Ionizing radiation: its biological impacts and how it is used to treat disease
Mar 13, 2025
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Ileana Silvestre Patallo is a medical physicist at the UK's National Physical Laboratory, and Ruth McLauchlan is a consultant radiotherapy physicist at Imperial College Healthcare NHS Trust. They dive into the dual nature of ionizing radiation, detailing how it can both harm and heal. The discussion covers the precision of radiotherapy in targeting cancer cells while protecting healthy tissue, the evolution of treatment techniques, and exciting innovations like flash radiotherapy. They emphasize the importance of technology in improving patient outcomes.
Radiotherapy effectively targets and damages cancer cells' DNA while allowing healthy cells to recover through a fractionation approach.
Advancements like image guidance systems and adaptive radiotherapy enhance the precision of treatment, minimizing damage to surrounding healthy tissues.
Deep dives
Understanding Radiotherapy Mechanisms
Radiotherapy employs high-energy radiation, such as X-rays and charged particles, to target and eliminate cancer cells by damaging their DNA. This process hampers the cancer cells' ability to divide and triggers their death, a phenomenon that can continue for weeks following treatment. While radiotherapy is designed to maximize tumor destruction, it may also temporarily harm healthy cells; however, most healthy cells can recover after treatment. The challenges lie in precisely targeting tumors to minimize damage to surrounding healthy tissue, which continues to be a focal point for medical physicists.
The Importance of Fractionation in Treatment
Fractionation in radiotherapy refers to administering radiation doses in smaller, repeated sessions over several weeks. This approach, first introduced in the early 20th century, allows for significant damage to cancerous cells while providing healthy cells time to recover between treatments. The concept emerged from early clinical observations revealing that dividing cells are more sensitive to radiation, paving the way for strategies to optimize dose delivery and minimize side effects. This methodology enhances the therapeutic efficacy while managing potential adverse reactions associated with radiation exposure.
Innovations in Radiation Delivery Techniques
Advancements in radiation therapy, such as the use of multi-leaf collimators and adaptive radiotherapy, have greatly improved the precision of treatment delivery. These technologies enable medical physicists to tailor radiation beams to conform closely to tumor shapes, thus sparing more healthy tissue from unnecessary exposure. The introduction of image guidance systems allows for real-time adjustments during treatment, accommodating anatomical changes in patients. Additionally, emerging techniques like flash radiotherapy and mini-beam therapy show promise for further reducing collateral damage while effectively targeting tumors.
Future Directions in Radiation Therapy
The future of radiation therapy will likely involve a blend of existing techniques with new innovations tailored to personalized patient care. As cancer incidence rises globally, the demand for effective and efficient treatment modalities remains critical, with radiotherapy being a vital component of cancer management. Techniques that combine radiotherapy with immunotherapy are anticipated to enhance treatment outcomes by leveraging the body's immune response against tumors. Furthermore, ongoing clinical trials are crucial for validating these innovative methods and ensuring their safety and efficacy in patient treatment.
This episode of the Physics World Weekly podcast features Ileana Silvestre Patallo, a medical physicist at the UK’s National Physical Laboratory, and Ruth McLauchlan, consultant radiotherapy physicist at Imperial College Healthcare NHS Trust.
In a wide-ranging conversation with Physics World’s Tami Freeman, Patallo and McLauchlan explain how ionizing radiation such as X-rays and proton beams interact with our bodies and how radiation is being used to treat diseases including cancer.
This episode was created in collaboration with IPEM, the Institute of Physics and Engineering in Medicine. IPEM owns the journal Physics in Medicine & Biology.
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