‫اإلشعاعي‬

‫العالج اإلشعاعي‬
‫أجهزة العالج‬
‫أجهزة‬
‫‪Clinical Radiation Generator‬‬

‫إعـداد‬
‫م‪ .‬أنور صالح عطاالله‬

‫‪May 28, 2025‬‬ ‫‪Clinical Radiation Generator‬‬ ‫‪1‬‬

 ‫المعالجة اإلشعاعية‬
Radiotherapy

‫استخدام اإلشعاع المؤين في معالجة السرطان‬

Using the ionizing Radiation to treat cancer

)‫معالجة خارجية (عن بعد‬

External Beam
Therapy (EBT)
)‫معالجة داخلية (عن قرب‬
Brachytherapy
May 28, 2025 Clinical Radiation Generator 2
Radiotherapy
• One of the main treatment modalities
Siemens Oncology
for cancer (often in combination with
chemotherapy and surgery)
• It is generally assumed that 50 to 60% of
cancer patients will benefit from
radiotherapy
• Minor role in other diseases

May 28, 2025 Clinical Radiation Generator 3

 External Beam Radiotherapy
Beam 2
Beam 3
Beam 1

tumor
patient

May 28, 2025 Clinical Radiation Generator 4

External Beam Therapy (EBT)
 Non-invasive
 Target localization important and beam
placement may be tricky
 Usually multiple beams to place target
in the focus of all beams
Multiple non-
Single beam Three coplanar beam coplanar beams

patient

May 28, 2025 Clinical Radiation Generator 5

 External Beam Radiotherapy
• More than 90% of all radiotherapy patients
are treated using EBT
• Most of these are treated using X-rays
ranging from 20keV to 20MeV in peak-energy
• Other EBT treatment options include telecurie
units (60-Co and 137-Cs), electrons from
linear accelerators and accelerators for heavy
charged particles such as protons

May 28, 2025 Clinical Radiation Generator 6

 Cancer incidence (WHO)

May 28, 2025 Clinical Radiation Generator 7

 Major indications for
radiotherapy
• Head and neck cancers
• Gynaecological cancers (eg. Cervix)
• Prostate cancer
• Other pelvic malignancies (rectum, bladder)
• Adjuvant breast treatment
• Brain cancers
• Palliation
May 28, 2025 Clinical Radiation Generator 8
Approaches
• Palliative radiotherapy to reduce pain and
address acute symptoms - eg bone
metastasis, spinal cord compression, ...
• Radical radiotherapy as primary modality
for cure - eg head and neck
• Adjuvant treatment in conjunction with
surgery - eg breast cancer

May 28, 2025 Clinical Radiation Generator 9

 Patient
Aim Critical
organs
• To kill ALL viable
cancer cells
Beam
• To deliver as much directions target
dose as possible to the
target while
minimising the dose to
surrounding healthy
tissues

May 28, 2025 Clinical Radiation Generator 10

Prognostic Factors
• Cancer type and stage
• Patient performance
• Radiation dose Good prognosis
• ... survival

Bad prognosis
time

May 28, 2025 Clinical Radiation Generator 11

Prognostic Factors
• Cancer type and stage
• Patient performance
• Radiation dose
• ...
Accurate dose delivery
matters!

May 28, 2025 Clinical Radiation Generator 12

Dose should be accurate
• To target:
• 5% too low - may result in clinically detectable
reduction in tumour control (eg. Head and neck
cancer: 15%)
• To normal tissues:
• 5% too high - significant increase in normal
tissue complication probability = morbidity =
unacceptable side effects

May 28, 2025 Clinical Radiation Generator 13

 External beam radiotherapy (EBT)
treatment approaches
• Superficial X-rays
• Orthovoltage X-rays
• Telecurie units
• Megavoltage X-rays
• Electrons
• Heavy charged particles
• Others
May 28, 2025 Clinical Radiation Generator 14
 External beam radiotherapy (EBT)
treatment approaches
• Superficial X-rays 40 to 120kVp
• Orthovoltage X-rays 150 to 400kVp
• Telecurie units 137-Cs and 60-Co
• Megavoltage X-rays Linear accelerators
• Electrons Linear accelerators
• Heavy charged Protons from
particles cyclotron, C, Ar, ...
• Others Neutrons, pions
May 28, 2025 Clinical Radiation Generator 15
 Superficial radiotherapy
• 50 to 120kVp - similar to diagnostic X-ray qualities
• Low penetration
• Limited to skin lesions treated with single beam
• Typically small field sizes
• Applicators required to collimate beam on patient’s
skin
• Short distance between X-ray focus and skin

May 28, 2025 Clinical Radiation Generator 16

 Superficial radiotherapy

Philips RT 100

May 28, 2025 Clinical Radiation Generator 17

 Superficial radiotherapy issues
• Due to short FSD high output and large
influence of inverse square law
• Calibration difficult (strong dose gradient,
electron contamination)
• Dose determined by a timer - on/off effects
must be considered
• Photon beams may be contaminated with
electrons from the applicator
May 28, 2025 Clinical Radiation Generator 18
 Orthovoltage radiotherapy
• 150 - 400kVp
• Penetration sufficient for palliative
treatment of bone lesions relatively close to
the surface (ribs, spinal cord)
• Largely replaced by other treatment
modalities

May 28, 2025 Clinical Radiation Generator 19

60-‫أولجهاز معالجة بالكوبالت‬

1951

ELDORADO“A”
,Installed at Victoria Hospital
London, Ontario, Canada.

May 28, 2025 Clinical Radiation Generator 20

1962 The world’s first isocentric unit

THERATRON 80

Setting the world

standard
for 80 SAD units.

May 28, 2025 Clinical Radiation Generator 21

 Kilovoltage Equipment (150 - 400
kVp)
Depth dose
dramatically
affected by
the FSD

FSD 6cm, FSD 30cm,

HVL 6.8mm Cu HVL 4.4mm Cu

May 28, 2025 Clinical Radiation Generator 22

 Orthovoltage patient set-up
 Like for superficial
irradiation units the
beam is set-up with
cones directly on
the patient’s skin

May 28, 2025 Clinical Radiation Generator 23

 Megavoltage radiotherapy
• 60-Cobalt (energy 1.25MeV)
• Linear accelerators (4 to
25MVp)
• Skin sparing in photon beams
• Typical focus to skin distance
80 to 100cm
• Isocentrically mounted

May 28, 2025 Clinical Radiation Generator 24

 ‫مع أطيب األمنيات‬

May 28, 2025 Clinical Radiation Generator 25