Principles of radiation oncology outlines the physical and biological effects of ionising radiation, and its use in clinical oncology. Radiobiology, examining the response of tissue to ionising radiation, is described with regards to normal and malignant tissues. The effect of fractionation, the delivery of radiotherapy in a series of repeated exposures, is examined. The damaging effects on normal tissues are considered, particularly nonreversible late effects including carcinogenesis. Therapeutic exposure to ionising radiation is contrasted between radical and palliative radiotherapy. The physical properties of ionising radiation beams are described for superficial x-rays, megavoltage x-rays, and electrons. The process of treatment planning is summarised through beam dosimetry, target and critical organ outlining, dose planning, treatment verification, prescription and delivery. Computerised tomography is used for outlining and for verification, using cone beam CT. 0ther methods for image guided radiotherapy include fiducial markers. Increasingly intensity modulated radiotherapy is proving beneficial in reducing normal tissue damage during radical treatment. Stereotactic radiotherapy is used in the radical treatment of small unresectable malignancies. The clinical use of electron therapy, brachytherapy and intraoperative radiotherapy is described. Nuclear medicine uses unsealed radionuclides in imaging primary malignancies and their metastases, and in targeted radiotherapy. Examples include PET scanning, bone scanning, and radio iodine therapy. Whole body irradiation is used to improve outcomes after high-dose chemotherapy with stem cell or bone marrow transplantation.
The Biological effects of Ionising Radiation on the Thyroid Gland
