Technological Advancements in External Beam Radiation Therapy (EBRT): An Indispensable Tool for Cancer Treatment

Abstract

Krishna Koka,1 Amit Verma,2 Bilikere S Dwarakanath,3 Rao VL Papineni2,4 1Penn State University, Pennsylvania, PA, USA; 2PACT & Health LLC, Branford, CT, USA; 3Central Research Facility, Sri Ramachandra Institute of Higher Education and Research Porur, Chennai, India; 4Department of Surgery, University of Kansas Medical Center, Kansas City, KS, USACorrespondence: Rao VL Papineni; Amit Verma, PACT & Health LLC, Branford, CT, USA, Tel [phone] ; Tel [phone], Email [email protected]; [email protected]; [email protected]: Recent technological advancements have increased the efficacy of radiotherapy, leading to effective management of cancer patients with enhanced patient survival and improved quality of life. Several important developments like multileaf collimator, integration of imaging techniques like positron emission tomography (PET) and computed tomography (CT), involvement of advanced dose calculation algorithms, and delivery techniques have increased tumor dose distribution and decreased normal tissue toxicity. Three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), stereotactic radiotherapy, image-guided radiotherapy (IGT), and particle therapy have facilitated the planning procedures, accurate tumor delineation, and dose estimation for effective personalized treatment. In this review, we present the technological advancements in various types of EBRT methods and discuss their clinical utility and associated limitations. We also reveal novel approaches of using biocompatible yttrium oxide scintillator-photosensitizer complex (YSM) that can generate X-ray induced cytotoxic reactive oxygen species, facilitating X-ray activated photodynamic therapy (XPDT (external beam) and/or iXPDT (internal X-ray source)) and azido-derivatives of 2-deoxy-D-glucose (2-DG) as agents for site-specific radiation-induced DNA damage.Keywords: radiotherapy, external beam, computed tomography, 2-deoxy-D-glucose, 2-DG, 2-azido-2-deoxy-D-glucose, 2-AZ-2-DG

Keywords

• radiotherapy
• external beam
• computed tomography
• 2-deoxy-d-glucose (2-dg)
• 2-azido-2-deoxy-d-glucose (2-az-2-dg)