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November 11, 1992

Principles and Practice of Radiation Oncology

Author Affiliations

Northern Rockies Cancer Center Billings, Mont

JAMA. 1992;268(18):2587-2588. doi:10.1001/jama.1992.03490180119042

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Ionizing radiations have been used to treat cancer patients for almost a century now. At first they were used by all types of physicians and physicists and various practitioners, and results were reported in anecdotal fashion. In the early years of this century, information was accumulated slowly and painfully, as experience taught us what patients could and could not tolerate.

The concept of protracted fractionation, which now is universally recognized as the chief scientific basis of this clinical specialty, was introduced by Coutard in France in the 1920s. Regaud, in Paris, had documented that an intense single dose of radiation delivered to the scrotum of the ram was insufficient to necrotize the skin of that sensitive organ but was sufficient to sterilize the animal, while a much smaller daily dose, delivered in a series of daily fractions, not only led to complete sterility but had no permanent effect on the