Brachytherapy - History

History

Brachytherapy dates back to 1901 (shortly after the discovery of radioactivity by Becquerel in 1896) when Pierre Curie suggested to Henri-Alexandre Danlos that a radioactive source could be inserted into a tumour. It was found that the radiation caused the tumour to shrink. Independently, Alexander Graham Bell also suggested the use of radiation in this way. In the early twentieth century, techniques for the application of brachytherapy were pioneered at the Curie institute in Paris by Danlos and at St Luke's and Memorial Hospital in New York by Robert Abbe.

Interstitial radium therapy was common in the 1930's. Gold seeds filled with radon were used as early as 1942 until at least 1958. Gold shells were selected by Gino Failla around 1920 to shield beta rays while passing gamma rays. Cobalt needles were also used briefly after world war II. Radon and cobalt were replaced by radioactive tantalum and gold, before iridium rose in prominence. First used in 1958, iridium is the most commonly used artificial source for brachytherapy today.

Following initial interest in brachytherapy in Europe and the US, its use declined in the middle of the twentieth century due to the problem of radiation exposure to operators from the manual application of the radioactive sources. However, the development of remote afterloading systems, which allow the radiation to be delivered from a shielded safe, and the use of new radioactive sources in the 1950s and 1960s, reduced the risk of unnecessary radiation exposure to the operator and patients. This, together with more recent advancements in three dimensional imaging modalities, computerised treatment planning systems and delivery equipment has made brachytherapy a safe and effective treatment for many types of cancer today.