Betje Levie, physician and radiologist in the Netherlands Cancer Institute from 1931 to 1940. Note: after the Second World War, she changes her name to Betty Levie.
On 20 April 1937, radiologist Betty Levie takes her doctorate from the University of Amsterdam with her dissertation "Concerning malignant pharynx tumours and modern radiation therapy" . In her thesis she describes the historical development of irradiation techniques for neck tumours in the Netherlands Cancer Institute from 1915, after 1921 and from 1932. She also describes the modern X-ray contact therapy of 1937. The irradiation techniques and the motivations for protraction or fractionation of the dose are examined for their efficacy.
The work of Betty Levie.
Betty Levie is first named in 1930 in the NKI annual report when she presents during the annual Leeuwenhoek Day "Experiments on glucose burden". She is at that time a voluntary assistant. In 1931 she is engaged as resident and is in training for radiologist under Den Hoed. From 1932 she reports on her research on the treatment of pharynx carcinoma. From 1935, her research together with Den Hoed is on the effectiveness of protraction versus fractionation,
NB Protraction: the prescribed dose is obtained by low dose rate irradiation in a large number of fractions. Fractionation: the prescribed dose is given in daily fractions with high dose rate, by which the fraction dose is reached in a much shorter time. Research into the influence of the time factor on the effect of X-ray irradiation is an important part of her work.
In 1935, together with Den Hoed, she studies complications in whole body irradiation.
The history of pharynx irradiation technique in the Netherlands Cancer Institute, described by Levie in her thesis (shortened): During the years 1914 to 1921, for X-ray therapy a weak radiation with a limited penetration was applied. The X-ray tube high voltage was at 80 kV to 100 kV at 2 to 3 mA. At a large number of ports small fields were given with long irradiation times.; i.e. for a tumour at the base of the tongue, 6 fields were used. Around 1921, the tube voltage was increased to 180 kV and the radiation was more strongly filtered. The radiation became harder and could penetrate deeper into the body. Treating on many small fields remained in use for a long time. A treatment course would typically last for months. The total dose was then 3 x 4500 r, divided over small fields so that the each field dose hit only a section of the target area. After 1925, the fields were enlarged and a total dose of 2 or 3 x 800 r per field was given. Only after 1931 when fractionation was applied, was the total dose increased.
History of radium application. In 1915 only superficial applications were given. These were often difficult to apply, so that the irradiation had to be discontinued after a few hours. After 1923, hard rubber prostheses and dental composite offered a better fixation of the radium applicators. The so-called radium implant also came into use, whereby the radioactive needles were placed in and around the tumour area. In 1926 a radium treatment with a wax collar was also introduced. Radium tubes were fixed on a 1 cm thick layer of wax mixture. The collar was moulded around the neck so that the tumour area could be irradiated to a depth of 2 cm.
Levie was born on 5 March 1905 in Assen (The Netherlands) and died on 29 April 1992 in Tel Aviv (Israel). She studied medicine in Groningen and from 1931 she specialized in therapeutic radiology in the Netherlands Cancer Institute. In 1937, she received her doctorate “On the subject of malignant pharynx tumours in connection with modern radiation therapy”, under the direction of Professor van Ebbenhorst Tengbergen. She was removed from her position in 1941 by the German Occupation Authority because she was Jewish. She survived WWII by going into hiding in circles of Philips’s engineers in Eindhoven where she acted as a courier for the resistance. She emigrated to Israel in 1946. In 1957, she became head of the radiotherapy department in the Beilinson Hospital in Tel Aviv and, in 1968, she was appointed Associate Professor in Radiotherapy at the University of Tel Aviv. Mrs Betty Kazim-Rosenbaum gratefully provided information on her aunt from family sources and Israeli archives.