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Brachytherapy: The Original Altered Fractionation

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Alternate Fractionation in Radiotherapy

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

No text related to altered fractionation would be complete without the recognition that the original short-course (altered fractionation) radiotherapy was the initial form of any type of radiotherapy. From the discovery of polonium and radium by Marie and Pierre Curie in the late nineteenth century (Curie and Curie, Proceedings of the academy of science, 1898) and the first use of radium in the treatment of cancer in the late nineteenth century (Eve, Madame Curie: a biography by Eve Curie, Country Life Press, Garden City, NY, 1937), brachytherapy (as it would eventually be termed) used in focused and short treatment courses was established as the original “altered fractionation.” As radiation oncology has metamorphosed from brachytherapy alone to the development of crude contact devices to the evolution to megavoltage 60Co devices and now to the modern platform of artificially produced multi-fraction megavoltage photons over many weeks (to months) of therapy, the paradigm has shifted backwards. As Dr. Ted Yaeger has so eloquently termed this paradigm shift in the Introduction of this book, “We wish this book to be atouch-stoneto re-kindle interest in the development of a new paradigm in radiotherapy … altered fractionation.” The “touchstone” term is deliberately used to identify a refocusing of our efforts toward a new fractionation which is, in the most basic sense, a return to our roots. From the historic to the modern treatment of cervical cancer where brachytherapy is essential, to the modern treatment of breast cancer, where brachytherapy is a now accepted option for early-stage disease (Polgar et al., Radiother Oncology, 108:197–202, 2013; Strnad et al., Lancet, 387: 229–238, 2016; Wenz et al., Breast Care, 10:247S2, 2015; Cuttino et al., International Journal of Radiation Oncology, Biology, Physics, 90(5):1025–1029, 2014; Shah et al., Brachytherapy, 12:267–277, 2013; Polgar et al., Brachytherapy: an international perspective, Springer, Berlin, 2016), this altered fraction modality has maintained a prominent place in the armamentarium of radiation oncology.

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Authors and Affiliations

  1. Allegheny General Hospital, Allegheny Health Network Cancer Institute, Professor of Radiation Oncology, Drexel University College of Medicine, Pittsburgh, Pennsylvania, USA

    Mark Trombetta

  2. Professor, Head of Brachytherapy Department, Greater Poland Cancer Centre, Associate Professor, Electroradiology Department (secondary), Poznan University of Medical Science, Poznań, Poland

    Janusz Skowronek

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Correspondence to Mark Trombetta .

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Editors and Affiliations

  1. Allegheny General Hospital Allegheny Health Network Cancer Institute, Drexel University College of Medicine, Pittsburgh, PA, USA

    Mark Trombetta

  2. Radiation Oncology Department, Erasmus University Medical Center, Rotterdam, The Netherlands

    Jean-Philippe Pignol

  3. Allegheny Health Network, Temple University School of Medicine, Pittsburgh Campus, Pittsburgh, PA, USA

    Paolo Montemaggi

  4. Hylda Cohn/American Cancer Society, Drexel University College of Medicine, Philadelphia, PA, USA

    Luther W. Brady

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Trombetta, M., Skowronek, J. (2017). Brachytherapy: The Original Altered Fractionation. In: Trombetta, M., Pignol, JP., Montemaggi, P., Brady, L.W. (eds) Alternate Fractionation in Radiotherapy. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2017_95

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