Radiation oncology: historical development in Germany.

In the first period after the discovery of x-rays by Roentgen until World War II, German radiotherapy made major contributions to the development of the specialty. During the Nazi regime and World War II, German doctors were separated from international developments, and after the war the technical standard was poor. It took German radiotherapy a relatively long time to return to international standards again. Because of the difficulties caused by the war, mistakes were made in placing too much emphasis on technical, physical, and biological questions in the publications of the 1960s and 1970s, while in other countries clinical research was promoted. An exception is the work of K. Musshoff (47, 48) from Freiburg. His treatment results in Hodgkin's disease were known and acknowledged internationally. Because of a variety of reasons, it was and is difficult to perform prospective randomized trials in Germany even today. In addition, the turn to the English language in medicine made it difficult for publications written in German to be popular outside of Germany. Therefore, today German journals publish abstracts in English, too. In the meantime, the clinical and technical standard as well as scientific work in German radiotherapy are comparable again to the international level, especially relative to the United States, Great Britain, France, and the Scandinavian countries.