Selecting Megavoltage Treatment Technologies in External Beam Radiotherapy
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Selecting Megavoltage Treatment Technologies in External Beam Radiotherapy - IAEA
SELECTING MEGAVOLTAGE
TREATMENT TECHNOLOGIES
IN EXTERNAL BEAM RADIOTHERAPY
IAEA HUMAN HEALTH REPORTS No. 17
SELECTING MEGAVOLTAGE
TREATMENT TECHNOLOGIES
IN EXTERNAL BEAM RADIOTHERAPY
INTERNATIONAL ATOMIC ENERGY AGENCY
VIENNA, 2022
COPYRIGHT NOTICE
All IAEA scientific and technical publications are protected by the terms of the Universal Copyright Convention as adopted in 1952 (Berne) and as revised in 1972 (Paris). The copyright has since been extended by the World Intellectual Property Organization (Geneva) to include electronic and virtual intellectual property. Permission to use whole or parts of texts contained in IAEA publications in printed or electronic form must be obtained and is usually subject to royalty agreements. Proposals for non-commercial reproductions and translations are welcomed and considered on a case-by-case basis. Enquiries should be addressed to the IAEA Publishing Section at:
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© IAEA, 2022
Printed by the IAEA in Austria
January 2022
STI/PUB/1948
IAEA Library Cataloguing in Publication Data
Names: International Atomic Energy Agency.
Title: Selecting megavoltage treatment technologies in external beam radiotherapy / International Atomic Energy Agency.
Description: Vienna : International Atomic Energy Agency, 2022. | Series: IAEA human health reports, ISSN 2074–7667 ; no. 17 | Includes bibliographical references.
Identifiers: IAEAL 21-01424 | ISBN 978–92–0–116821–4 (paperback : alk. paper) | ISBN 978–92–0–116921–1 (pdf) | ISBN 978–92–0–117021–7 (epub)
Subjects: LCSH: Cancer — Radiotherapy. | Radiotherapy, High Energy. | Medical physics.
Classification: UDC 615.849 | STI/PUB/1948
FOREWORD
The global incidence of cancer is rising significantly, with low and middle income countries (LMICs) experiencing the highest increases. Radiotherapy is one of the three main modalities for the treatment of cancer, along with surgery and chemotherapy. The aim of radiotherapy is to control a malignant tumour by exposing it to a high dose of radiation, while at the same time limiting to acceptable levels the radiation dose received by normal tissue. In the light of the rising cancer incidence and the lack of sufficient treatment capabilities, the need for additional radiation treatment technologies is considerable. This is particularly the case in LMICs, where the shortage of radiotherapy capabilities is acute. In preparation for the expected increases in cancer incidence and in the corresponding number of patients in the coming decade, a large number of new high energy radiotherapy machines capable of delivering megavoltage beams will be required globally. However, the answer is not simply to buy a new linear accelerator (linac) or ⁶⁰Co teletherapy machine.
Radiotherapy can be delivered with different types of machine, such as external beam high energy radiation machines, kilovoltage machines and brachytherapy equipment. Variations in the incidence of different cancer types, the complexity and cost of treatment technologies, and differences in local social, economic and physical circumstances are all factors that influence technology acquisition, purchase and implementation.
The radiotherapy treatment process is itself complicated and involves much more than just radiotherapy machines. A cancer diagnosis requires, at a minimum, pathology and diagnostic imaging. Once radiotherapy is prescribed, imaging is needed to determine the location and extent of the disease. Without adequate numbers of professionally trained radiation oncologists, medical physicists and radiation therapists, treatment cannot proceed accurately or safely.
This publication addresses just one of the many factors, albeit an important one, associated with the planning of a new radiotherapy facility or the upgrade of an existing one. This concerns the selection of a high energy (megavoltage) radiotherapy machine. The two main high energy machine types are linacs and ⁶⁰Co machines.