Radiation protection in radiation therapy

In order to keep a tumour under control, a sufficiently high dose of radiation is necessary. In many cases, a higher dose leads to a higher likelihood of cure. On the other hand, radiation-sensitive organs at risk surrounding the tumour should be spared as much as possible. This is the only way to largely avoid radiation-induced side effects which in some cases occur only long after radiation therapy and may impair the quality of life of a patient.

Balancing benefits and risks

Every radiation therapy may lead to side effects. For this reason, a so-called justifying indication has to be given by the attending specialist physician prior to radiation treatment for the protection of the patient. This means that a radiation therapy may only be administered if the expected benefit of the therapy (cure of the disease or alleviation of the complaints) outweighs the risk for the patient (occurrence of side effects).

During this balancing, the physician also has to consider whether alternative treatment options exposing the patient to less radiation and promising similar results would be possible.

Protecting the patient

A large number of measures before and during radiation treatment protect the patient from too high a dose of radiation. These include

• an individual radiotherapy treatment plan
• the immobilisation of the irradiated area of the body using positioning aids
• regular verification of the radiation field
• a dose distribution which is optimally adapted to the tumour and the surrounding healthy organs

The basic principle of fractionation (dividing the total radiation dose into many small individual doses, so-called fractions) is aimed at preventing side effects in healthy tissue and thus at protecting the patient.

The development of new forms of therapy (for example the irradiation with protons and heavy ions) is intended to permit the administering of higher doses of radiation while sparing the surrounding healthy organs as much as possible. This is meant to improve cure rates and - at the same time - tolerability which is also in line with radiation protection. Whether it is possible or not, is being investigated as part of clinical studies.