What is radiation therapy? Radiotherapist Dictionary

X-ray treatment, or radiotherapy, is a method that allows the treatment of some chronic inflammatory and degenerative pathologies

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A whole group of diseases affecting cartilage, bones, soft tissues and joints may respond poorly to long-term and intensive drug therapy; as a result, the patient is unable to lead a full life and is often limited in movement. Joint diseases are also treated with the help of special gymnastics, acupuncture methods, temporary fixation of affected joints, and all these methods are usually very effective, but in some cases they have a limited effect and are not able to provide long-term results.

When all possible therapeutic methods have been exhausted, a specialist may recommend radiotherapy of the joints. This treatment allows you to stimulate the area of ​​the damaged joint; in addition, it has a pronounced analgesic effect and helps restore joint function.

Therapeutic irradiation with small doses has been studied by specialists for many years; Both the analgesic and restorative effects of x-ray therapy have been confirmed by many years of practice.

When did radiation therapy appear?

In 1896 in Vienna, Dr. Freund was the first in the world to use x-rays not to diagnose a disease, but to treat a superficially located benign formation. A few years later, the spouses Pierre and Marie Curie discovered radioactive radium, which began to be used for contact radionuclide therapy.

Over the past 125 years, radiation therapy has undergone a long journey of improvement, has become widely used and has reached a qualitatively new level. According to the expert community, currently at least 60-70% of all cancer patients require radiation therapy.

When is radiation treatment for heel spurs contraindicated?

X-ray radiation is radioactive and in high concentrations can cause significant harm to health. However, this does not mean that radiotherapy should be abandoned in any case.

Often this type of physiotherapy is a last resort and helps to avoid surgical removal of a heel spur. Before prescribing a course, the attending physician must assess possible risks and collect anamnesis and examine the patient.

Contraindications for X-ray treatment are:

• radiation sickness, oncological diseases and their treatment with radiotherapy;
• pathologies of the hematopoietic system;
• diseases of internal organs and systems;
• exhaustion of the body, vitamin deficiencies;
• pregnancy, postpartum period;
• acute infectious diseases;
• heel wounds, inflammatory processes.

After completing a course of radiotherapy, women must take measures to prevent pregnancy for 6 months.

As a rule, they try not to prescribe treatment with low doses of radiation to people of fertile age, as well as to people over 65 years of age.

Goals of radiotherapy

The goal of radiation therapy is to achieve the maximum possible effect on the tumor and areas of its clinical and subclinical spread with a high degree of accuracy and minimal consequences for surrounding tissues and organs. The goal of radiation therapy is the destruction of the tumor mass, ideally leading to its elimination or reduction in size and metastatic potential, slowing growth, which helps prolong life and improve its quality.

Radiation therapy can be used at different stages of treatment:

• Preoperative (so-called induction, or neoadjuvant)
• Intraoperative – during surgery
• Postoperative (adjuvant)
• Independent (definitive)

Preoperative radiotherapy

The goal of preoperative radiation therapy is to minimize the tumor volume, prevent tumor cells from entering the lymphatic or circulatory system, and reduce the risk of developing distant metastases. For most types of tumors, a tandem of radiation and chemotherapy is most often used. This combined effect allows further radical intervention with complete removal of the tumor. In some cases, preoperative radiation/chemoradiotherapy can lead to complete regression of the tumor, thus becoming an independent treatment method. Achieving complete clinical regression, proven by radiological methods (CT, MRI, PET-CT) and supported by biopsy data, increases the possibility of delaying or refusing surgery. Thus, for rectal tumors with a complete clinical response to chemoradiotherapy, the “waitandsee” concept has gained recognition, i.e. “wait and watch”, enshrined in international and national treatment standards.

Intraoperative radiotherapy

Intraoperative radiation therapy is the irradiation of the tumor bed immediately after its surgical removal, directly in the surgical field. This is an effective method of reducing the risk of local relapse. Intraoperative radiation therapy is used for breast tumors, soft tissue sarcomas, and even gastrointestinal tumors. This method is very effective, but is not without its drawbacks. Firstly, it requires special mobile and compact radiation units, which can be located in the operating room. Secondly, a single dose of radiation may be insufficient, and the volume of intraoperatively irradiated tissue is quite limited. Intraoperative radiation therapy does not allow the lymphatic flow to be affected. It is difficult to ensure the accuracy of dosimetric planning. The radiation procedure increases the time the patient remains under anesthesia and the overall duration of the intervention. Therefore, intraoperative radiation therapy is often an integral part of combined irradiation, a stage of complex treatment.

Treatment of heel spurs with radiotherapy

All over the world, X-ray therapy is considered a dangerous procedure and has many contraindications and side effects. This method is used when other physical procedures, such as shock wave therapy for heel spurs, laser treatment, and electrophoresis, have not brought the expected results.

Physiotherapeutic treatment of heel spurs with X-rays takes place on an outpatient basis using a special device that emits X-rays in the range of 20-400 kV. During the procedure, ionizing (radioactive) radiation specifically affects the osteophyte, minimally damaging other tissues.

Under the influence of small doses of radioactive X-rays, the nerve endings are blocked and the intensity of pain decreases.

Bone growth under the influence of radiation is not eliminated, but this type of therapy has the following positive effects:

1. Anesthesia. The effect is noticeable after the 1st procedure, and a lasting result is observed after 4-5 irradiation sessions.
2. Relief of inflammation. In the affected area, blood circulation processes are enhanced, which leads to the suppression of the production of prostaglandins, which cause tissue inflammation.
3. Regeneration. Small doses of radiation help accelerate the recovery of damaged fascia cells.

Also, ionizing radiation enhances the effect of anti-inflammatory drugs, therefore, when undergoing a course of radiotherapy, the attending physician, as a rule, makes adjustments to the drug treatment regimen for heel spurs.

Postoperative radiotherapy

Postoperative radiation therapy is the effect on the area of ​​the removed tumor and lymphatic drainage pathways in order to prevent the possibility of the spread of individual tumor cells during surgery, i.e. reducing the risk of developing local and distant metastases. Postoperative radiation therapy is necessary both after major operations and after minimally invasive interventions. Currently, it is most often used in the treatment of breast cancer, soft tissue sarcomas, and head and neck tumors.

Is treatment with radioisotopes safe?

Strictly speaking, both receptors for prostate-specific membrane antigen and receptors for somatostatin are also present on healthy cells. But on the membranes of malignantly degenerated cells their number is many times greater. This means that the vast majority of molecular complexes with radioactive elements will join these cells. Consequently, the radiation dose received by the tumor will be much higher. This property of radionuclide therapy is called targeting (from the word target, or “goal”), it means high accuracy of the effect on the malignant neoplasm, and not on healthy tissue.

In addition, the types of radiation used during treatment play an important role in the safety of treatment. Lutetium-177 produces beta radiation, while actinium-225 and radium produce alpha radiation. The penetrating ability of beta particles is quite small - they are stopped by only 2–2.5 centimeters of living tissue. That is, this radiation will affect exclusively at the local level. The penetrating ability of alpha particles is even less - it can pass through only 5-10 neighboring cells. This means that the targeting of tumor cells will be as high as possible.

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Independent or definitive radiotherapy

Independent radiation/chemoradiation therapy is indicated in cases where its effectiveness is comparable to radical surgical treatment, i.e. for early cancer, or, on the contrary, when radical intervention is impossible - in the presence of general contraindications or due to the spread of the tumor. Currently, it is considered as an alternative treatment method for early tumors of the vocal larynx and a number of skin tumors. It is most widely used in the treatment of prostate cancer. In combination with chemotherapy, it is successfully used for early tumors of the esophagus and anal canal. Chemoradiation treatment is the leading treatment for cervical cancer.

Finally, radiation therapy is used to eliminate symptoms of a tumor disease, such as pain, difficulty swallowing, etc. (symptomatic radiation therapy) or to contain the tumor process (palliative radiation therapy).

Radiotherapy technology

The sequence of treatment measures for each patient is decided on by an oncological council consisting of an oncological surgeon, a chemotherapist and a radiotherapist. Having determined the indications for radiation treatment, the radiotherapist formulates a general treatment plan: course duration, dose fractionation regimen (dose per one radiation session), total radiation dose, the need for simultaneous chemoradiation treatment, and the use of radiomodifiers. Irradiation sessions are preceded by a pre-radiation preparation stage.

Pre-radiation preparation includes:

• Computer (X-ray) topometry
• Contouring of the target and adjacent organs
• Dosimetric planning

Computer topometry

The creation of an individual dosimetric radiation map begins with computer topometry, which is carried out by a radiologist together with a radiotherapist. On a computed tomography simulator, with the same fixing devices and in the same position in which the treatment will be carried out, the area of ​​the anatomical location of the tumor is scanned (chest, abdominal cavity, brain, etc.). Structural and anatomical features are assessed - tumor localization, volume extent, relationship with adjacent organs, density of internal tissues. During this procedure, graphic landmarks are placed on the patient’s skin—marks for centering the radiation beams, which will further speed up navigation during treatment sessions. A sequence of computer scans is transmitted to a planning station to create an individual radiation plan.

Contouring of the target and adjacent organs

Next comes the stage of processing the resulting images. The scans are imported into the planning system, where the radiotherapist, with the help of a radiologist, outlines the tumor target and all adjacent organs in each scan received. Based on a set of volumetric images, dose loads during treatment on the tumor and neighboring organs are subsequently calculated, taking into account their tolerance to radiation.

Dosimetric planning

After completing the delineation, assessing the location of the tumor and adjacent organs, the stage of dosimetric planning of the course of radiation treatment begins, which is performed by medical physicists. Dosimetric planning is the selection of the number and conditions for the formation of radiation beams, their spatial placement in order to deliver the maximum possible therapeutic dose to the tumor with minimal consequences for neighboring organs. Modern medical accelerators with multi-leaf collimators make it possible to form fields of complex configurations that most accurately match the volume and shape of the irradiated target, producing the so-called. conformal irradiation. Based on the objectives, optimal target coverage can be planned using 3D multifield intensity modulated radiation (IMRT) or intensity modulated arc radiation (VMAT).

The image shows an example of 3D multifield radiation. It can be seen that 3 beams are used to irradiate the tumor.

X-ray therapy of heel spurs: recommendations from doctors

When undergoing treatment for heel spurs with x-rays, you must adhere to medical recommendations:

• a week before the start of the course, stop using locally irritating ointments and compresses;
• during the treatment, do not take hot baths, warming up, or heating pads;
• effectively relieve the heel exposed to radiation.
• treat the heel at the site of radiation exposure with special “Pyatkashpor” creams, which actively moisturize and protect against overdrying;

To reduce the load on your heels, you need to choose the right insoles or heel pads.

You can get acquainted with the selection of the best heel supports and choose the best option, taking into account your condition, foot structure and features, on our website.

Doctors also recommend wearing high-quality orthopedic shoes and using the best insoles for spurs, “Concept Antishock” or other products that best suit you.

Attention! Increased stress on the irradiated tissue can lead to undesirable effects, the appearance of calluses around the growth and infection of surrounding tissues. Use orthotic devices to reduce stress on your heel when walking and at rest.

Patient immobilization means

In order to accurately deliver ionizing radiation to the irradiated target, it is necessary to clearly reproduce the position in which the process of preparation for radiation treatment took place, i.e. computer topometry and dosimetric planning. This is provided by a variety of means for positioning and immobilizing the patient. They can be in the form of different standard decks with headrests, fastenings, bolsters and supports for arms, legs, and pelvis. There are also individual means. For example, vacuum mattresses and thermoplastic masks that fix the individual shape of the patient’s body in the irradiation position. These devices make it possible to avoid displacement of the irradiated area due to involuntary movements of the patient.

Types of radiation therapy

External beam radiotherapy

With remote irradiation, the source of ionizing radiation is located at a distance - outside the patient’s body and outside the tumor target. Depending on the type of radiation device, external beam radiation therapy includes x-ray therapy, telegammatherapy, electron and proton therapy. The most common option for external beam radiation therapy today is irradiation with high-energy photons and electron beams at medical electron accelerators. Modern models of accelerators, using computer control of the parameters and geometry of the radiation beam, ensure maximum compliance with the shape of the target source and the distribution of the radiation dose in it. The ability to form beams of bremsstrahlung (photon) and corpuscular (electronic) radiation with varying powers - from 6 MeV to 18-20 MeV - makes it possible to irradiate both surface and deep-lying objects in the body tissues.

Particular attention is currently focused on proton therapy. Russia's first clinical proton therapy center was built in St. Petersburg. The advantage of the method is the peculiarity of heavy charged particles (protons). Protons release their braking energy as much as possible at the end of their travel path, and the dose decrease from 90% to 20% occurs at a distance of 2-5 mm. This possibility of concentrating the dose at the end of the particle path allows not only to best concentrate the dose, but also to minimize the radiation load on the tissue along the beam and behind the pathological focus. Proton therapy is relevant in onco-ophthalmology, radioneurosurgery, and especially for pediatric patients. Currently, the scope of proton therapy is expanding, but so far the use of the method is significantly limited by its high cost.

Modern technology of external irradiation is stereotactic radiation therapy - a method of high-precision large-fraction irradiation of tumors no larger than 5 cm in size. Unlike radiosurgery, developed for the treatment of brain tumors, which uses a single irradiation, the total number of fractions with stereotactic irradiation varies from 1 to 5-6. A single focal dose ranges from 8 Gy to 20 Gy, the total equivalent absorbed dose from 50 Gy to 150 Gy, which is significantly higher than with the classic version of fractionation of radiation therapy. Gamma knife is one of the types of radiation installations for stereotactic irradiation of brain tumors. Accelerators with microleaf collimators allow stereotactic irradiation of any lesion (brain, prostate, lung, bones, liver, pancreas, lymph nodes, soft tissues). During stereotactic irradiation, displacements of the focus that occur during breathing must be taken into account. For this purpose, CT images are recorded during CT simulation with synchronization of the respiratory cycle (4D radiation therapy).

X-ray therapy

X-ray therapy is a medical discipline that studies the theory and practice of using X-ray radiation for therapeutic purposes.

It is a special branch of radiation therapy, in which X-ray radiation with an energy of 10 to 250 kV is used for therapeutic purposes. As the voltage on the X-ray tube increases, the radiation energy increases and, at the same time, its penetrating ability in tissues increases from several millimeters to 8-10 cm.

The use of X-ray therapy began in 1897, but X-ray therapy received its scientific basis only with the development of physics, dosimetry, radiobiology and the accumulation of clinical experience. Until the 50s of our century, X-ray therapy at voltages from 160 to 250 kV was the only method of remote irradiation of deep-lying pathological processes of both an inflammatory and dystrophic nature, and malignant tumors. However, for cancer of internal organs, which is characterized by low radiosensitivity and requires large doses of radiation (within 60-70 Gy) for its destruction, radiotherapy has proven to be ineffective.

There are deep or orthovoltage X-ray therapy (focus-skin distance 30 cm or more) and close-focus (focus-skin distance 7.5-20 cm).

X-ray radiation generated in X-ray tubes using high-voltage electrical devices, when exposed to tissues and organs of the human body, causes suppression of the functions of individual cells, inhibition of their growth, and in some cases, their destruction. These phenomena turn out to be a consequence of absorption and scattering—the primary physical processes of interaction of X-ray radiation with the biological environment. The primary physical ones are followed by physicochemical and biochemical processes that determine the development of the therapeutic effect. A feature of X-ray radiation is its continuous energy spectrum, in which there are radiation quanta with any energy, up to the maximum value corresponding to the highest generation voltage. The latter currently in radiotherapy usually does not exceed 250 kV.

To obtain a homogeneous beam, filters that absorb soft rays are used. For low-energy radiation, filters made of light metals (aluminum, brass 0.5-6 mm thick) are used. For high-energy radiation (180-200 kV), radiation uniformity is achieved by using filters made of heavy metals (zinc, copper 0.5-2 mm thick).

To limit the irradiation field and make centration easier during radiotherapy, cylindrical or rectangular tubes are used, providing the skin-focal distance required for each individual patient. The exit window of the tubes of devices for short-focus X-ray therapy has a diameter of up to 10 cm and for deep X-ray therapy an area of ​​16-400 cm2.

The therapeutic effect of radiotherapy is associated with the absorbed dose of radiation in the area of ​​the pathological focus. The magnitude of the optimal absorbed dose, its fragmentation, and the rhythm of irradiation are determined in each case by the nature of the pathological process. The degree of concomitant reactions of healthy tissues and organs surrounding the pathological focus, as well as reactions of the whole organism, is influenced by the magnitude of integral doses in these individual anatomical structures and in the entire body of the patient.

The effects of X-ray therapy are not clear for different histological structures, which is due to the different sensitivity of the latter to ionizing radiation.

However, the sensitivity of irradiated tissues in the human body also depends on a number of other numerous factors - age, gender, body temperature and the irradiated area, the localization of the latter, its hydrophilicity, blood supply, oxygen saturation, its functional activity, the intensity of metabolic processes, and many others. etc., including the initial state, as well as the reactivity of the body. The biological effects of radiotherapy are influenced by the nature of the radiation dose distribution over time. Fractional irradiation is less damaging than single irradiation. In this case, the differential sensitivity of tissues and the so-called therapeutic interval are better identified - the difference in the sensitivity of normal and pathological histostructures.

X-ray therapy can cause various effects. Depending on the magnitude of the absorbed dose of radiation, the rhythm of irradiation, the object of influence, the nature and stage of the disease and, finally, the reactivity of the patient’s body, anti-inflammatory, desensitizing, destructive, analgesic and other effects may occur. In connection with the expansion of the possibilities of using high-energy radiation sources, X-ray therapy is used mainly in cases where the pathological focus is relatively shallow and when it is possible to use small doses of radiation.

X-ray therapy is an effective method of radiation treatment in various fields of medicine: oncology, dermatology and cosmetology, traumatology and orthopedics.

For the treatment of superficial malignant neoplasms of basal cell and squamous cell skin cancer, early stages of lip cancer and vulvar cancer, close-focus radiotherapy is the method of choice and has a number of advantages over surgical treatment methods. With a greater spread of the process, X-ray therapy is combined with remote methods of radiation therapy.

Close-focus radiotherapy is an independent radical method of treating precancerous diseases (senile keratoma, Bowen's disease, cutaneous horn, leukoplakia, etc.), a number of degenerative inflammatory and hypertrophic skin diseases (Dupuytren's syndrome, plantar fibromatosis, keloid scars, warts and condylomas, dermatological diseases , including psoriasis, mycoses fungoides, eczema, neurodermatitis).

X-ray therapy is used in the treatment of gynecomastia, postoperative lymphorrhea, and is a highly effective method of treating degenerative and inflammatory diseases (neuralgia and neuritis of the facial nerve, brachial plexus, lumbosacral radiculitis, arthrosis).

X-ray therapy can also be used for some nonspecific degenerative-dystrophic and inflammatory processes of the osteoarticular apparatus, accompanied by reactive inflammation of soft tissues and severe pain.

A good result is obtained with radiotherapy of acute inflammatory processes, using small single doses of the order of 0.1-0.15 Gy and a total dose not exceeding 1 Gy - recommended only in the early stages of acute inflammatory diseases and in cases of absence of other equivalent methods of treatment or ineffectiveness the latter in persons over 40 years of age. For non-tumor diseases in children, radiotherapy should not be used.

X-ray therapy should be used only if there are scientifically substantiated indications for such treatment and only in patients with an impeccably proven disease.

The possibility of using different radiation dose fractionation modes makes this method applicable to the treatment of even very elderly patients.

It is possible to use 1-2 irradiation sessions at intervals of several weeks or 5-10 sessions every other day for 3 weeks, as well as other options.

In the radiotherapy department of the State Budgetary Healthcare Institution TOKOD, since June 2, 2015, X-ray therapy has been carried out on a modern XTRAHL 200 X-ray therapy unit (Great Britain).

The XTRAHL 200 system is ideal for both close-focus radiotherapy of superficial skin tumors and orthovoltage therapy of secondary lesions, including bone metastases.

Indications for radiotherapy:

• squamous cell or basal cell skin cancer stage I-II or stage 2 after DHT
• vulvar cancer as part of combined radiation therapy
• cancer of the lower lip stage I-II or stage 2 after DHT
• recurrence of breast cancer (in the scar, soft tissues, skin)
• intraosseous MTS into the ribs (single lesions)
• non-tumor diseases (heel spurs, osteoarthritis of the knee joints, keloid scars, postoperative lymphorrhea)

Contraindications to radiotherapy can be absolute and relative.

Absolute contraindications.

• general serious condition of the patient
• severe cachexia
• the presence of concomitant diseases of other organs (heart, lungs, liver, kidneys) in the stage of decompensation.
• leukopenia and thrombocytopenia, anemia.
• radiation sickness or radiation damage, even suffered in the past.

Relative contraindications.

• acute septic and infectious diseases
• generalized skin lesions.
• formed abscesses and phlegmons before opening
• pregnancy.
• childhood

In most cases, radiotherapy does not cause systemic consequences. Most of the side effects are due to a skin reaction, which manifests itself in the form of epidermatitis. First, during each session, swelling, redness, and itching occur. As treatment continues, symptoms become more pronounced and reach a maximum by the third week of therapy and disappear 1 - 1.5 months after its completion.

Blisters filled with exudate form on the affected area of ​​the skin. They burst, revealing an inflamed, bright red epidermis. This serves as a gateway for pathogenic flora, and if the doctor’s recommendations are not followed, a bacterial infection can develop. The appearance of wounds covered with crusts is also noted.

The sensitivity of the skin to radiation depends on many factors.

These are: localization of the tumor, the anterior surface of the neck is more susceptible to radiation exposure than the skin of the wings of the nose and other areas of the face and back of the head; air temperature, in hot weather the blood supply to the epidermis improves, which increases the risk of developing the consequences of treatment; in cold weather this probability decreases; excess weight, it has been proven that the skin of obese people is more susceptible to the effects of radiation; cracks and scratches increase the permeability of the epidermis; age-related changes.

A dangerous consequence of such treatment is a radiation ulcer. Under the influence of radioactive isotopes, microcirculation in the blood vessels located under the skin is disrupted. The risk of complications increases in proportion to the depth of penetration of the pathological process and the strength of radiation.

The onset of ulcerative changes in the skin is indicated by the following symptoms: dryness and peeling; disappearance of the surface pattern of the epidermis; the appearance of spider veins; pigmentation disorder.

If the tumor is located near the mucous membranes of the nose or mouth, inflammation may occur - mucositis. It is characterized by dry epithelium, burning and pain when touched. However, such consequences are rare. During radiation treatment of a tumor in the eye area, recurrent conjunctivitis is noted.

Long-term complications of radiation therapy

Over time, the skin exposed to radiation becomes thinner, and the vascular network is visible underneath. A year to a year and a half after the end of treatment, lighter or, conversely, darker areas of the epidermis may appear. The severity of these signs depends on the duration of treatment, the radiation dose received as a result of therapy, and the area of ​​exposure. It is worth noting that the radiation ulcer discussed above may also appear several months after the end of treatment.

The most dangerous consequence is the high risk of developing a more severe, malignant form of skin cancer - squamous cell cancer. For this reason, radiation exposure is not recommended for patients under 50 years of age. Also, due to the risk of complications, this method of treatment is not used for relapses of basal cell carcinoma. After exposure to radiation on the scalp, hair loss is observed. Over time, they grow back, but become brittle, dull, and their color becomes more faded.

When treating tumors located on the facial skin near the eyes, cataracts may occur. How high the risk of such a disease is is unknown, since today the threshold dose of radiation to the lens has not been established. Due to tissue scarring after the destruction of neoplasm cells, their mobility is limited, which affects facial expressions. There are also changes in the functioning of the sebaceous and sweat glands in the area of ​​exposure to radiation.

Prevention of complications

The patient is warned that before starting the course of treatment (as well as during it) the skin should be protected from damage. In addition, it is recommended to adhere to the following rules:

protect yourself from direct sunlight, do not visit the solarium, go outside in long sleeves, cover your face with a wide-brimmed hat, apply a special cream to exposed skin;

You cannot rub the skin that has been exposed to irradiation, massage it, apply cupping, apply mustard plasters, treat it with antiseptics and alcohol solutions (iodine, brilliant green, peroxide) without a doctor’s prescription;

hygienic procedures should be carried out with care so as not to wash off the marks made by the doctor that define the area of ​​radiation exposure;

It is forbidden to make compresses or use a heating pad;

before using scented soap or shower gel, bath foam, deodorant, cream, you should definitely consult a doctor; decorative cosmetics (if allowed) should be washed off 4 hours before the radiation treatment session for basal cell carcinoma;

To prevent bacterial infection, it is worth limiting visits to public places such as swimming pools or baths.

Radiation therapy is a serious burden on the body. Therefore, if any disturbing symptoms appear, you should seek advice from your doctor or nurse. It is also better to coordinate changes in diet and climate with them. It is worth remembering that the danger of the consequences of radiation treatment and x-ray therapy remains for the rest of your life.

Contact radiotherapy

With contact radiation therapy or brachytherapy, a radiation source is introduced into the affected organ. The advantages of this type of therapy are a short course, high accuracy and low load on adjacent organs, which is very important for the future quality of life of patients. For brachytherapy, various radioactive sources are used - isotopes of cobalt (Co⁶⁰), iridium (Ir¹⁹²), cesium (Cs¹³⁶).

Contact radiation therapy has different types: application, intracavitary, interstitial and radionuclide radiation therapy.

Application radiotherapy

In application radiation therapy, the source is located on the surface of the external object being irradiated (skin).

Intracavitary radiotherapy

In intracavitary radiation therapy, the source is brought directly to the tumor in the organ cavity. It is most often used for cancer of the rectum, anal canal, esophagus, and intrabronchial formations. Intracavitary or intraluminal brachytherapy is more often used as a stage of combined radiation therapy, before or after external beam irradiation. However, brachytherapy as an independent method is often sufficient after minimally invasive surgery in the early stages of cancer. In the palliative treatment of esophageal cancer, brachytherapy is an effective way to eliminate dysphagia (swallowing disorder).

Interstitial radiotherapy

In interstitial radiation therapy, the source is injected into the tissue of the tumor itself. Interstitial brachytherapy is most common for prostate tumors and is widely used for breast radiation, head and neck tumors, and liver tumors.

Radionuclide radiotherapy

In radionuclide or radioisotope therapy, the source of radiation is a radiopharmaceutical, which, after being introduced into the patient’s body, selectively accumulates in tumor tissues. The most widely used radiopharmaceuticals are radionuclides containing iodine I¹³¹ (thyroid cancer), I¹²⁵ (in the form of granules for the treatment of prostate cancer), strontium Sr⁸⁹ (bone metastases). Disadvantages limiting the use of radionuclide therapy are a narrow therapeutic range, limited possibility of precise dosimetric planning, and the inapplicability of multifraction irradiation. Considering the number of absolute restrictions, the cost of the method is quite high.