The battle against cancer

To begin with, no there were no dedicated devices for radiation therapy. The first major step in this direction was the X-ray tube developed by William Coolidge in 1913, which generated harder radiation able to penetrate further into the body. Building on this invention, Friedrich Dessauer, a pioneer of radiation therapy, went on to develop his Reform Apparatus. Meanwhile, Reiniger, Gebbert & Schall (RGS) in Erlangen also created a successful X-ray device designed specifically for deep therapy, the Symmetry Apparatus. 

As radiotherapy sessions often lasted for hours at a time, radiation protection became a key focus – even more so than in diagnostic X-ray procedures. In 1922, the “Siemens Bestrahlungskasten” (irradiation box) became the first Siemens device to reliably protect operators and patients from the harmful effects of deep X-ray therapy, such as radiation, but also high electrical voltage. The development simplified treatment, while reducing the discomfort involved. Key components of the Bestrahlungskasten were the Stabilivolt and Multivolt systems, which were less prone to malfunctions and allowed shorter exposure times.

Despite these major breakthroughs, in the early days of radiotherapy it was not possible to generate X-rays hard enough to successfully treat deep-seated tumors. A solution to this problem arrived in the form of circular accelerators, which used electromagnetic fields to accelerate electrons on a circular path before abruptly decelerating them, thereby generating very hard X-rays. In 1950, Siemens-Reiniger-Werke unveiled the Betatron circular accelerator at the International Congress of Radiology in London.

In the following decades, these devices were replaced by linear accelerators – such as the Siemens Mevatron. Accelerating electrons in a straight line resulted in superior output and radiation that was even better suited to cancer treatment. As a result, radiotherapy became established as the second pillar of cancer treatment alongside surgery. The third pillar – chemotherapy – followed in the 1950s.

However, the growing precision with which X-rays could be focused on the tumor made it all the more important to control the patient’s position during radiotherapy. To this end, hybrid systems combining linear accelerators and CT scanners were developed. In 2002, PRIMATOM became the first such hybrid system on the market, and image-guided radiotherapy emerged as the new standard. Meanwhile, given that tumors and their surrounding environment can also change during radiotherapy, there was a need for systems that could provide real-time monitoring and, where necessary, dosage adjustment during treatment. This was made possible by the ARTISTE system, launched in 2006, resulting in even more effective protection of the healthy surrounding tissue.