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The majority of epithelial cancers are only moderately radiosensitive, and require a significantly higher dose of radiation (60-70 Gy) to achieve a radical cure. These include leukemias, most lymphomas and germ cell tumors. Highly radiosensitive cancer cells are rapidly killed by modest doses of radiation. The response of a cancer to radiation is described by its radiosensitivity. Radiation therapy for a patient with a diffuse intrinsic pontine glioma, with radiation dose color-coded.ĭifferent cancers respond to radiation therapy in different ways. 5.3 Brachytherapy (sealed source radiotherapy).5.1.6 Temporally feathered radiation therapy (TFRT).5.1.5 Volumetric modulated arc therapy (VMAT).5.1.4 Intensity-modulated radiation therapy (IMRT).5.1.3 Virtual simulation, and 3-dimensional conformal radiation therapy.5.1.1 Conventional external beam radiation therapy.4.2.3 Estimation of dose based on target sensitivity.The use of radiation therapy in non-malignant conditions is limited partly by worries about the risk of radiation-induced cancers. Radiation therapy has several applications in non-malignant conditions, such as the treatment of trigeminal neuralgia, acoustic neuromas, severe thyroid eye disease, pterygium, pigmented villonodular synovitis, and prevention of keloid scar growth, vascular restenosis, and heterotopic ossification. Brachytherapy, in which a radioactive source is placed inside or next to the area requiring treatment, is another form of radiation therapy that minimizes exposure to healthy tissue during procedures to treat cancers of the breast, prostate and other organs.
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Total body irradiation (TBI) is a radiation therapy technique used to prepare the body to receive a bone marrow transplant. The precise treatment intent (curative, adjuvant, neoadjuvant therapeutic, or palliative) will depend on the tumor type, location, and stage, as well as the general health of the patient. Most common cancer types can be treated with radiation therapy in some way. It is also common to combine radiation therapy with surgery, chemotherapy, hormone therapy, immunotherapy or some mixture of the four. It may also be used as palliative treatment (where cure is not possible and the aim is for local disease control or symptomatic relief) or as therapeutic treatment (where the therapy has survival benefit and can be curative).
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Radiation may be prescribed by a radiation oncologist with intent to cure ("curative") or for adjuvant therapy. Radiation oncology is the medical specialty concerned with prescribing radiation, and is distinct from radiology, the use of radiation in medical imaging and diagnosis.
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These uncertainties can be caused by internal movement (for example, respiration and bladder filling) and movement of external skin marks relative to the tumor position. It is necessary to include a margin of normal tissue around the tumor to allow for uncertainties in daily set-up and internal tumor motion. Besides the tumour itself, the radiation fields may also include the draining lymph nodes if they are clinically or radiologically involved with the tumor, or if there is thought to be a risk of subclinical malignant spread. To spare normal tissues (such as skin or organs which radiation must pass through to treat the tumor), shaped radiation beams are aimed from several angles of exposure to intersect at the tumor, providing a much larger absorbed dose there than in the surrounding healthy tissue. Ionizing radiation works by damaging the DNA of cancerous tissue leading to cellular death. Radiation therapy is commonly applied to the cancerous tumor because of its ability to control cell growth. A physician who practices in this subspecialty is a radiation oncologist. The subspecialty of oncology concerned with radiotherapy is called radiation oncology.
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Radiation therapy is synergistic with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery to remove a primary malignant tumor (for example, early stages of breast cancer). Radiation therapy may be curative in a number of types of cancer if they are localized to one area of the body. Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator.