Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, 30 Fruit St., Boston, MA 02114, USA.
Br J Radiol. 2011 Jun;84(1002):485-98. doi: 10.1259/bjr/86221320.
The remarkable progress in radiation therapy over the last century has been largely due to our ability to more effectively focus and deliver radiation to the tumour target volume. Physics discoveries and technology inventions have been an important driving force behind this progress. However, there is still plenty of room left for future improvements through physics, for example image guidance and four-dimensional motion management and particle therapy, as well as increased efficiency of more compact and cheaper technologies. Bigger challenges lie ahead of physicists in radiation therapy beyond the dose localisation problem, for example in the areas of biological target definition, improved modelling for normal tissues and tumours, advanced multicriteria and robust optimisation, and continuous incorporation of advanced technologies such as molecular imaging. The success of physics in radiation therapy has been based on the continued "fuelling" of the field with new discoveries and inventions from physics research. A key to the success has been the application of the rigorous scientific method. In spite of the importance of physics research for radiation therapy, too few physicists are currently involved in cutting-edge research. The increased emphasis on more "professionalism" in medical physics will tip the situation even more off balance. To prevent this from happening, we argue that medical physics needs more research positions, and more and better academic programmes. Only with more emphasis on medical physics research will the future of radiation therapy and other physics-related medical specialties look as bright as the past, and medical physics will maintain a status as one of the most exciting fields of applied physics.
在过去的一个世纪里，放射治疗取得了显著的进展，这在很大程度上要归功于我们能够更有效地将辐射聚焦并输送到肿瘤靶区。物理发现和技术发明是这一进展的重要推动力。然而，通过物理手段，如图像引导、四维运动管理和粒子治疗，以及提高更紧凑、更便宜技术的效率，仍有很大的改进空间。物理学家在放射治疗方面面临着更大的挑战，除了剂量定位问题，还包括生物靶区定义、正常组织和肿瘤的改进建模、先进的多标准和稳健优化，以及不断融入先进的技术，如分子成像。物理学在放射治疗中的成功基于物理研究的新发现和发明不断为该领域提供“燃料”。成功的关键是应用严格的科学方法。尽管物理研究对放射治疗至关重要，但目前参与前沿研究的物理学家太少了。对医学物理更“专业化”的强调将使这种情况更加失衡。为了防止这种情况发生，我们认为医学物理需要更多的研究职位，以及更多更好的学术项目。只有更加重视医学物理研究，放射治疗和其他与物理相关的医学专业的未来才会像过去一样光明，医学物理也将保持其作为应用物理最令人兴奋的领域之一的地位。
