can appear in carcinoma up to 40 years after treatment. The use of radiation continues today as a treatment for cancer in radiation therapy.
Video History of radiation therapy
Early development of radiotherapy (1895-1905)
The property of x-ray imaging was found, their practical utility for research and diagnosis was immediately apparent, and soon its use spread in the medical field. X-rays are used to diagnose fractures, heart disease, and phthisis. Inventory procedures for different diagnostic purposes are created, such as filling the digestive cavity with bismuth, which allows them to be seen through tissues and bones.
Discovery of therapeutic potential of radiation
During initial practical work and scientific inquiry, the researchers realized that prolonged exposure to X-rays creates inflammation and, less frequently, tissue damage to the skin. Biological effects appeal to LÃÆ' Â © opold Freund and Eduard Schiff, who, just one or two months after the RÃÆ'¶ntgen announcement, suggested they were used in the treatment of the disease. At about the same time, Emil Grubbe, from Chicago was probably the first American doctor to use X-rays to treat cancer, starting in 1896, began experimenting in Chicago with the use of medical x-rays. Escharotics has now been used to treat skin malignancy through caustic burns, and electrotherapy has also experimented with, in order to stimulate skin tissue.
The first x-ray treatment performed by Victor Despeignes, a French doctor who used it in patients with stomach cancer. In 1896, he published a paper with results: week-long treatment followed by reduced pain and reduced tumor size, although the case was ultimately fatal. The results can not be concluded, because patients are simultaneously given other treatments. Freund's first attempt was a tragic failure; he applied x-rays to the nevus to induce deep epilation and ulcer results, which rejected further treatment by radiation. The first successful treatment was by Schiff, working with Freund, in the case of lupus vulgaris. A year later, in 1897, both published their success report and this sparked further experiments in X-ray therapy. After that they succeeded in healing lupus erythematosus in 1898. This lesion took the general form of the 'butterfly patch' that appeared on both sides of the face, and Schiff applied irradiation to one side only, to compare the effect..
Within a few months, scientific journals were flooded with reports of the successful treatment of various types of malignant skin tissue with x-rays. In Sweden, Thor Stenbeck published the first successful treatment outcome of rodent ulcers and epithelioma in 1899, later that year confirmed by Tage SjÃÆ'¶gren. Soon after, their findings were confirmed by a number of other doctors.
The nature of active agents in therapeutic treatment is still unknown, and is subject to widespread disputes. Freund and Schiff believe it was due to electrical discharges, Nikola Tesla believes them because of the ozone generated by x-rays, while others argue that it is x-rays themselves. Tesla's position was immediately disproved, and only two other theories remained. In 1900, Robert KienbÃÆ'¶ck produced a study based on a series of experiments which showed that it was the x-rays themselves. Studies published in 1899 and 1900 show that rays vary in penetration according to the vacancy rate in the tube.
Niels Finsen and phototherapy
Niels Finsen, a Faroe-Danish physician, had at that time pursued an interest in the biological effects of light. He published a paper, "Om Lysets Indvirkninger paa Huden" ("About the effects of light on the skin") in 1893. Inspired by the discovery that x-rays can have a therapeutic effect, he expanded his research to check the rays of light that directed. In 1896, he published a paper on his findings, Om Anvendelse i Medicinen af ​​koncentrerede kemiske Lysstraaler ("The use of chemical light rays concentrated in medicine"). Finsen found that lupus can receive treatment with ultraviolet light when separated by a quartz crystal system, and after that creates a lamp to filter out the rays. The so-called Finsen lamps are becoming widely used for phototherapy, and their derivatives are used when experimenting with other types of radiotherapy. Modifications were made to the original design of Finsen, and found the most common form in the Finsen-Reyn lamp and the Finsen-Lomholt lamp.
In 1905, it was estimated that 50 percent of cases of lupus were successfully cured by the Finsen method. Finsen was immediately awarded the Nobel Prize for his research.
RÃÆ'¶ntgenotherapy
From early therapeutic experiments, a new field of x-ray therapy was born, referred to as rÃÆ'¶ntgenotherapy after Wilhelm RÃÆ'¶ntgen, the inventor of x-rays. It remains unclear how the x-rays act in the skin; however, it is generally agreed that the affected area is killed and disposed of or absorbed.
In 1900, there were four classes of problems treated with x-rays, based on a set of five classes originally outlined by Freund: 1. in hypertrichosis, to remove hair undesirable; 2. in the treatment of hair and hair follicles where it is necessary to remove hair; 3. in the treatment of skin inflammatory affections such as eczema and acne; 4. and in the treatment of malignant affection on the skin in cases such as lupus and epithelioma.
In addition, x-rays successfully applied to other appearances of carcinoma, experiments were performed in treating leukemia, and due to suspected bactericidal properties, there are suggestions that can be used in diseases such as tuberculosis. Experiments were also conducted using x-rays to treat epilepsy, which previously also experimentally been treated with electric current.
Maps History of radiation therapy
Further development and radium use (1905-1915)
Because of the excitement over new treatments, the literature on therapeutic effects of x-rays often exaggerates the tendency to cure diseases. Reports of the fact that in some cases, the deteriorating care of some patient conditions is negligible for optimistic optimism. Henry G. Piffard calls these practitioners "radiomania" and "radiographer". It was found that x-rays are only capable of producing drugs in certain cases of epithelial basal cell types and are extremely unreliable in malignant cancers, not making them a suitable substitute for surgery. In many cases of treatment, the cancer recurs after a period of time. An X-ray experiment on pulmonary tuberculosis proved to be useless. Apart from the medical profession that loses faith in x-ray therapeutic capabilities, people increasingly consider it a dangerous type of treatment. This results in a period of pessimism about the use of x-rays, lasting from about 1905 to 1910 or 1912.
Radium Therapy
Immediately after the discovery of radium in 1898 by Marie Curie, there was speculation as to whether radiation could be used for therapy in the same way as from X-rays. The physiological effects of radium were first observed in 1900 by Otto Walkhoff, and then confirmed by what is known as "Becquerel burn". In 1901, Henri Becquerel had placed a radium tube in a vest pocket where he remained for several hours; a week or two after which there is severe skin inflammation beneath where the radium has been deposited. Ernest Besnier, a dermatologist, examined the skin and expressed the opinion that it was because of radium, which led to experiments by Curie who confirmed it. Besnier recommends the use of radium for therapy along the same goals as x-rays and ultraviolet light.
Becquerel for this purpose lent some radium to Henri-Alexandre Danlos from Louis St. Louis in Paris in 1901. Danlos successfully treated several cases of lupus with a mixture of radium and barium chloride. Further experiments of radium therapy begin, albeit at a much slower pace than those who use X-rays because radium is expensive and difficult to obtain.
Application method
Radium is immediately seen as a way to treat disorders that are not adequately affected by x-ray treatment because it can be applied in many ways in which x-rays can not. Various methods of applying radium have been tested, which is divided into two categories: the use of radium emanation (now called radon), and the use of the radium salt.
One method of using emanation is through inhalation, where it is mixed with air. Radium inhalation is most widely studied in Germany, where a regular inhalation institute is established, and the goal is to target the lungs. It is done either to treat lung diseases, such as tuberculosis, or absorbed through the surface of the lungs into the blood, where it can circulate through the body. It is claimed that the beneficial effect produced by a shower of radium water is the result of inhaling the vapors.
Another method of treatment is to solidify emanations at liquid air temperatures in substances such as vasolin, glycerine, and lanolin, to be applied externally to the affected part; or on quinine, bismuth, subnitrate, and arsenic, to be consumed or applied internally.
Radium Emanation is also passed into a glass or metal tube or a tight-glass applicator and applied in the same way as a radium tube. In other cases it is also stored at metal points or flat surfaces of metal using electrical devices, which have the same radioactivity levels as the parent radium, but persist in shorter durations. One way of treatment is to then transfer the deposits of radioactive material into tissues using galvanic currents. It is also a method of applying radium emissions to specially designed applicators that are built to meet the needs of the patient, who can later bring them home.
A dilute aqueous salt salt solution is also prepared, intended for internal use. Patients will be prescribed the usual dose. Less commonly, salt is also suspended in the liquid to be injected in subcutaneous treatments, which can be applied locally to the affected tissue. It is considered the most expensive method, because the radium used is lost and irreparable.
Like radium emanations, a free radial salt solution is also placed in a tube; in this case, the tube is made of platinum. In metal tubes, radium can be used in several ways: externally; to the inside of the body in places such as the mouth, nose, throat, rectum and vagina; and into the substance of the tumor through the incision.
Radium bath
In 1903, the inventor of electron, J. J. Thomson, wrote a letter to the journal Nature where he detailed his findings on the existence of radioactivity in well water. Soon after, others found that the waters in many of the world's most famous well-known wells are also radioactive. This radioactivity is due to the radium emission produced by radium present in the ground through which water flows. In 1904, Nature published a study of the natural radioactivity of different mineral waters.
Inspired by this, using radium salt preparation in a water bath is recommended as a way for patients to be treated at home, because the radio activity in the water bath is permanent. Radium bath be used experimentally to treat arthritis, gout, and neuralgia.
RÃÆ'¶ntgenotherapy vs. radium therapy
X-rays and radium are recorded by doctors to have different advantages in different cases. The most prominent effects generated with radium therapy are with lupus, growth of ulcers, and keloids, mainly because they can be applied more specifically to tissues than with x-rays. Radium is generally preferred when local reactions are desired, while for x-rays when large areas need to be treated. Radium is also believed to be bactericidal, whereas x-rays do not. Because they can not be applied locally, x-rays are also found to have a worse cosmetic effect than radium when handling malignancy. In certain cases, a combination of x-rays and radium therapy is recommended. In many skin diseases, ulcers will be treated with radium and the surrounding area with x-rays that will have a positive impact on the lymphatic system.
Tuberculosis and iodo-radium therapy
After using radium in surgical treatment of tuberculosis, researchers including BÃÆ' Â © la Augustin and A. de Szendeffy immediately developed a treatment using radioactive methanol iodine, patented under the name dioradin (formed from "iodine and radium") on 1911. This treatment application is referred to as iodo-radium therapy, and is involved in injecting intramuscular dioradin. It seems promising to the developers, because in some cases, fever and hemoptysis have disappeared. Inhalation of iodine itself has been an experimental treatment for tuberculosis in France between 1830 and 1870.
Commercialization, quackery, and ending era (1915-1935)
Extensive commercial exploitation of radium only began in 1913, at which time more efficient methods for extracting radium from pitchblende had been discovered and radium mining had taken off.
Commercial products
Radiums commonly used in bath salts, water, and mud are in low-level preparations, as their costs, and their use in curative solutions are questionable, as it has been agreed by physicians that radium can only be used successfully at high levels. dose. It is believed that even radiation emission at higher useful doses will not cause harm, since radioactive deposits are found to have been absorbed and released in urine and waste within a period of three hours.
Activation of radiation emulation
Radium emulsion activator , an apparatus that will apply radium emission to water, begins to be produced and marketed. Scientifically built Emanators are sold to hospitals, universities and independent researchers. Certain companies are advertised that they will only give it to others with a doctor's prescription and will guarantee the strength of radium in each dose.
Many products that mimic wider emanation activators are marketed to the public. One such product is Revigator , "radioactive water jug." Dispensing jar made from ore containing radium, the idea is that the radon produced by the ore will dissolve in water overnight. It was advertised: "Fill tubes every night, drink freely... when thirsty and when it shows up and retires, averages six or more glasses per day." The American Medical Association (AMA) worries that the public has been deceived by fraudsters. In response, the AMA established a guideline (valid 1916-1929) that an emanator seeking AMA approval should generate more than 2? Ci (74 kBq) radon per liter of water in a 24 hour period. Most devices on the market, including Revigator do not meet that standard.
Patent medications
Many quack drugs and other patents are sold in the market. Radithor, a radium salt solution, claimed by its developer William J. A. Bailey has curative properties. Many brands of toothpaste mixed with radium that is claimed to make the teeth glow more white, such as Doramad Radioactive Toothpaste. Perhaps, this is because radium will kill bacteria in one's mouth. One item, called "Degnen's Radio-Active Eye Apicator" produced by Radium Appliance Company of Los Angeles, California, is sold as a treatment for myopia, hypermethropia, and presbyopia. Face cream and powder are sold, with names like 'Revigorette' and 'Tho-radia'. It is also sold as a supplement for smoking. The company also marks the radioactive pads and compresses for the treatment of diseases.
Joachimsthal radium spa hotel
Given the curative nature of radioactivity, the spa is opened in Joachimsthal, the place where Madame Curie collected some of his original radium samples from a spring. Radon inhalation space was established, in which the air tube carrying gas rises from the processing tank in the basement; visitors will then use it through the inhalation apparatus. The treated bath is also irradiated, and the irradiated air is also filtered through a trumpet-shaped tubing to inhale.
Public health issues
Worries about radium were raised before the US Senate by California Senator John D. Works since 1915. In a speech on the floor, he quoted a letter from a doctor asking about the efficacy of a marketed product. He stressed that radiation has the effect of making many cancers worse, many doctors think the belief that radium can be used to cure cancer at a stage of therapeutic development is "delusional" - a physician citing the cited failure-to-100 to 1 success rate - and the effects of water radium is inevitable.
Around the early 1920s, new public health problems were triggered by the death of factory workers at the radioluminescent watch factory, later referred to as Radium Girls. In 1932, a famous industrialist, Eben Byers died of radiation poisoning from the use of Radithor, the radium water guaranteed by the manufacturer contains 2? Ci radium. Cases arose from the development of carcinoma in patients who had been using conventional radium therapy for up to 40 years after the original treatment.
Robley D. Evans made the first measurement of radon exhalation and radium excretion from a former painter in 1933. At MIT he collected reliable body content measurements from 27 call painters. This information was used in 1941 by the National Bureau of Standards to establish a tolerance level for radium 0.1? Ci (3.7 kBq).
Coutard Method
At the International Congress of Oncology in Paris in 1922, Henri Coutard, a French radiologist working with the Curie Institute, presented evidence that laryngeal cancer can be treated without harmful side effects. Coutard was inspired by Claudius Regaud's observations, which found that a single dose of X-rays was sufficient to produce severe skin damage and tissue damage to rabbits, if given in fractions, for several days, would sterilize the rabbit but had no effect on subcutaneous tissue.
In 1934, Coutard has developed a protracted fractionation process that remains the basis for current radiation therapy. Coutard dose and fractionation is designed to create severe but recoverable acute mucosal reactions. Unlike previous physicians, who believed that cancer cells were more affected by radiation, he assumed that the population of cancer cells had the same sensitivity to normal cell regeneration. Coutard reports a 23% healing rate in the treatment of head and neck cancers. In 1935, hospitals everywhere began to follow the treatment plan.
Today's radiation therapy (1935 -)
Cancer treatment with x-rays today generally follows the Coutard fractionation process, while the emitted rod is used in brachytherapy.
The three main divisions of radiation therapy are external beam radiation therapy or teletapy, brachytherapy or closed source radiation therapy, and systemic radioisotopes or non-sealed radiotherapy sources. The difference is related to the position of the radiation source; Externally outside the body, brachytherapy using closed radioactive sources is placed right in the area under treatment, and systemic radioisotopes are administered via infusion or oral consumption.
Particle therapy is a special case of external beam radiation therapy in which particles are protons or heavier ions.
Intraoperative radiation therapy or IORT is a special type of radiation therapy given immediately after surgical removal of the cancer. This method has been used in breast cancer (Introperative TARGeted or TARGIT radiation therapy), brain tumor and rectal cancer.
Radioactive iodine, as developed in 1911, survives today especially in the treatment of thyrotoxicosis (hyperthyroidism) and some types of thyroid cancers that absorb iodine. Treatment involves essential iso iodine-131 ( 131 I), often simply called "radioiodine" (although technically all iodine radioisotopes are radioiodin; see isotope isotope).
Note
References
Source of the article : Wikipedia
0 Comments