Technological Advancements in External Beam Radiation Therapy (EBRT): An Indispensable Tool for Cancer Treatment

Abstract

Recent technological advancements have increased the efficacy of radiotherapy, leading to effective management of cancer patients with enhanced patient survival and improved quality of life. Several important developments like multileaf collimator, integration of imaging techniques like positron emission tomography (PET) and computed tomography (CT), involvement of advanced dose calculation algorithms, and delivery techniques have increased tumor dose distribution and decreased normal tissue toxicity. Three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), stereotactic radiotherapy, imageguided radiotherapy (IGT), and particle therapy have facilitated the planning procedures, accurate tumor delineation, and dose estimation for effective personalized treatment. In this review, we present the technological advancements in various types of EBRT methods and discuss their clinical utility and associated limitations. We also reveal novel approaches of using biocompatible yttrium oxide scintillator-photosensitizer complex (YSM) that can generate X-ray induced cytotoxic reactive oxygen species, facilitating X-ray activated photodynamic therapy (XPDT (external beam) and/or iXPDT (internal X-ray source)) and azido-derivatives of 2-deoxy-D-glucose (2-DG) as agents for site-specific radiation-induced DNA damage.

Mortality and biochemical recurrence after surgery, brachytherapy, or external radiotherapy for localized prostate cancer: a 10-year follow-up cohort study

“…Finally, the treatments were applied over one decade ago; since then, diagnostic techniques and treatments for prostate cancer have evolved. For instance, most new high-tech radiotherapy modalities seem to enhance patient survival and therapeutic gain 29 , but hypofractionation is still controversial 30 ; therefore, further research in patients undergoing new modalities of treatment is needed.…”

‘Is the technology essential or emerging?’ Ways to keep radiation therapy curriculum agile amid rapidly advancing technology

“…Innovations in RT can significantly influence clinical practice and patient outcomes. The drivers for implementing change are varied, though usually the motivations are direct improvements to patients' overall survival, reduced morbidity or practice/workflow efficiencies 3 , 10 and major innovations take decades to integrate within radiation oncology practice (Fig. 1 ).…”

“…2 Similarly, implementation of new treatment delivery systems has included tomotherapy and cyberknife in the 2010s and recent innovations in hybrid magnetic resonance linear accelerators (MR Linacs) and particle therapy. 3 Continuous change in RT practice is seen as a ‘constant companion’ rather than a ‘sometimes friend’.…”

“…Innovations in radiation therapy (RT) have seen advancements from 2‐dimensional to 3‐dimensional conformal RT in the late 1990s, to image‐guided RT, intensity‐modulated RT (IMRT) and volumetric modulated arc therapy (VMAT) in the 2000s 2 . Similarly, implementation of new treatment delivery systems has included tomotherapy and cyberknife in the 2010s and recent innovations in hybrid magnetic resonance linear accelerators (MR Linacs) and particle therapy 3 . Continuous change in RT practice is seen as a ‘constant companion’ rather than a ‘sometimes friend’.…”

An estimation of cost of concrete shielding in a radiotherapy room housing a clinical linear accelerator that produces high-energy photons – Part II

“…Photon beams produced by large clinical particle linear accelerators are widely used for the treatment of various kind of cancer [SCARINGI, 2018;TSENG, 2020]. In the last decades external beam radiation therapy has significantly evolved due to the appearing of new technologies and advanced techniques of treatment, such as IMRT (intensity modulated radiation therapy), VMAT (volumetric modulated arc therapy), IGRT (image guided radiotherapy) and SBRT (stereotactic body radiation therapy) [KOKA, 2022]. All these modern treatment procedures used in external beam radiotherapy have the capability to deliver a high and conformal radiation dose distribution to the tumor.…”