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Radiation Therapy

Using focused beams or radioactive particles to kill tumour cells while sparing healthy tissue.

External beam radiation has moved from 2D fields to intensity-modulated, image-guided, stereotactic, and particle (proton, carbon) therapy. Adaptive and MR-guided delivery, ultra-high dose rate FLASH, and combination with immunotherapy are the frontier. Radiopharmaceuticals deliver radiation systemically to a molecular target.

Radiation Therapy: how this front works · animated schematic, not to scale

Technologies

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Established
AI auto-contouring and adaptive planning

Software that draws organs and tumours on scans automatically, saving hours per patient and making daily plan adaptation practical.

Approved
Boron neutron capture therapy

In boron neutron capture therapy a boron drug accumulates in tumour cells, then a neutron beam makes only those cells explode from inside.

Standard of care
Brachytherapy

Brachytherapy places a radioactive source directly inside or next to the tumour.

Established
Carbon-ion therapy

Heavier charged particles that kill even radiation-resistant tumours, available at only a handful of centres worldwide.

Phase 1
FLASH radiotherapy

Delivering an entire dose in under a second, which in animals spares healthy tissue while still killing the tumour.

Established
Hyperthermia

Hyperthermia heats tumours to 40-43 °C to make radiation and chemotherapy work better.

Standard of care
IMRT / IGRT (modern external beam)

Radiation shaped precisely to the tumour and checked with daily imaging, sparing surrounding organs.

Established
Intraoperative radiotherapy (IORT)

Giving a single large dose of radiation directly to the tumour bed during surgery, with normal organs moved out of the way; used mainly in breast cancer as an alternative to weeks of external radiotherapy.

Phase 2
Lattice and GRID radiotherapy

Deliberately treating a big tumour unevenly, with a lattice of very high dose peaks inside it, instead of a uniform dose.

Phase 2
Magnetic nanoparticle hyperthermia

Magnetic nanoparticle hyperthermia injects iron-oxide nanoparticles into a tumour and heats them from outside with an alternating magnetic field.

Established
MR-guided adaptive radiotherapy

The MR-linac is a radiation machine with an MRI inside it, so the plan is adjusted to where the tumour is that very day.

Standard of care
Palliative radiotherapy

Short courses of radiation, often a single treatment, to relieve pain from bone metastases, stop bleeding, open blocked airways or protect the spinal cord. Among the most cost-effective treatments in cancer.

Established
Prophylactic cranial irradiation vs MRI surveillance

Small-cell lung cancer spreads to the brain so often that doctors used to irradiate the whole brain pre-emptively. Regular MRI scans are now challenging that practice.

Phase 1
Proton arc therapy

Rotating the proton beam continuously around the patient instead of firing from a few fixed angles, to spread the entrance dose and sharpen the target dose.

Established
Proton therapy

Radiation using protons, which stop inside the tumour instead of passing through, so tissue behind it gets no dose.

Phase 2
Radiodynamic therapy and radiosensitising nanoparticles

Nanoparticles that turn ordinary radiotherapy X-rays into a much bigger dose exactly where they sit.

Established
Radioembolisation (TARE / SIRT, yttrium-90)

Millions of tiny radioactive glass or resin beads are injected into the liver artery, lodging in the tumour and irradiating it from within.

Standard of care
Radioiodine therapy and whole-body iodine scanning

Using the thyroid's natural appetite for iodine to image and treat thyroid cancer with a radioactive form of it. The oldest theranostic, and now used more selectively than it was.

Approved
Radioligand therapy (beta emitters)

A drug that finds tumour cells and carries a radioactive atom that irradiates them from inside the body.

Standard of care
Radiotherapy treatment planning and QA software

The software that calculates exactly how radiation beams should be shaped and checks the machine delivered it.

Standard of care
SBRT / SABR (stereotactic radiotherapy)

Very high, very precise radiation doses in 1-5 sessions that can ablate a tumour like surgery.

Phase 2
Sonodynamic therapy

A drug that does nothing until ultrasound hits it, then kills the cells that took it up. Being tested in brain tumours because sound reaches where light cannot.

Preclinical
Very-high-energy electron therapy

Using very fast electrons instead of photons or protons: a possible way to deliver FLASH-speed radiation to deep tumours from a compact machine.

Connected

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technologies

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companies

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institutions

83
Aarhus University HospitalAll India Institute of Medical Sciences, New DelhiAmerican Society for Radiation OncologyApollo Hospitals (Apollo Cancer Centres)Cancer Care Alberta (Alberta Health Services)Cancer Center Clínica Universidad de Navarra / CIMACancer Institute (WIA), AdyarCentre Antoine LacassagneCentre Oscar LambretChampalimaud Foundation – Champalimaud Clinical CentreChang Gung Memorial HospitalCharlotte Maxeke Johannesburg Academic Hospital / University of the WitwatersrandChris O'Brien LifehouseComprehensive Cancer Center Freiburg (CCCF)Comprehensive Cancer Center Mainfranken, University Hospital WürzburgComprehensive Cancer Center Vienna – Medical University of Vienna / AKHDharmais National Cancer CenterEuropean Society for Radiotherapy and OncologyEuropean Society of Gynaecological OncologyFundación Arturo López PérezGroote Schuur Hospital / University of Cape TownGunma University Heavy Ion Medical CenterHacettepe University Cancer InstituteHarold C. Simmons Comprehensive Cancer Center, UT SouthwesternHealthCare Global EnterprisesHo Chi Minh City Oncology HospitalHokkaido University HospitalHospital Universitari i Politècnic La FeHunan Cancer HospitalInstitut National d'Oncologie, RabatInstitut Salah AzaïezInstitute of Oncology LjubljanaInstituto Nacional de Cancerología (Mexico)Instituto Nacional de Enfermedades NeoplásicasInstituto Português de Oncologia do Porto Francisco GentilInternational Atomic Energy Agency – Rays of HopeInternational Extranodal Lymphoma Study GroupIRCCS Humanitas Research HospitalIstanbul University Institute of OncologyJuravinski Cancer Centre / Escarpment Cancer Research InstituteKenyatta National HospitalKidwai Memorial Institute of OncologyKing Faisal Specialist Hospital and Research CentreKoo Foundation Sun Yat-Sen Cancer CenterKorle Bu Teaching HospitalLagos University Teaching HospitalLeeds Cancer Centre, St James's University HospitalMaria Skłodowska-Curie National Research Institute of OncologyMasaryk Memorial Cancer InstituteMayo Clinic Comprehensive Cancer Center – FloridaNational Cancer Center Hospital EastNational Cancer Center KoreaNational Cancer Centre SingaporeNational Cancer Institute, Cairo UniversityNational Institute of Oncology, HungaryNational Taiwan University HospitalNCT/UCC Dresden – University Hospital Carl Gustav CarusO'Neal Comprehensive Cancer Center at UABOcean Road Cancer InstituteOxford Cancer – Oxford University Hospitals and University of OxfordPostgraduate Institute of Medical Education and Research, ChandigarhQST Hospital (National Institutes for Quantum Science and Technology)Rajiv Gandhi Cancer Institute and Research CentreRoyal Adelaide HospitalShandong Cancer Hospital and InstituteShizuoka Cancer CenterSidney Kimmel Comprehensive Cancer Center at Jefferson HealthTaipei Veterans General HospitalTata Medical Center, KolkataTawam HospitalTianjin Medical University Cancer Institute and HospitalTROG Cancer ResearchUMC Utrecht Cancer CenterUnion Hospital, Tongji Medical CollegeUniversity College London Hospitals / UCL Cancer InstituteUniversity of Florida Health Cancer CenterUniversity of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer CenterUppsala University Hospital / Uppsala UniversityUZ Leuven / Leuven Cancer InstituteVelindre Cancer CentreVietnam National Cancer Hospital (K Hospital)West German Cancer Center (WTZ), University Hospital EssenZhejiang Cancer Hospital

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