X-ray therapy

Radiotherapy is a treatment method that uses X-rays or other types of ionizing radiation to treat a variety of medical conditions, including cancer and certain other diseases. This method is also called radiotherapy or radiation therapy.

The basic principles of radiotherapy include:

1. Ionization: X-rays and other types of ionizing radiation have enough energy to rip electrons from atoms and molecules in body tissues. This can cause DNA damage inside cells and lead to cell death.
2. Localization: The X-ray procedure usually focuses as much as possible on the specific area of the body where the disease is located. This minimizes damage to surrounding healthy tissue.
3. Fractionation: Radiotherapy is usually performed in several sessions (fractions) over a period of time. This allows healthy tissue to recover between sessions and increases the effectiveness of the treatment.

Radiotherapy can be used to treat a variety of cancers including:

• Breast cancer
• Prostate cancer
• Lung cancer
• Cervical cancer
• Stomach cancer
• Head and neck cancer
• Skin cancer
• Other cancers

It can also be used to treat certain non-tumor diseases such as skin conditions, arthritis, and other conditions.

X-ray therapy is administered in specialized medical facilities and usually requires careful planning and monitoring under the supervision of specialists in oncology and radiology. It is important to keep in mind that X-ray therapy can cause side effects and the decision to administer it is always made on an individual basis, taking into account the benefits and risks to the patient. [1]

Indications for the procedure

Indications for radiotherapy include:

1. Cancer: X-ray therapy is used to treat various types of cancer, including breast, lung, stomach, prostate, cervical, and others.
2. Malignant tumors: This technique can be used to treat malignant tumors in different parts of the body, including skin (such as melanoma), head and neck, soft tissue, and bone.
3. Neuroendocrine tumors: X-ray therapy can be used to treat neuroendocrine tumors such as carcinoid tumors.
4. Lymphoma: Radiotherapy can be part of a comprehensive treatment for patients with different types of lymphoma.
5. Sarcoma: Sarcomas, which are malignant tumors of soft tissue or bone, may also be treated with radiation therapy.
6. Metastases: If the cancer has spread to other organs or tissues, radiotherapy may be used to control and treat metastases.

The indications for X-ray therapy depend on the specific clinical case, the stage of the disease and the treatment plan developed by the physician. It is important to consult with a medical professional to determine the best treatment method for your case. [2]

X-ray therapy can be used to treat a variety of conditions and diseases, including joints, heel spurs, and basalioma. Here is a brief description of X-ray therapy for these cases:

1. Joint X-ray therapy: X-ray therapy can be used to treat inflammatory and degenerative joint diseases such as arthritis and osteoarthritis. X-ray beams are directed at the affected joint in order to reduce inflammation and pain. This method can help slow the progression of the disease and relieve symptoms, but its use may be limited due to the risk of damaging surrounding tissues.
   • Knee X-ray therapy: X-ray therapy can be used to treat knee joint pain caused by arthritis or other conditions. X-ray beams can be directed at the knee joint to reduce inflammation and pain.
   • Shoulder X-ray therapy: X-ray therapy can be used for inflammatory conditions of the shoulder joint, such as arthritis. It can help reduce pain and inflammation in the shoulder area.
2. Heel SpurRadiotherapy: A heel spur is a growth of bone tissue on the heel bone that can cause heel pain. X-ray therapy may be one treatment option to reduce pain and inflammation in the heel spur area.
3. Basalioma X-ray therapy: Basalioma is a type of malignant skin tumor that can occur on various parts of the body, including the face. X-ray therapy can be used in basaloma treatment to destroy cancer cells and prevent them from growing.
4. X-ray therapy of the lower lip: X-ray therapy can be used to treat malignant tumors such as lip cancer. The goal of radiation therapy in this case is to destroy or reduce the size of the tumor and prevent it from growing. Different forms of radiotherapy may be used depending on the specific characteristics of the tumor and the patient.
5. X-ray therapy for hemangiomas: Hemangiomas are vascular masses that can develop in the skin or inside organs. X-ray therapy can be one treatment for hemangiomas, especially in cases where they can cause problems such as bleeding or pressure on surrounding tissues.
6. Spine X-ray therapy: Spine X-ray therapy may be used to treat certain tumors or diseases of the spine, such as spinal cancer or cancer metastases. The goal of radiation therapy in this case is to shrink or destroy the tumor and alleviate symptoms.
7. X-ray therapy for osteomyelitis: Osteomyelitis is an infectious inflammatory disease of the bones and brain. X-ray therapy can be used in combination with other treatments, such as antibiotics and surgery, to fight osteomyelitis. Radiation therapy can help kill bacteria and soothe inflammation.

It is important to note that X-ray therapy can have side effects and risks and should be administered under the supervision of experienced medical professionals. The treatment plan and dosage will depend on the specific disease and clinical features of each patient. Therefore, you should consult your doctor for details about the possibility of using X-ray therapy in your specific case.

Preparation

Preparation for X-ray therapy can vary depending on the type and location of the cancer to be treated and the individual patient. However, preparation usually includes the following steps:

1. Consultation with anoncologist: Before starting X-ray therapy, you will have a consultation with an oncologist. The doctor will analyze your medical data, determine the stage of your cancer and decide whether X-ray therapy is suitable for your case.
2. Preparing a treatment plan: Your doctor and team of specialists will develop an individualized X-ray treatment plan that will take into account the size, shape and location of the tumor, as well as the patient's health.
3. X-rays and CT scans: X-rays, CT scans, or MRI scans may be needed to accurately locate the tumor and plan treatment. These studies can help doctors better visualize the cancer and surrounding tissues.
4. Diet: Depending on the location of the tumor, you may need certain dietary recommendations before treatment begins. For example, if radiation therapy will be directed to the abdominal area, you may be advised to temporarily eliminate certain foods from your diet.
5. Avoiding certain medications and supplements: Your doctor may ask you to temporarily stop using certain medications, such as anticoagulants, and supplements that may affect the results of radiation therapy.
6. Marking for precise positioning: In some cases, you may have markings placed on your skin to ensure precise positioning during each treatment session.
7. Psychological preparation: Radiotherapy can be emotionally and physically taxing. Psychological support and counseling can help you cope with stress and anxiety.
8. Adherence to doctor's recommendations: It is important to strictly follow all doctor's recommendations and follow the treatment plan. This includes attending X-ray therapy sessions at scheduled times and following all diet and medication cessation instructions.

Your doctor and medical team will explain to you in detail all the steps involved in preparing for and carrying out X-ray therapy. It is important to discuss all your questions and concerns with them so that you can be prepared for the treatment and make it as effective and safe as possible.

Technique of the radiotherapy

The technique of x-ray therapy includes the following basic steps:

1. Treatment Planning:

• Diagnosis: The patient first undergoes a diagnostic test to determine the size and spread of the tumor or affected tissue. This may include computed tomography (CT), magnetic resonance imaging (MRI), and other educational diagnostic techniques.
• Determining the target area: Radiologists and oncologists determine the exact location of the tumor and tissue to be irradiated.

1. Creating a treatment plan:

• Dose Development: Specialists determine the dose of radiation needed to destroy or shrink a tumor while minimizing the impact on surrounding healthy tissue.
• Trajectory calculation: Taking into account the tumor size and localization, the optimal trajectory of the beams to be used during treatment is determined.

1. Performing X-ray therapy:

• The patient is laid on the table of a treatment machine, usually a linear gas pedal.
• Specialists ensure that the patient is positioned accurately by using special fixation devices such as masks, pillows or special skirts.
• The linear gas pedal generates X-rays that are directed at the target area specified in the treatment plan. The beams pass through the skin and then irradiate the target area.
• Treatments can last only a few minutes and are given daily for weeks or months, depending on the treatment plan.

1. Monitoring and control:

• The patient is under constant medical supervision during treatment. Controls such as real-time imaging (e.g. X-ray fluoroscopy) are used to ensure that the beams are accurately aimed at the target.
• Treatment is adapted as needed depending on tumor response and changes in size.

1. Outcome Assessment:

• After treatment is completed, the effectiveness of the treatment is evaluated, for example, through repeat diagnostic tests to determine whether the tumor size has been reduced or cancer cells have been destroyed.

X-ray therapy is performed under strict medical supervision and control, eliminating doses and minimizing exposure to surrounding tissues. This maximizes the effectiveness of the treatment with minimal side effects. [3]

Depending on the parameters and characteristics of the rays, as well as the distance of their source from the patient, there are several varieties of X-ray therapy:

1. Superficial X-ray therapy (superficial X-ray therapy): In this technique, X-ray beams are used to treat superficial tumors or skin conditions such as basaliomas or skin cancer. The source of the rays is close to the surface of the body.
2. Short-distance X-ray therapy (orthovoltage X-ray therapy): This technique uses medium-energy X-rays to treat tumors located slightly deeper under the skin. The source of the beams is located some distance from the patient.
3. Remote X-ray therapy (teletherapy): In remote X-ray therapy, the source of the beams is located at a considerable distance from the patient and the X-ray beams are directed at the tumor from the outside. It is the most common type of radiotherapy and is used to treat different types of tumors.
4. Long-focus X-ray therapy (megavoltage X-ray therapy): This method uses high-energy (megavoltage) X-ray beams and can penetrate deeper into tissue, making it more effective for treating deep-seated tumors. [4]
5. Deep X-ray therapy (deep X-ray therapy): This technique was developed to treat certain types of cancer located deep inside organs, such as deep in the soft tissue layers.
6. Orthovoltage X-ray therapy (kilovoltage X-ray therapy): This is a variation of short-distance X-ray therapy that uses lower energy (kilovoltage) X-rays.

Types of X-ray therapy

Here are some of the main types of X-ray therapy:

1. External beam therapy: This is the most common method of radiotherapy. An external beam source (radiation machine) is directed to a specific area of the patient's body to irradiate the tumor. This method is used for a variety of cancers and can be used for both radical treatment and palliative purposes.
2. Internal radiation therapy (brachytherapy): In this method, the radiation source is placed directly inside or near the tumor. This allows a higher dose of radiation therapy to be delivered to the target area while minimizing the effects on surrounding tissue. Brachytherapy is used, for example, to treat prostate or cervical cancer.
3. Tomotherapy: This is a modern method of external beam radiation therapy that combines X-rays and computed tomography (CT). Tomotherapy allows more precise irradiation of the tumor while minimizing the impact on healthy tissue.
4. Intensity Modulated Radiation Therapy (IMRT): IMRT is an advanced form of external beam radiation therapy where radiation beams are adjusted so that they can be varied in intensity and direction, allowing for more precise radiation therapy dose shaping and irradiation of the tumor while minimizing adjacent organs and tissues.
5. Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT): These techniques are designed to treat small tumors or metastases in or near the brain and other organs. They allow high doses of radiation to be delivered precisely to a very small area in one or more sessions.

The choice of X-ray therapy method depends on the type of tumor, its location, stage of the disease, general condition of the patient and other factors.

Contraindications to the procedure

Radiotherapy, like any medical procedure, may have contraindications. These may vary depending on the specific condition of the patient and the purpose of the radiotherapy. Here are some common contraindications to radiotherapy:

1. Pregnancy: Radiotherapy may adversely affect the developing fetus and is therefore not usually performed in pregnant women. If treatment is urgently needed, a detailed discussion of risks and benefits should be held with the patient and specialists.
2. Cardiovascular Disease: Patients with serious heart and vascular disease may have limitations for X-ray therapy, as the procedure may increase the workload on the heart.
3. Immunodeficiency conditions: Patients with reduced immunity, such as those living with HIV or those taking immunosuppressive medications, may be more vulnerable to the side effects of radiotherapy.
4. Severe general weakness or exhaustion: Patients who are too weak may not be able to tolerate X-ray therapy and it may worsen their condition.
5. Previous radiotherapy: Some patients who have had radiotherapy in the past may have restrictions on having repeat radiotherapy in the same area.
6. Special medical conditions: Patients with certain conditions, such as active infections or severe inflammation in the area to be treated, may also have contraindications.

These are just general examples of contraindications, and each case must be considered individually by the oncologist or radiologist who evaluates the patient and makes a decision about the appropriateness and safety of radiotherapy.

Consequences after the procedure

The effects after an X-ray therapy procedure can vary depending on a variety of factors, including the dose of radiation therapy, the area of radiation, the type of tumor, the patient's condition, and more. In most cases, patients can expect both temporary and long-term effects. Here are some of them:

1. Temporary side effects:

• Fatigue and weakness.
• Redness or irritation of the skin in the irradiated area.
• Localized pain or discomfort.
• Changes in taste sensation or appetite.
• Loss of hair in the irradiated area (alopecia).

1. Increased risk of infections: Radiotherapy can suppress bone marrow function and weaken the immune system, which increases the risk of infections.
2. Damage to blood vessels and tissues: In some cases, X-ray therapy may cause damage to surrounding blood vessels and tissues, which may result in bleeding or painful symptoms.
3. Long-term implications:

• Development of secondary tumors in the area of irradiation.
• Risk of developing chronic diseases in the future.
• Changes in the skin (such as scarring or pigmentation).

It is important to note that most side effects of X-ray therapy are temporary and diminish after treatment is completed. Long-term effects, such as the risk of developing secondary tumors, may occur years later and require long-term follow-up by physicians.

Every patient is unique, and the effects of X-ray therapy will vary. Physicians carefully monitor and warn against possible risks and side effects when developing a treatment plan and providing care recommendations after the procedure. Patients should discuss all possible outcomes and issues in detail with their medical professional so that they can be prepared and receive the necessary support and treatment if needed.

Complications after the procedure

Radiotherapy (radiation therapy) can cause a variety of complications, and their nature can depend on many factors, including the type of tumor, its location, the dose of radiation therapy, and the individual patient. Complications can be temporary or long-term. Here are some of the possible complications:

1. Skin redness and irritation: If X-ray therapy is directed to an area close to the surface of the skin, the patient may develop redness, dryness, itching or even burning of the skin. These symptoms are usually temporary and disappear after treatment is completed.
2. Fatigue and weakness: Radiation therapy can cause fatigue and weakness, especially during treatment. This may be due to the effects on healthy tissues and the immune system.
3. Hair loss: If X-ray therapy is given to the scalp area, it may cause temporary or permanent hair loss in the exposed area.
4. Digestive changes: X-ray therapy to the stomach area may cause digestive problems, nausea, vomiting, diarrhea, or changes in appetite.
5. Urologic complications: Radiation therapy to the pelvic area can affect the function of the genitourinary system and cause urologic symptoms.
6. Breathing problems: X-ray therapy to the sternum area can cause breathing problems, especially if it targets the lungs.
7. Skin infections: In rare cases, radiotherapy may increase the risk of skin infections in the area of radiation.
8. Long-term complications: Some complications may occur several years after X-ray therapy is completed, such as radio-induced tumors (secondary tumors caused by radiation therapy) and long-term changes in tissues and organs.

It is important to note that the treating physician should provide detailed information about possible complications and assess the risks and benefits of X-ray therapy for each individual case.

Care after the procedure

After an X-ray therapy procedure, it is important to follow your healthcare professional's recommendations to ensure a safe recovery and minimize possible side effects. Here are some general guidelines for care after x-ray therapy:

1. Stay under observation: After each X-ray therapy session, you may remain under medical supervision for a period of time to monitor your condition and assess your response to treatment.
2. Avoid unnecessary pressureon the irradiated area: It is important to avoid unnecessary pressure, friction or rubbing of the irradiated skin area. This can prevent irritation and damage to the skin.
3. Skin care: If yourskin is irradiated, use mild and non-greasy skin care products. Do not use soap or cosmetics on the irradiated area without consulting your doctor.
4. Avoid sun exposure: Irradiated skin can be more sensitive to sunlight. Therefore, avoid direct sunlight and use sunscreen with a high SPF if you have to go outdoors.
5. Consider nutrition: Maintain a healthy diet and drink enough fluids. This can help tissue repair and ease the side effects of treatment.
6. Take prescribed medications: If you are prescribed medications to relieve pain or manage side effects, follow your doctor's instructions and take them as scheduled.
7. Maintain your emotional well-being: X-ray therapy can be a physically and emotionally demanding procedure. Maintain your emotional well-being, communicate with your loved ones and, if necessary, consult a psychologist or psychotherapist.
8. Follow yourdoctor's recommendations: It is important to communicate regularly with your healthcare professional and follow all of their recommendations for care and monitoring after x-ray therapy.
9. Watch for side effects: If you experience any new symptoms or side effects after X-ray therapy, tell your doctor. Some side effects may require specific treatment.

Remember, care after X-ray therapy is individualized and may vary depending on your condition and treatment plan. Follow your health care professional's recommendations to ensure a successful recovery and maximize the effectiveness of your treatment.

List of authoritative books and studies related to the study of radiotherapy

1. "Principles and Practice of Radiation Therapy" - by Charles M. Washington (Year: 2020)
2. "Radiation Therapy Planning" - by Gunilla C. Bentel (Year: 2015)
3. "Clinical Radiation Oncology" - by Leonard L. Gunderson, Joel E. Tepper (Year: 2015)
4. "Radiation Therapy for Cancer" - by Dr. Brian L. Ang (Year: 2021)
5. "Radiation Therapy Physics" - by William R. Hendee (Year: 2004)
6. "Radiation Oncology: A Question-Based Review" - by Borislav Hristov (Year: 2013)
7. "Radiation Therapy Study Guide: A Radiation Therapist's Review" - by Amy Heath (Year: 2020)
8. "Radiation Therapy Treatment Effects: An Evidence-Based Guide to Managing Toxicity" - by Bridget F. Koontz, Robert E. Fitch, Andrzej Niemierko (Year: 2016)
9. "The Physics of Radiation Therapy" - by Faiz M. Khan, John P. Gibbons (Year: 2014)
10. "Introduction to Radiologic Sciences and Patient Care" - by Arlene M. Adler, Richard R. Carlton (Year: 2021)
11. "The Physics of Clinical MR Taught Through Images" - by Val M. Runge, Wolfgang Nitz (Year: 2017)
12. "Radiobiology for the Radiologist" - by Eric J. Hall, Amato J. Giaccia (Year: 2018)

Literature

• Maria Makarova, Orthovoltage radiotherapy in the treatment of osteoarthritis, LAP Lambert Academic Publishing, 2014.
• Fundamentals of Radiation Diagnosis and Therapy. National Manual on Radiation Diagnostics and Therapy. Edited by S.K. Ternovoy, GEOTAR-Media, 2013.