ABSTRACT
Brachytherapy has been used for the treatment of disease from the very early days of radiation discovery. 226Ra provided a very stable source of gamma radiation and in the rst two decades of the twentieth century was applied to many clinical settings, in particular, intracavitary treatment of gynecological tumors and surface treatment of skin and breast tumors. ere was little attention paid to radiation protection or the hazards of radon release and no formal dosimetry. However, successful treatments were described in the early literature, and the use of this modality expanded. With this expansion emerged three major schools of brachytherapy in Europe based in Manchester, Paris, and Stockholm and in the United States at Memorial Hospital in New York. e “Manchester rules” published in 1938 set out requirements for brachytherapy source distributions to achieve good homogeneous dose distributions for a wide range of applications ranging from intracavitary gynecological insertions to surface molds and interstitial brachytherapy, as shown in Figure 18.1. Similarly, work in Paris, Stockholm, and Houston developed systems that were proven in clinical practice to be safe and eective and that to this day form the basis of modern brachytherapy.
