Overview
Shortly after Roentgen discovered radiographs in 1895, their clinical usefulness as a means of cancer treatment was first appreciated. Since that time, radiation therapy has developed into a recognized medical specialty. The Curie family discovered radium in 1898. Alexander Graham Bell suggested its use in brachytherapy for direct implantation in malignant tumors.
The lack of a precise method of measuring dosage limited the early use of radiation therapy. An early prescription typically called for an erythema dose as the standard unit of radiation. One of the limiting factors in early treatment was skin tolerance.
This hurdle was overcome by Coutard’s recognition of the usefulness of fractionation—that is, dividing the dose into several smaller increments rather than administering a single massive dose. At the same time, high-energy supervoltage was developed, and later, megavoltage-dedicated radiotherapy units were introduced.
A study by Atun et al reported that there is currently a large gap worldwide between the need for radiation therapy and the ability to access it, with the investigators estimating that global expansion of such access between 2015 and 2035 in low- and middle-income countries could save 26.9 million life-years and produce a net economic benefit over 20 years of $278.1 to $365.4 billion.