ABSTRACT
Organized radiation therapy actively participated in political activities that supported growth of its devices and departments in the face of its concerns about clinical effectiveness. Radiotherapy leaders used temporal correlations between voltage increases and survival gains to claim a causal connection between the two. In general, cancer treatment trends in California in the 1940s and 1950s moved toward surgery and away from radiation. Although improvements in surgical technique and availability of antibiotics to control postsurgical infections would have played a role in the growing preference for surgery, the decline in radiation use in the first treatment course suggests that some doctors were wrestling with their faith in the technology. Clinicians were chagrined when more time and more patients showed essentially equivalent survival rates for all supervoltage devices—and even, in a number of cases, survival rates equivalent to those of kilovoltage. Many radiation therapy leaders have retrospectively portrayed the linear accelerator as the ultimate in device achievement.
