Genba Sopanrao Moze College of Pharmacy, Wagholi, Pune
Cancer continues to be a significant health challenge despite advancements in our understanding of its development and treatment methods. Managing cancer in clinical settings remains highly complex. Currently, healthcare providers employ various treatment modalities, including surgery, chemotherapy, radiation therapy, immunotherapy, and hormone therapy. Recent improvements in radiotherapy technology have greatly enhanced cancer treatment outcomes by providing better tumor control, increasing survival rates, and improving the quality of life for patients. Current research in beam radiation therapy primarily focuses on enhancing techniques such as External Beam Radiation Therapy (EBRT), Intensity-Modulated Radiation Therapy (IMRT), and Proton Therapy to achieve more precise tumor targeting while minimizing damage to adjacent healthy tissues. Additionally, internal radiation therapies like brachytherapy, along with innovative methods such as Stereotactic Body Radiation Therapy (SBRT) and FLASH radiotherapy (FLASH-RT), are gaining traction due to their potential benefits for challenging cancers. Radiation therapy remains a crucial component of cancer treatment; approximately half of all cancer patients will receive radiation at some stage of their care, contributing significantly to curing about 40% of cancers. The fundamental principle behind radiation therapy is straightforward yet vital: it functions by damaging the DNA within cancer cells, inhibiting their ability to grow or replicate. This review aims to examine how radiation therapy operates, its application in contemporary medicine, and the exciting developments aimed at further enhancing its effectiveness.
Radiation therapy—commonly referred to as radiotherapy—is a prevalent and effective method for treating cancer. It utilizes high-energy beams to target and eliminate cancerous cells. The most frequently employed method involves X-rays; however, newer alternatives like proton therapy are also emerging. Often abbreviated as RT, this form of treatment can be administered alone or in conjunction with other therapies like surgery or chemotherapy. While highly effective at combating cancer, radiation therapy does carry certain risks; it can inadvertently affect surrounding healthy tissues and organs leading to severe side effects or lasting damage. Particularly challenging cases include advanced cancers such as glioblastoma brain tumors and pancreatic or lung cancers that often show poor responsiveness to treatments with low survival rates. Fortunately, technological advances have rendered radiation therapy more precise and effective over time. These innovations enable physicians to better target tumors which can lead to improved patient outcomes and higher survival probabilities.
Radiation may be administered through different methods depending on the source's location:
Type
1. External Beam Radiation Therapy (EBRT):
It is widely recognized as the primary form of radiation treatment for cancer. It directs high-energy beams—typically X-rays but occasionally electrons or protons at tumors using machines positioned externally from the patient's body.
Figure 1: External beam radiation therapy
Several advanced variants of EBRT exist that are specifically designed to enhance precision:-
2. Internal Radiation Therapy:
Internal radiation therapy entails positioning a radioactive substance close to the tumor site within the body itself commonly utilized for cancers affecting head/neck regions breast cervix uterus or prostate areas:
Figure 2: Internal beam radiation therapy
Advancement and Technologies Currently Used:
Table 1: Advantages and disadvantages for radiation therapies
Sr No. |
Beam radiation therapy technologies |
Types of cancer treated |
Advantages |
Disadvantages |
1. |
3 dimensional conformal radiotherapy (3DCRT) |
Brain tumors, breast , gastrointestinal (GI) cancer, lung cancer and gynecologic malignancies |
Improve short-term response rate, reduce mouth dryness and parotid gland injury, and promote the prognosis of patients with nasopharyngeal carcinoma. |
Shows higher GI toxicities in patients with endometrial cancers. Difficult to perform correct quality procedures, positioning, imaging, contouring, dosimetry, follow-up, and dose delivery |
2. |
Intensity modulated radiotherapy (IMRT |
Head and neck, prostate, breast, lung, brain, gynecologic, and GI cancers. |
Provides high conformity and high precision. |
IMRT is prone to geometrical errors, due to higher dose conformity indices. |
3. |
Volumetric modulated arc therapy (VMAT) |
Head and neck, non-small cell lung cancer (NSCLC), prostate, gastrointestinal, gynecological, thoracic, central nervous system, and breast tumors |
Provides a full 360° of beam directions with the entire dose volume delivered in a single rotation VMAT treatment shows a lower risk of OAR irradiation and has better homogeneity compared to IMRT. Significant role in uncomfortable immobilization. |
Increase in the low dose radiation to the surrounding tissues and organs, with a greater chance of having secondary malignancies. |
4. |
Image guided radiotherapy (IGRT) |
Prostate, lung and head and neck cancers |
Significant reduction in set-up margins resulting in reduced toxicities in sites with demonstrable, quantifiable, and correctable inter/ or intra- fraction motion |
Uncertainties in target volume delineation, image quality, longer acquisition times, high intra-fractional errors, and extra-dose delivery during daily imaging |
5. |
Stereotactic body radiation therapy (SBRT) |
Prostate, head and neck, spinal, renal,metastases, and pancreatic |
Provides high doses of radiation to the tumor and has low risk of postoperative risk and death. |
Post treatment side-effects. |
6. |
Particle therapy Proton Neutron Carbon |
Stage II–III NSCLC, prostate carcinoma, and hepatocellular carcinoma etc. |
Particle radiation has a higher biological effectiveness and is very effective in radio-resistant cancers. |
The production of particle radiation therapy is much more expensive than the production of photons, and has more logistical requirements |
Challenges And Future Prospects
Current Challenges:
Future Prospects:
1. Advanced Treatment Approaches :
2. Combinatorial Strategies For Enhanced Outcomes :
Objectives:
Striking balance between adequate destruction versus preservation ratios deemed essential ensuring maximizing efficacy whilst safeguarding integrity surrounding cellular constituents encountered therein .
Minimizing collateral damages critical fostering comfortable recoveries thereby improving life quality experienced ultimately benefitting long-term well-being observed through consistent evaluations conducted periodically thereafter .
Modernized interventions aspire not solely eradicate neoplasias aiming simultaneously uplift longevity improving patient lifestyles amidst therapeutic diversifications adopted accordingly henceforth progressing steadily forward .
Innovative techniques evolving protect critical organ functionalities vital preserving essential capabilities such speech/breathing bladder control resonates positively effectuating significant lifestyle enhancements .
Segmental administration distributes cumulative dosages permitting reparatory intermissions aiding recovery whilst compounding cumulative detrimental accrual amongst neoplastic entities facilitating optimal therapeutic potentials realized fully evident thereafter .
CONCLUSION
Concluding insights reveal profound implications inherent beam-radiation applications facilitates impactful survivorship experiences alongside elevated living standards attributable ongoing evolutions witnessed current methodologies emphasizing intensity-modulated strategies coupled stereotactic interventions achieving remarkable efficiency targets preserving adjacent non-cancerous environments concurrently alleviating toxicity concerns faced historically previously exhibited thus underscoring persistent challenges existing particularly addressing resistive formations demanding attention moving forth conclusively directing expansive future inquiries dedicated amalgamative explorations aimed refining holistic therapeutic trajectories advancing patient welfare progressively hence forthwith noted consequently reaffirmed herein.
REFERENCES
Pratiksha Pawar, Tanvi Raskar, Sushma Nakhate, Kiran Bhosale, Dr. Tushar Shelke, Beam Radiation Therapy for Cancer Treatment: Advancements and New Approaches, Int. J. of Pharm. Sci., 2025, Vol 3, Issue 10, 285-292. https://doi.org/10.5281/zenodo.17255329