101
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Si J, Zhou R, Zhao B, Xie Y, Gan L, Zhang J, Wang Y, Zhou X, Ren X, Zhang H. Effects of ionizing radiation and HLY78 on the zebrafish embryonic developmental toxicity. Toxicology 2019; 411:143-153. [DOI: 10.1016/j.tox.2018.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/18/2018] [Accepted: 10/11/2018] [Indexed: 01/02/2023]
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102
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McMahon SJ. The linear quadratic model: usage, interpretation and challenges. ACTA ACUST UNITED AC 2018; 64:01TR01. [DOI: 10.1088/1361-6560/aaf26a] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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103
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Nielsen S, Bassler N, Grzanka L, Laursen L, Swakon J, Olko P, Andreassen CN, Alsner J, Singers Sørensen B. Comparison of Coding Transcriptomes in Fibroblasts Irradiated With Low and High LET Proton Beams and Cobalt-60 Photons. Int J Radiat Oncol Biol Phys 2018; 103:1203-1211. [PMID: 30529373 DOI: 10.1016/j.ijrobp.2018.11.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/27/2018] [Accepted: 11/29/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To identify differential cellular responses after proton and photon irradiation by comparing transcriptomes of primary fibroblasts irradiated with either radiation type. METHODS AND MATERIALS A panel of primary dermal fibroblast cultures was irradiated with low and higher linear energy transfer (LET) proton beams. Cobalt-60 photon irradiation was used as reference. Dose was delivered in 3 fractions of 3.5 Gy (relative biological effectiveness) using a relative biological effectiveness of 1.1 for proton doses. Cells were harvested 2 hours after the final fraction was delivered, and RNA was purified. RNA sequencing was performed using Illumina NextSeq 500 with high-output kit. The edgeR package in R was used for differential gene expression analysis. RESULTS Pairwise comparisons of the transcriptomes in the 3 treatment groups showed that there were 84 and 56 differentially expressed genes in the low LET group compared with the Cobalt-60 group and the higher LET group, respectively. The higher LET proton group and the Cobalt-60 group had the most distinct transcriptome profiles, with 725 differentially regulated genes. Differentially regulated canonical pathways and various regulatory factors involved in regulation of biological mechanisms such as inflammation, carcinogenesis, and cell cycle control were identified. CONCLUSIONS Inflammatory regulators associated with the development of normal tissue complications and malignant transformation factors seem to be differentially regulated by higher LET proton and Cobalt-60 photon irradiation. The reported transcriptome differences could therefore influence the progression of adverse effects and the risk of developing secondary cancers.
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Affiliation(s)
- Steffen Nielsen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark.
| | - Niels Bassler
- Medical Radiation Physics, Department of Physics, Stockholm University, Stockholm, Sweden
| | - Leszek Grzanka
- Proton Radiotherapy Group, Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - Louise Laursen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Jan Swakon
- Proton Radiotherapy Group, Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - Pawel Olko
- Proton Radiotherapy Group, Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | | | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Brita Singers Sørensen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
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104
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Oeck S, Szymonowicz K, Wiel G, Krysztofiak A, Lambert J, Koska B, Iliakis G, Timmermann B, Jendrossek V. Relating Linear Energy Transfer to the Formation and Resolution of DNA Repair Foci After Irradiation with Equal Doses of X-ray Photons, Plateau, or Bragg-Peak Protons. Int J Mol Sci 2018; 19:ijms19123779. [PMID: 30486506 PMCID: PMC6320817 DOI: 10.3390/ijms19123779] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/24/2018] [Accepted: 11/26/2018] [Indexed: 12/27/2022] Open
Abstract
Proton beam therapy is increasingly applied for the treatment of human cancer, as it promises to reduce normal tissue damage. However, little is known about the relationship between linear energy transfer (LET), the type of DNA damage, and cellular repair mechanisms, particularly for cells irradiated with protons. We irradiated cultured cells delivering equal doses of X-ray photons, Bragg-peak protons, or plateau protons and used this set-up to quantitate initial DNA damage (mainly DNA double strand breaks (DSBs)), and to analyze kinetics of repair by detecting γH2A.X or 53BP1 using immunofluorescence. The results obtained validate the reliability of our set-up in delivering equal radiation doses under all conditions employed. Although the initial numbers of γH2A.X and 53BP1 foci scored were similar under the different irradiation conditions, it was notable that the maximum foci level was reached at 60 min after irradiation with Bragg-peak protons, as compared to 30 min for plateau protons and photons. Interestingly, Bragg-peak protons induced larger and irregularly shaped γH2A.X and 53BP1 foci. Additionally, the resolution of these foci was delayed. These results suggest that Bragg-peak protons induce DNA damage of increased complexity which is difficult to process by the cellular repair apparatus.
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Affiliation(s)
- Sebastian Oeck
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Virchowstrasse 173, 45122 Essen, Germany.
- Department of Therapeutic Radiology, Yale University School of Medicine, 15 York Street, New Haven, CT 06520, USA.
| | - Klaudia Szymonowicz
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Virchowstrasse 173, 45122 Essen, Germany.
| | - Gesa Wiel
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Virchowstrasse 173, 45122 Essen, Germany.
| | - Adam Krysztofiak
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Virchowstrasse 173, 45122 Essen, Germany.
| | - Jamil Lambert
- West German Proton Therapy Centre Essen, University Hospital Essen, Am Muehlenbach 1, 45147 Essen, Germany.
| | - Benjamin Koska
- West German Proton Therapy Centre Essen, University Hospital Essen, Am Muehlenbach 1, 45147 Essen, Germany.
| | - George Iliakis
- Institute of Medical Radiation Biology; University of Duisburg-Essen; Medical School; Hufelandstr. 55, 45122 Essen, Germany.
| | - Beate Timmermann
- West German Proton Therapy Centre Essen, University Hospital Essen, Am Muehlenbach 1, 45147 Essen, Germany.
| | - Verena Jendrossek
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Virchowstrasse 173, 45122 Essen, Germany.
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105
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Lomax A. What will the medical physics of proton therapy look like 10 yr from now? A personal view. Med Phys 2018; 45:e984-e993. [DOI: 10.1002/mp.13206] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 07/29/2018] [Accepted: 08/31/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Antony Lomax
- Centre for Proton Therapy Paul Scherrer Institute 5232 Villigen Aargau Switzerland
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106
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Influence of Linear Energy Transfer on the Nucleo-shuttling of the ATM Protein: A Novel Biological Interpretation Relevant for Particles and Radiation. Int J Radiat Oncol Biol Phys 2018; 103:709-718. [PMID: 30342967 DOI: 10.1016/j.ijrobp.2018.10.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 09/19/2018] [Accepted: 10/08/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE Linear energy transfer (LET) plays an important role in radiation response. Recently, the radiation-induced nucleo-shuttling of ATM from cytoplasm to the nucleus was shown to be a major event of the radiation response that permits a normal DNA double-strand break (DSB) recognition and repair. Here, we aimed to verify the relevance of the ATM nucleo-shuttling model for high-LET particles and various radiation types. METHODS AND MATERIALS ATM- and H2AX-immunofluorescence was used to assess the number of recognized and unrepaired DSB in quiescent fibroblast cell lines exposed to x-rays, γ-rays, 9- and 12-MeV electrons, 3- and 65-MeV protons and 75-MeV/u carbon ions. RESULTS The rate of radiation-induced ATM nucleo-shuttling was found to be specific to each radiation type tested. By increasing the permeability of the nuclear membrane with statin and bisphosphonates, 2 fibroblast cell lines exposed to high-LET particles were shown to be protected by an accelerated ATM nucleo-shuttling. CONCLUSIONS Our findings are in agreement with the conclusion that LET and the radiation/particle type influence the formation of ATM monomers in cytoplasm that are required for DSB recognition. A striking analogy was established between the DSB repair kinetics of radioresistant cells exposed to high-LET particles and that of several radiosensitive cells exposed to low-LET radiation. Our data show that the nucleo-shuttling of ATM provides crucial elements to predict radiation response in human quiescent cells, whatever the LET value and their radiosensitivity.
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107
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Panek A, Miszczyk J, Swakoń J. Biological effects and inter-individual variability in peripheral blood lymphocytes of healthy donors exposed to 60 MeV proton radiotherapeutic beam. Int J Radiat Biol 2018; 94:1085-1094. [PMID: 30273081 DOI: 10.1080/09553002.2019.1524941] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: The aim of our study was to investigate the amount of initial DNA damage and cellular repair capacity of human peripheral blood lymphocytes exposed to the therapeutic proton beam and compare it to X-rays. Materials and methods: Lymphocytes from 10 healthy donors were irradiated in the Spread Out Bragg Peak of the 60 MeV proton beam or, as a reference, exposed to 250 kV X-rays. DNA damage level was assessed using the alkaline version of the comet assay method. For both sources of radiation, dose-DNA damage response (0-4 Gy) and DNA repair kinetics (0-120 min) were estimated. The observed DNA damage was then used to calculate the relative biological effectiveness (RBE) of the proton beam in comparison to that of X-rays. Results: Dose-response relationships for the DNA damage level showed linear dependence for both proton beam and X-rays (R2 = 0.995 for protons and R2 = 0.993 for X-rays). Within the dose range of 1-4 Gy, protons were significantly more effective in inducing DNA damage than were X-rays (p < .05). The average RBE, calculated from the proton and X-ray doses required for the iso-effective, internally standardized tail DNA parameter (sT-DNA) was 1.28 ± 0.57. Similar half-life time of residual damage and repair efficiency of induced DNA damage for both radiation types were observed. In the X-irradiated group, significant inter-individual differences were observed. Conclusions: Proton therapy was more effective at high radiation doses. However, DNA damage repair mechanism after proton irradiation seems to differ from that following X-rays.
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Affiliation(s)
- Agnieszka Panek
- a Institute of Nuclear Physics Polish Academy of Sciences , Krakow , Poland
| | - Justyna Miszczyk
- a Institute of Nuclear Physics Polish Academy of Sciences , Krakow , Poland
| | - Jan Swakoń
- a Institute of Nuclear Physics Polish Academy of Sciences , Krakow , Poland
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108
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Hellweg CE, Chishti AA, Diegeler S, Spitta LF, Henschenmacher B, Baumstark-Khan C. Molecular Signaling in Response to Charged Particle Exposures and its Importance in Particle Therapy. Int J Part Ther 2018; 5:60-73. [PMID: 31773020 PMCID: PMC6871585 DOI: 10.14338/ijpt-18-00016.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/13/2018] [Indexed: 12/17/2022] Open
Abstract
Energetic, charged particles elicit an orchestrated DNA damage response (DDR) during their traversal through healthy tissues and tumors. Complex DNA damage formation, after exposure to high linear energy transfer (LET) charged particles, results in DNA repair foci formation, which begins within seconds. More protein modifications occur after high-LET, compared with low-LET, irradiation. Charged-particle exposure activates several transcription factors that are cytoprotective or cytodestructive, or that upregulate cytokine and chemokine expression, and are involved in bystander signaling. Molecular signaling for a survival or death decision in different tumor types and healthy tissues should be studied as prerequisite for shaping sensitizing and protective strategies. Long-term signaling and gene expression changes were found in various tissues of animals exposed to charged particles, and elucidation of their role in chronic and late effects of charged-particle therapy will help to develop effective preventive measures.
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Affiliation(s)
- Christine E. Hellweg
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Radiation Biology Department, Köln, Germany
| | - Arif Ali Chishti
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Radiation Biology Department, Köln, Germany
- The Karachi Institute of Biotechnology and Genetic Engineering, University of Karachi, Karachi, Pakistan
| | - Sebastian Diegeler
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Radiation Biology Department, Köln, Germany
| | - Luis F. Spitta
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Radiation Biology Department, Köln, Germany
| | - Bernd Henschenmacher
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Radiation Biology Department, Köln, Germany
| | - Christa Baumstark-Khan
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Radiation Biology Department, Köln, Germany
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109
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Morton LM, Ricks-Santi L, West CML, Rosenstein BS. Radiogenomic Predictors of Adverse Effects following Charged Particle Therapy. Int J Part Ther 2018; 5:103-113. [PMID: 30505881 PMCID: PMC6261418 DOI: 10.14338/ijpt-18-00009.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/16/2018] [Indexed: 12/31/2022] Open
Abstract
Radiogenomics is the study of genomic factors that are associated with response to radiation therapy. In recent years, progress has been made toward identifying genetic risk factors linked with late radiation-induced adverse effects. These advances have been underpinned by the establishment of an international Radiogenomics Consortium with collaborative studies that expand cohort sizes to increase statistical power and efforts to improve methodologic approaches for radiogenomic research. Published studies have predominantly reported the results of research involving patients treated with photons using external beam radiation therapy. These studies demonstrate our ability to pool international cohorts to identify common single nucleotide polymorphisms associated with risk for developing normal tissue toxicities. Progress has also been achieved toward the discovery of genetic variants associated with radiation therapy-related subsequent malignancies. With the increasing use of charged particle therapy (CPT), there is a need to establish cohorts for patients treated with these advanced technology forms of radiation therapy and to create biorepositories with linked clinical data. While some genetic variants are likely to impact toxicity and second malignancy risks for both photons and charged particles, it is plausible that others may be specific to the radiation modality due to differences in their biological effects, including the complexity of DNA damage produced. In recognition that the formation of patient cohorts treated with CPT for radiogenomic studies is a high priority, efforts are underway to establish collaborations involving institutions treating cancer patients with protons and/or carbon ions as well as consortia, including the Proton Collaborative Group, the Particle Therapy Cooperative Group, and the Pediatric Proton Consortium Registry. These important radiogenomic CPT initiatives need to be expanded internationally to build on experience gained from the Radiogenomics Consortium and epidemiologists investigating normal tissue toxicities and second cancer risk.
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Affiliation(s)
- Lindsay M. Morton
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Catharine M. L. West
- Division of Cancer Sciences, The University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, United Kingdom
| | - Barry S. Rosenstein
- Department of Radiation Oncology and Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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110
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Pfuhl T, Horst F, Schuy C, Weber U. Dose build-up effects induced by delta electrons and target fragments in proton Bragg curves—measurements and simulations. ACTA ACUST UNITED AC 2018; 63:175002. [DOI: 10.1088/1361-6560/aad8fc] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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111
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Bravatà V, Minafra L, Cammarata FP, Pisciotta P, Lamia D, Marchese V, Petringa G, Manti L, Cirrone GA, Gilardi MC, Cuttone G, Forte GI, Russo G. Gene expression profiling of breast cancer cell lines treated with proton and electron radiations. Br J Radiol 2018; 91:20170934. [PMID: 29888960 DOI: 10.1259/bjr.20170934] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Technological advances in radiation therapy are evolving with the use of hadrons, such as protons, indicated for tumors where conventional radiotherapy does not give significant advantages or for tumors located in sensitive regions, which need the maximum of dose-saving of the surrounding healthy tissues. The genomic response to conventional and non-conventional linear energy transfer exposure is a poor investigated topic and became an issue of radiobiological interest. The aim of this work was to analyze and compare molecular responses in term of gene expression profiles, induced by electron and proton irradiation in breast cancer cell lines. METHODS We studied the gene expression profiling differences by cDNA microarray activated in response to electron and proton irradiation with different linear energy transfer values, among three breast cell lines (the tumorigenic MCF7 and MDA-MB-231 and the non-tumorigenic MCF10A), exposed to the same sublethal dose of 9 Gy. RESULTS Gene expression profiling pathway analyses showed the activation of different signaling and molecular networks in a cell line and radiation type-dependent manner. MCF10A and MDA-MB-231 cell lines were found to induce factors and pathways involved in the immunological process control. CONCLUSION Here, we describe in a detailed way the gene expression profiling and pathways activated after electron and proton irradiation in breast cancer cells. Summarizing, although specific pathways are activated in a radiation type-dependent manner, each cell line activates overall similar molecular networks in response to both these two types of ionizing radiation. Advances in knowledge: In the era of personalized medicine and breast cancer target-directed intervention, we trust that this study could drive radiation therapy towards personalized treatments, evaluating possible combined treatments, based on the molecular characterization.
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Affiliation(s)
- Valentina Bravatà
- 1 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR) , Cefalù , Italy
| | - Luigi Minafra
- 1 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR) , Cefalù , Italy
| | - Francesco Paolo Cammarata
- 1 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR) , Cefalù , Italy
| | - Pietro Pisciotta
- 1 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR) , Cefalù , Italy.,2 National Institute for Nuclear Physics, Laboratori Nazionali del Sud, INFN-LNS , Catania , Italy.,3 Department of Physics and Astronomy, University of Catania , Catania , Italy
| | - Debora Lamia
- 1 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR) , Cefalù , Italy
| | - Valentina Marchese
- 2 National Institute for Nuclear Physics, Laboratori Nazionali del Sud, INFN-LNS , Catania , Italy
| | - Giada Petringa
- 2 National Institute for Nuclear Physics, Laboratori Nazionali del Sud, INFN-LNS , Catania , Italy
| | - Lorenzo Manti
- 4 Department of Physics, University of Naples Federico II, via Cintia, I-80126 Naples , Italy
| | - Giuseppe Ap Cirrone
- 2 National Institute for Nuclear Physics, Laboratori Nazionali del Sud, INFN-LNS , Catania , Italy
| | - Maria Carla Gilardi
- 1 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR) , Cefalù , Italy.,5 Department of Health Sciences, Tecnomed Foundation, University of Milano-Bicocca , Milan , Italy
| | - Giacomo Cuttone
- 2 National Institute for Nuclear Physics, Laboratori Nazionali del Sud, INFN-LNS , Catania , Italy
| | - Giusi Irma Forte
- 1 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR) , Cefalù , Italy
| | - Giorgio Russo
- 1 Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR) , Cefalù , Italy.,2 National Institute for Nuclear Physics, Laboratori Nazionali del Sud, INFN-LNS , Catania , Italy
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112
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Dosanjh M, Jones B, Pawelke J, Pruschy M, Sørensen BS. Overview of research and therapy facilities for radiobiological experimental work in particle therapy. Report from the European Particle Therapy Network radiobiology group. Radiother Oncol 2018; 128:14-18. [DOI: 10.1016/j.radonc.2018.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 11/30/2022]
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113
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Lipiec E, Wood BR, Kulik A, Kwiatek WM, Dietler G. Nanoscale Investigation into the Cellular Response of Glioblastoma Cells Exposed to Protons. Anal Chem 2018; 90:7644-7650. [PMID: 29799188 DOI: 10.1021/acs.analchem.8b01497] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Exposure to ionizing radiation can induce cellular defense mechanisms including cell activation and rapid proliferation prior to metastasis and in extreme cases can result in cell death. Herewith we apply infrared nano- and microspectroscopy combined with multidimensional data analysis to characterize the effect of ionizing radiation on single glioblastoma nuclei isolated from cells treated with 10 Gy of X-rays or 1 and 10 Gy of protons. We observed chromatin fragmentation related to the formation of apoptotic bodies following X-ray exposure. Following proton irradiation we detected evidence of a DNA conformational change (B-DNA to A-DNA transition) related to DNA repair and accompanied by an increase in protein content related to the synthesis of peptide enzymes involved in DNA repair. We also show that proton exposure can increase cholesterol and sterol ester synthesis, which are important lipids involved in the metastatic process changing the fluidity of the cellular membrane in preparation for rapid proliferation.
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Affiliation(s)
- Ewelina Lipiec
- Institute of Nuclear Physics , Polish Academy of Sciences , PL-31342 Krakow , Poland.,Institute of Physics, Laboratory of Physics of Living Matter , Ecole Polytechnique Fédérale de Lausanne (EPFL) , CH-1015 Lausanne , Switzerland.,Centre for Biospectroscopy and School of Chemistry , Monash University , 3800 Clayton , Victoria , Australia
| | - Bayden R Wood
- Centre for Biospectroscopy and School of Chemistry , Monash University , 3800 Clayton , Victoria , Australia
| | - Andrzej Kulik
- Institute of Physics, Laboratory of Physics of Living Matter , Ecole Polytechnique Fédérale de Lausanne (EPFL) , CH-1015 Lausanne , Switzerland
| | - Wojciech M Kwiatek
- Institute of Nuclear Physics , Polish Academy of Sciences , PL-31342 Krakow , Poland
| | - Giovanni Dietler
- Institute of Physics, Laboratory of Physics of Living Matter , Ecole Polytechnique Fédérale de Lausanne (EPFL) , CH-1015 Lausanne , Switzerland
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114
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Ghaffari H, Beik J, Talebi A, Mahdavi SR, Abdollahi H. New physical approaches to treat cancer stem cells: a review. Clin Transl Oncol 2018; 20:1502-1521. [PMID: 29869042 DOI: 10.1007/s12094-018-1896-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/14/2018] [Indexed: 12/13/2022]
Abstract
Cancer stem cells (CSCs) have been identified as the main center of tumor therapeutic resistance. They are highly resistant against current cancer therapy approaches particularly radiation therapy (RT). Recently, a wide spectrum of physical methods has been proposed to treat CSCs, including high energetic particles, hyperthermia (HT), nanoparticles (NPs) and combination of these approaches. In this review article, the importance and benefits of the physical CSCs therapy methods such as nanomaterial-based heat treatments and particle therapy will be highlighted.
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Affiliation(s)
- H Ghaffari
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Junction of Shahid Hemmat and Chamran Expressway, Tehran, Iran
| | - J Beik
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Junction of Shahid Hemmat and Chamran Expressway, Tehran, Iran
| | - A Talebi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Junction of Shahid Hemmat and Chamran Expressway, Tehran, Iran
| | - S R Mahdavi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Junction of Shahid Hemmat and Chamran Expressway, Tehran, Iran.
- Department of Medical Physics and Radiation Biology Research Center, Iran University of Medical Sciences, Junction of Shahid Hemmat and Chamran Expressway, Tehran, Iran.
| | - H Abdollahi
- Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Junction of Shahid Hemmat and Chamran Expressway, Tehran, Iran.
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115
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Lühr A, von Neubeck C, Pawelke J, Seidlitz A, Peitzsch C, Bentzen SM, Bortfeld T, Debus J, Deutsch E, Langendijk JA, Loeffler JS, Mohan R, Scholz M, Sørensen BS, Weber DC, Baumann M, Krause M. "Radiobiology of Proton Therapy": Results of an international expert workshop. Radiother Oncol 2018; 128:56-67. [PMID: 29861141 DOI: 10.1016/j.radonc.2018.05.018] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/17/2018] [Accepted: 05/17/2018] [Indexed: 12/25/2022]
Abstract
The physical properties of proton beams offer the potential to reduce toxicity in tumor-adjacent normal tissues. Toward this end, the number of proton radiotherapy facilities has steeply increased over the last 10-15 years to currently around 70 operational centers worldwide. However, taking full advantage of the opportunities offered by proton radiation for clinical radiotherapy requires a better understanding of the radiobiological effects of protons alone or combined with drugs or immunotherapy on normal tissues and tumors. This report summarizes the main results of the international expert workshop "Radiobiology of Proton Therapy" that was held in November 2016 in Dresden. It addresses the major topics (1) relative biological effectiveness (RBE) in proton beam therapy, (2) interaction of proton radiobiology with radiation physics in current treatment planning, (3) biological effects in proton therapy combined with systemic treatments, and (4) testing biological effects of protons in clinical trials. Finally, important research avenues for improvement of proton radiotherapy based on radiobiological knowledge are identified. The clinical distribution of radiobiological effectiveness of protons alone or in combination with systemic chemo- or immunotherapies as well as patient stratification based on biomarker expressions are key to reach the full potential of proton beam therapy. Dedicated preclinical experiments, innovative clinical trial designs, and large high-quality data repositories will be most important to achieve this goal.
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Affiliation(s)
- Armin Lühr
- Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cläre von Neubeck
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jörg Pawelke
- Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany
| | - Annekatrin Seidlitz
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Claudia Peitzsch
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, and; Helmholtz Association/Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Germany
| | - Søren M Bentzen
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health and the Maryland Proton Therapy Center, Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
| | - Thomas Bortfeld
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital, Boston, USA
| | - Jürgen Debus
- German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiation Oncology, University Heidelberg German Consortium for Translational Oncology (DKTK), Germany; National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Eric Deutsch
- Department of Radiation Oncology Gustave Roussy Cancer Campus, INSERM, 1030 Villejuif, France; Université Paris-Sud, Faculté de Medecine du Kremlin Bicetre Paris Sud, Le Kremlin-Bicêtre, France
| | - Johannes A Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jay S Loeffler
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, USA; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, USA
| | - Radhe Mohan
- Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, USA
| | - Michael Scholz
- GSI Helmholtz Center for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
| | - Brita S Sørensen
- Dept. Experimental Clinical Oncology, Aarhus University Hospital, Denmark
| | - Damien C Weber
- Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Villigen, Switzerland
| | - Michael Baumann
- Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, and; Helmholtz Association/Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Mechthild Krause
- Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; German Cancer Consortium (DKTK), Partner Site Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, and; Helmholtz Association/Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Germany
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Heavy Charged Particles: Does Improved Precision and Higher Biological Effectiveness Translate to Better Outcome in Patients? Semin Radiat Oncol 2018. [DOI: 10.1016/j.semradonc.2017.11.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Howard ME, Beltran C, Anderson S, Tseung WC, Sarkaria JN, Herman MG. Investigating Dependencies of Relative Biological Effectiveness for Proton Therapy in Cancer Cells. Int J Part Ther 2018; 4:12-22. [PMID: 30159358 DOI: 10.14338/ijpt-17-00031.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose Relative biological effectiveness (RBE) accounts for the differences in biological effect from different radiation types. The RBE for proton therapy remains uncertain, as it has been shown to vary from the clinically used value of 1.1. In this work we investigated the RBE of protons and correlated the biological differences with the underlying physical quantities. Materials and Methods Three cell lines were irradiated (CHO, Chinese hamster ovary; A549, human lung adenocarcinoma; and T98, human glioma) and assessed for cell survival by using clonogenic assay. Cells were irradiated with 71- and 160-MeV protons at depths along the Bragg curve and 6-MV photons to various doses. The dose-averaged lineal energy ( y‒D ) was measured under similar conditions as the cells by using a microdosimeter. Dose-averaged linear energy transfer (LETd) was also calculated by using Monte Carlo (MC) simulations. Survival data were fit by using the linear quadratic model. The RBE values were calculated by comparing the physical dose (D6MV/Dp) that results in 50% (RBE0.5) and 10% (RBE0.1) cell survival, and survival after 2 Gy (RBE2Gy). Results Proton RBE values ranged from 0.89 to 2.40. The RBE for all 3 cell lines increased with decreasing proton energy and was higher at 50% survival than at 10% survival. Additionally, both A549 and T98 cells generally had higher RBE values relative to the CHO cells, indicating a greater biological response to protons. An increase in RBE corresponded with an increase in y‒D and LETd. Conclusion Proton RBE was found to depend on mean proton energy, survival end point, and cell type. Changes in both y‒D and LETd were also found to impact proton RBE values, but consideration of the energy spectrum may provide additional information. The RBE values in this study vary greatly, indicating the clinical value of 1.1 may not be suitable in all cases.
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Affiliation(s)
| | - Chris Beltran
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Sarah Anderson
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Wan Chan Tseung
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Jann N Sarkaria
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Michael G Herman
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
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Rucinski A, Battistoni G, Collamati F, De Lucia E, Faccini R, Frallicciardi PM, Mancini-Terracciano C, Marafini M, Mattei I, Muraro S, Paramatti R, Piersanti L, Pinci D, Russomando A, Sarti A, Sciubba A, Solfaroli Camillocci E, Toppi M, Traini G, Voena C, Patera V. Secondary radiation measurements for particle therapy applications: charged particles produced by 4He and 12C ion beams in a PMMA target at large angle. Phys Med Biol 2018; 63:055018. [PMID: 29265011 DOI: 10.1088/1361-6560/aaa36a] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Proton and carbon ion beams are used in the clinical practice for external radiotherapy treatments achieving, for selected indications, promising and superior clinical results with respect to x-ray based radiotherapy. Other ions, like [Formula: see text] have recently been considered as projectiles in particle therapy centres and might represent a good compromise between the linear energy transfer and the radiobiological effectiveness of [Formula: see text] ion and proton beams, allowing improved tumour control probability and minimising normal tissue complication probability. All the currently used p, [Formula: see text] and [Formula: see text] ion beams allow achieving sharp dose gradients on the boundary of the target volume, however the accurate dose delivery is sensitive to the patient positioning and to anatomical variations with respect to photon therapy. This requires beam range and/or dose release measurement during patient irradiation and therefore the development of dedicated monitoring techniques. All the proposed methods make use of the secondary radiation created by the beam interaction with the patient and, in particular, in the case of [Formula: see text] ion beams are also able to exploit the significant charged radiation component. Measurements performed to characterise the charged secondary radiation created by [Formula: see text] and [Formula: see text] particle therapy beams are reported. Charged secondary yields, energy spectra and emission profiles produced in a poly-methyl methacrylate (PMMA) target by [Formula: see text] and [Formula: see text] beams of different therapeutic energies were measured at 60° and 90° with respect to the primary beam direction. The secondary yield of protons produced along the primary beam path in a PMMA target was obtained. The energy spectra of charged secondaries were obtained from time-of-flight information, whereas the emission profiles were reconstructed exploiting tracking detector information. The obtained measurements are in agreement with results reported in the literature and suggests the feasibility of range monitoring based on charged secondary particle detection: the implications for particle therapy monitoring applications are also discussed.
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Affiliation(s)
- A Rucinski
- INFN-Sezione di Roma, Italy. Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy. Institute of Nuclear Physics Polish Academy of Sciences, PL-31342 Krakow, Poland
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Jones B, McMahon SJ, Prise KM. The Radiobiology of Proton Therapy: Challenges and Opportunities Around Relative Biological Effectiveness. Clin Oncol (R Coll Radiol) 2018; 30:285-292. [PMID: 29454504 DOI: 10.1016/j.clon.2018.01.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 01/16/2018] [Indexed: 01/31/2023]
Abstract
With the current UK expansion of proton therapy there is a great opportunity for clinical oncologists to develop a translational interest in the associated scientific base and clinical results. In particular, the underpinning controversy regarding the conversion of photon dose to proton dose by the relative biological effectiveness (RBE) must be understood, including its important implications. At the present time, the proton prescribed dose includes an RBE of 1.1 regardless of tissue, tumour and dose fractionation. A body of data has emerged against this pragmatic approach, including a critique of the existing evidence base, due to choice of dose, use of only acute-reacting in vivo assays, analysis methods and the reference radiations used to determine the RBE. Modelling systems, based on the best available scientific evidence, and which include the clinically useful biological effective dose (BED) concept, have also been developed to estimate proton RBEs for different dose and linear energy transfer (LET) values. The latter reflect ionisation density, which progressively increases along each proton track. Late-reacting tissues, such as the brain, where α/β = 2 Gy, show a higher RBE than 1.1 at a low dose per fraction (1.2-1.8 Gy) at LET values used to cover conventional target volumes and can be much higher. RBE changes with tissue depth seem to vary depending on the method of beam delivery used. To reduce unexpected toxicity, which does occasionally follow proton therapy, a more rational approach to RBE allocation, using a variable RBE that depends on dose per fraction and the tissue and tumour radiobiological characteristics such as α/β, is proposed.
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Affiliation(s)
- B Jones
- Oxford Institute for Radiation Oncology, University of Oxford, Old Road Campus Research Building, Oxford, UK.
| | - S J McMahon
- Centre for Cancer Research & Cell Biology, Queen's University Belfast, Belfast, UK
| | - K M Prise
- Centre for Cancer Research & Cell Biology, Queen's University Belfast, Belfast, UK
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Abstract
OBJECTIVE Understanding the goals of targeted radiation therapy in pediatrics is critical to developing high quality and safe anesthetic plans in this patient population. An ideal anesthetic plan includes allaying anxiety and achieving optimal immobilization, while ensuring rapid and efficient recovery. METHODS We conducted a retrospective chart review of children receiving anesthesia for radiation oncology procedures from 1/1/2014 to 7/31/2016. No anesthetics were excluded from the analysis. The electronic anesthesia records were analyzed for perianesthetic complications along with efficiency data. To compare our results to past and current data, we identified relevant medical literature covering a period from 1984-2017. RESULTS A total of 997 anesthetic procedures were delivered in 58 unique patients. The vast majority of anesthetics were single-agent anesthesia with propofol. The average duration of radiation treatment was 13.24 min. The average duration of anesthesia was 37.81 min, and the average duration to meet discharge criteria in the recovery room was 29.50 min. There were seven instances of perianesthetic complications (0.7%) and no complications noted for the 80 CT simulations. Two of the seven complications occurred in patients receiving total body irradiation. DISCUSSION The 5-year survival rate for pediatric cancers has improved greatly in part due to more effective and targeted radiation therapy. Providing an anesthetic with minimal complications is critical for successful daily radiation treatment. The results of our data analysis corroborate other contemporary studies showing minimal risk to patients undergoing radiation therapy under general anesthesia with propofol. CONCLUSION Our data reveal that single-agent anesthesia with propofol administered by a dedicated anesthesia team is safe and efficient and should be considered for patients requiring multiple radiation treatments under anesthesia.
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Miszczyk J, Rawojć K, Panek A, Borkowska A, Prasanna PGS, Ahmed MM, Swakoń J, Gałaś A. Do protons and X-rays induce cell-killing in human peripheral blood lymphocytes by different mechanisms? Clin Transl Radiat Oncol 2018; 9:23-29. [PMID: 29594247 PMCID: PMC5862687 DOI: 10.1016/j.ctro.2018.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/31/2017] [Accepted: 01/15/2018] [Indexed: 01/02/2023] Open
Abstract
Purpose Significant progress has been made in the technological and physical aspects of dose delivery and distribution in proton therapy. However, mode of cell killing induced by protons is less understood in comparison with X-rays. The purpose of this study is to see if there is any difference in the mode of cell-killing, induced by protons and X-rays in an ex vivo human peripheral blood lymphocyte (HPBL) model. Materials and methods HPBL were irradiated with 60 MeV proton beam or 250-kVp X-rays in the dose range of 0.3–4.0 Gy. Frequency of apoptotic and necrotic cells was determined by the Fluorescein (FITC)-Annexin V labelling procedure, 1 and 4 h after irradiation. Chip-based DNA Ladder Assay was used to confirm radiation-induced apoptosis and necrosis. Chip-based DNA Ladder Assay was used to confirm radiation-induced apoptosis. Results Ex vivo irradiation of HPBL with proton beams of 60 MeV or 250 kVp X-rays resulted in apoptotic as well as necrotic modes of cell-killing, which were evident at both 1 and 4 h after irradiation in the whole dose and time range. Generally, our results indicated that protons cause relatively higher yields of cell death that appears to be necrosis compared to X-rays. The analysis also demonstrates that radiation type and dose play a critical role in mode of cell-killing. Conclusion Obtained results suggest that X-rays and protons induce cell-killing by different modes. Such differences in cell-killing modes may have implications on the potential of a given therapeutic modality to cause immune modulation via programmed cell death (X-rays) or necrotic cell death (proton therapy). These studies point towards exploring for gene expression biomarkers related necrosis or apoptosis to predict immune response after proton therapy.
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Affiliation(s)
- J Miszczyk
- Institute of Nuclear Physics Polish Academy of Sciences, PL-31342, Poland
| | - K Rawojć
- Department of Endocrinology, Nuclear Medicine Unit, The University Hospital, Kraków, Poland
| | - A Panek
- Institute of Nuclear Physics Polish Academy of Sciences, PL-31342, Poland
| | - A Borkowska
- Institute of Nuclear Physics Polish Academy of Sciences, PL-31342, Poland
| | - P G S Prasanna
- Radiation Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - M M Ahmed
- Radiation Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Swakoń
- Institute of Nuclear Physics Polish Academy of Sciences, PL-31342, Poland
| | - A Gałaś
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kraków, Poland
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Ilicic K, Combs SE, Schmid TE. New insights in the relative radiobiological effectiveness of proton irradiation. Radiat Oncol 2018; 13:6. [PMID: 29338744 PMCID: PMC5771069 DOI: 10.1186/s13014-018-0954-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/05/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Proton radiotherapy is a form of charged particle therapy that is preferentially applied for the treatment of tumors positioned near to critical structures due to their physical characteristics, showing an inverted depth-dose profile. The sparing of normal tissue has additional advantages in the treatment of pediatric patients, in whom the risk of secondary cancers and late morbidity is significantly higher. Up to date, a fixed relative biological effectiveness (RBE) of 1.1 is commonly implemented in treatment planning systems with protons in order to correct the physical dose. This value of 1.1 comes from averaging the results of numerous in vitro experiments, mostly conducted in the middle of the spread-out Bragg peak, where RBE is relatively constant. However, the use of a constant RBE value disregards the experimental evidence which clearly demonstrates complex RBE dependency on dose, cell- or tissue type, linear energy transfer and biological endpoints. In recent years, several in vitro studies indicate variations in RBE of protons which translate to an uncertainty in the biological effective dose delivery to the patient. Particularly for regions surrounding the Bragg peak, the more localized pattern of energy deposition leads to more complex DNA lesions. These RBE variations of protons bring the validity of using a constant RBE into question. MAIN BODY This review analyzes how RBE depends on the dose, different biological endpoints and physical properties. Further, this review gives an overview of the new insights based on findings made during the last years investigating the variation of RBE with depth in the spread out Bragg peak and the underlying differences in radiation response on the molecular and cellular levels between proton and photon irradiation. Research groups such as the Klinische Forschergruppe Schwerionentherapie funded by the German Research Foundation (DFG, KFO 214) have included work on this topic and the present manuscript highlights parts of the preclinical work and summarizes the research activities in this context. SHORT CONCLUSION In summary, there is an urgent need for more coordinated in vitro and in vivo experiments that concentrate on a realistic dose range of in clinically relevant tissues like lung or spinal cord.
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Affiliation(s)
- K Ilicic
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, 81675, München, Germany.,Institute of Innovative Radiotherapy, Helmholtz Zentrum München, Neuherberg, Germany
| | - S E Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, 81675, München, Germany.,Institute of Innovative Radiotherapy, Helmholtz Zentrum München, Neuherberg, Germany.,Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, Munich, Germany
| | - T E Schmid
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, 81675, München, Germany. .,Institute of Innovative Radiotherapy, Helmholtz Zentrum München, Neuherberg, Germany.
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Howard ME, Beltran C, Anderson S, Tseung WC, Sarkaria JN, Herman MG. Investigating Dependencies of Relative Biological Effectiveness for Proton Therapy in Cancer Cells. Int J Part Ther 2018. [PMID: 30159358 DOI: 10.14338/ijpt-17-0031.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
PURPOSE Relative biological effectiveness (RBE) accounts for the differences in biological effect from different radiation types. The RBE for proton therapy remains uncertain, as it has been shown to vary from the clinically used value of 1.1. In this work we investigated the RBE of protons and correlated the biological differences with the underlying physical quantities. MATERIALS AND METHODS Three cell lines were irradiated (CHO, Chinese hamster ovary; A549, human lung adenocarcinoma; and T98, human glioma) and assessed for cell survival by using clonogenic assay. Cells were irradiated with 71- and 160-MeV protons at depths along the Bragg curve and 6-MV photons to various doses. The dose-averaged lineal energy ( y‒D ) was measured under similar conditions as the cells by using a microdosimeter. Dose-averaged linear energy transfer (LETd) was also calculated by using Monte Carlo (MC) simulations. Survival data were fit by using the linear quadratic model. The RBE values were calculated by comparing the physical dose (D6MV/Dp) that results in 50% (RBE0.5) and 10% (RBE0.1) cell survival, and survival after 2 Gy (RBE2Gy). RESULTS Proton RBE values ranged from 0.89 to 2.40. The RBE for all 3 cell lines increased with decreasing proton energy and was higher at 50% survival than at 10% survival. Additionally, both A549 and T98 cells generally had higher RBE values relative to the CHO cells, indicating a greater biological response to protons. An increase in RBE corresponded with an increase in y‒D and LETd. CONCLUSION Proton RBE was found to depend on mean proton energy, survival end point, and cell type. Changes in both y‒D and LETd were also found to impact proton RBE values, but consideration of the energy spectrum may provide additional information. The RBE values in this study vary greatly, indicating the clinical value of 1.1 may not be suitable in all cases.
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Affiliation(s)
| | - Chris Beltran
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Sarah Anderson
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Wan Chan Tseung
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Jann N Sarkaria
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Michael G Herman
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
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Miousse IR, Ewing LE, Kutanzi KR, Griffin RJ, Koturbash I. DNA Methylation in Radiation-Induced Carcinogenesis: Experimental Evidence and Clinical Perspectives. Crit Rev Oncog 2018; 23:1-11. [PMID: 29953365 PMCID: PMC6369919 DOI: 10.1615/critrevoncog.2018025687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Ionizing radiation is a valuable tool in many spheres of human life. At the same time, it is a genotoxic agent with a well-established carcinogenic potential. Progress achieved in the last two decades has demonstrated convincingly that ionizing radiation can also target the cellular epigenome. Epigenetics is defined as heritable changes in the expression of genes that are not due to alterations of DNA sequence but consist of specific covalent modifications of chromatin components, such as methylation of DNA, histone modifications, and control performed by non-coding RNAs. Accumulating evidence suggests that DNA methylation, a key epigenetic mechanism involved in the control of expression of genetic information, may serve as one of the driving mechanisms of radiation-induced carcinogenesis. Here, we review the literature on the effects of ionizing radiation on DNA methylation in various biological systems, discuss the role of DNA methylation in radiation carcinogenesis, and provide our opinion on the potential utilization of this knowledge in radiation oncology.
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Affiliation(s)
- Isabelle R. Miousse
- Department of Environmental and Occupational Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Laura E. Ewing
- Department of Environmental and Occupational Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Pharmacology and Toxicology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Kristy R. Kutanzi
- Department of Environmental and Occupational Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Robert J. Griffin
- Department of Radiation Oncology, Radiation Biology Division, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Igor Koturbash
- Department of Environmental and Occupational Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Purgason A, Zhang Y, Hamilton SR, Gridley DS, Sodipe A, Jejelowo O, Ramesh GT, Moreno-Villanueva M, Wu H. Apoptosis and expression of apoptosis-related genes in mouse intestinal tissue after whole-body proton exposure. Mol Cell Biochem 2017; 442:155-168. [DOI: 10.1007/s11010-017-3200-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/06/2017] [Indexed: 12/11/2022]
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Sørensen BS, Bassler N, Nielsen S, Horsman MR, Grzanka L, Spejlborg H, Swakoń J, Olko P, Overgaard J. Relative biological effectiveness (RBE) and distal edge effects of proton radiation on early damage in vivo. Acta Oncol 2017; 56:1387-1391. [PMID: 28830292 DOI: 10.1080/0284186x.2017.1351621] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The aim of the present study was to examine the RBE for early damage in an in vivo mouse model, and the effect of the increased linear energy transfer (LET) towards the distal edge of the spread-out Bragg peak (SOBP). METHOD The lower part of the right hind limb of CDF1 mice was irradiated with single fractions of either 6 MV photons, 240 kV photons or scanning beam protons and graded doses were applied. For the proton irradiation, the leg was either placed in the middle of a 30-mm SOBP, or to assess the effect in different positions, irradiated in 4 mm intervals from the middle of the SOBP to behind the distal dose fall-off. Irradiations were performed with the same dose plan at all positions, corresponding to a dose of 31.25 Gy in the middle of the SOBP. Endpoint of the study was early skin damage of the foot, assessed by a mouse foot skin scoring system. RESULTS The MDD50 values with 95% confidence intervals were 36.1 (34.2-38.1) Gy for protons in the middle of the SOBP for score 3.5. For 6 MV photons, it was 35.9 (34.5-37.5) Gy and 32.6 (30.7-34.7) Gy for 240 kV photons for score 3.5. The corresponding RBE was 1.00 (0.94-1.05), relative to 6 MV photons and 0.9 (0.85-0.97) relative to 240 kV photons. In the mice group positioned at the SOBP distal dose fall-off, 25% of the mice developed early skin damage compared with 0-8% in other groups. LETd,z = 1 was 8.4 keV/μm at the distal dose fall-off and the physical dose delivered was 7% lower than in the central SOBP position, where LETd,z =1 was 3.3 keV/μm. CONCLUSIONS Although there is a need to expand the current study to be able to calculate an exact enhancement ratio, an enhanced biological effect in vivo for early skin damage in the distal edge was demonstrated.
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Affiliation(s)
- Brita Singers Sørensen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Bassler
- Medical Radiation Physics, Department of Physics, Stockholm University, Stockholm, Sweden
| | - Steffen Nielsen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Michael R. Horsman
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Leszek Grzanka
- Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - Harald Spejlborg
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Jan Swakoń
- Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - Paweł Olko
- Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
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Abstract
PURPOSE To better estimate relative biological effectiveness (RBE) in therapeutic proton beams by using a modeled approach, in order to improve their clinical safety and effectiveness. INTRODUCTION Concerns exist about the 1.1 RBE used in proton therapy, since it may lead to unintentional over- and under-dosage in patients and so lead to unexpected clinical outcomes. Late reacting normal tissues (with low α/β values), might be overdosed if RBE >1.1; very radiosensitive tumors (with high α/β), might be under-dosed if RBE <1.1. Some physicists recommend ignoring RBE in favor of a LET × dose product to predict effects. MATERIAL AND METHODS Extensive linear-quadratic based modeling is scaled between a standard hospital megavoltage photon reference radiation (low LET of 0.22 keV μm-1) α and β values and their values at higher LETs, representative of the middle and end of the SOBPs. A previously published energy-efficiency model provide RBE estimates for different α/β (2-27 Gy). The concept of using a LET × dose product is assessed by comparing it with surviving fraction and the equivalent dose in 2 Gy fractions (EQD-2). RESULTS Low α/β value biosystems have the widest RBE ranges with dose per fraction changes and increasing LET, often above 1.1 even within the SOBP LET range, with lower values at higher dose per fraction. Highly radiosensitive tumors (α/β 10-27 Gy) have the lowest RBEs, often below 1.1, and are not fraction-sensitive. RBE's generally increase with LET, so curtailment of LET in normal tissues is important. The LET × dose product is insufficiently discriminating when compared with surviving fraction and biological effective dose (BED) or EQD-2. CONCLUSIONS An overall research framework is suggested. Proton therapy advantages will only be fully realized if reasonably correct RBE values are used.
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Affiliation(s)
- B. Jones
- Gray Laboratory, CRUK/MRC Oxford Oncology Institute, The University of Oxford, Oxford, UK
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128
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Nielsen S, Bassler N, Grzanka L, Swakon J, Olko P, Andreassen CN, Overgaard J, Alsner J, Sørensen BS. Differential gene expression in primary fibroblasts induced by proton and cobalt-60 beam irradiation. Acta Oncol 2017; 56:1406-1412. [PMID: 28885067 DOI: 10.1080/0284186x.2017.1351623] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Proton beam therapy delivers a more conformal dose distribution than conventional radiotherapy, thus improving normal tissue sparring. Increasing linear energy transfer (LET) along the proton track increases the relative biological effectiveness (RBE) near the distal edge of the Spread-out Bragg peak (SOBP). The severity of normal tissue side effects following photon beam radiotherapy vary considerably between patients. AIM The dual study aim was to identify gene expression patterns specific to radiation type and proton beam position, and to assess whether individual radiation sensitivity influences gene expression levels in fibroblast cultures irradiated in vitro. METHODS The study includes 30 primary fibroblast cell cultures from patients previously classified as either radiosensitive or radioresistant. Cells were irradiated at three different positions in the proton beam profile: entrance, mid-SOBP and at the SOBP distal edge. Dose was delivered in three fractions × 3.5 Gy(RBE) (RBE 1.1). Cobalt-60 (Co-60) irradiation was used as reference. Real-time qPCR was performed to determine gene expression levels for 17 genes associated with inflammation response, fibrosis and angiogenesis. RESULTS Differences in median gene expression levels were observed for multiple genes such as IL6, IL8 and CXCL12. Median IL6 expression was 30%, 24% and 47% lower in entrance, mid-SOBP and SOBP distal edge groups than in Co-60 irradiated cells. No genes were found to be oppositely regulated by different radiation qualities. Radiosensitive patient samples had the strongest regulation of gene expression; irrespective of radiation type. CONCLUSIONS Our findings indicate that the increased LET at the SOBP distal edge position did not generally lead to increased transcriptive response in primary fibroblast cultures. Inflammatory factors were generally less extensively upregulated by proton irradiation compared with Co-60 photon irradiation. These effects may possibly influence the development of normal tissue damage in patients treated with proton beam therapy.
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Affiliation(s)
- Steffen Nielsen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Bassler
- Medical Radiation Physics, Department of Physics, Stockholm University, Stockholm, Sweden
| | - Leszek Grzanka
- Proton Radiotherapy Group, Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - Jan Swakon
- Proton Radiotherapy Group, Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | - Pawel Olko
- Proton Radiotherapy Group, Institute of Nuclear Physics Polish Academy of Sciences, Krakow, Poland
| | | | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Brita Singers Sørensen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
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129
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Ulrich S, Wieser HP, Cao W, Mohan R, Bangert M. Impact of respiratory motion on variable relative biological effectiveness in 4D-dose distributions of proton therapy. Acta Oncol 2017; 56:1420-1427. [PMID: 28828913 DOI: 10.1080/0284186x.2017.1354131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Organ motion during radiation therapy with scanned protons leads to deviations between the planned and the delivered physical dose. Using a constant relative biological effectiveness (RBE) of 1.1 linearly maps these deviations into RBE-weighted dose. However, a constant value cannot account for potential nonlinear variations in RBE suggested by variable RBE models. Here, we study the impact of motion on recalculations of RBE-weighted dose distributions using a phenomenological variable RBE model. MATERIAL AND METHODS 4D-dose calculation including variable RBE was implemented in the open source treatment planning toolkit matRad. Four scenarios were compared for one field and two field proton treatments for a liver cancer patient assuming (α∕β)x = 2 Gy and (α∕β)x = 10 Gy: (A) the optimized static dose distribution with constant RBE, (B) a static recalculation with variable RBE, (C) a 4D-dose recalculation with constant RBE and (D) a 4D-dose recalculation with variable RBE. For (B) and (D), the variable RBE was calculated by the model proposed by McNamara. For (C), the physical dose was accumulated with direct dose mapping; for (D), dose-weighted radio-sensitivity parameters of the linear quadratic model were accumulated to model synergistic irradiation effects on RBE. RESULTS Dose recalculation with variable RBE led to an elevated biological dose at the end of the proton field, while 4D-dose recalculation exhibited random deviations everywhere in the radiation field depending on the interplay of beam delivery and organ motion. For a single beam treatment assuming (α∕β)x = 2 Gy, D95% was 1.98 Gy (RBE) (A), 2.15 Gy (RBE) (B), 1.81 Gy (RBE) (C) and 1.98 Gy (RBE) (D). The homogeneity index was 1.04 (A), 1.08 (B), 1.23 (C) and 1.25 (D). CONCLUSION For the studied liver case, intrafractional motion did not reduce the modulation of the RBE-weighted dose postulated by variable RBE models for proton treatments.
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Affiliation(s)
- Silke Ulrich
- Department of Medical Physics in Radiation Therapy, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Hans-Peter Wieser
- Department of Medical Physics in Radiation Therapy, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Wenhua Cao
- Department of Radiation Physics, MD Anderson Cancer Center, Houston, TX, USA
| | - Radhe Mohan
- Department of Radiation Physics, MD Anderson Cancer Center, Houston, TX, USA
| | - Mark Bangert
- Department of Medical Physics in Radiation Therapy, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
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130
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Jasińska-Konior K, Pochylczuk K, Czajka E, Michalik M, Romanowska-Dixon B, Swakoń J, Urbańska K, Elas M. Proton beam irradiation inhibits the migration of melanoma cells. PLoS One 2017; 12:e0186002. [PMID: 29016654 PMCID: PMC5634624 DOI: 10.1371/journal.pone.0186002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 09/22/2017] [Indexed: 12/12/2022] Open
Abstract
Purpose In recent years experimental data have indicated that low-energy proton beam radiation might induce a difference in cellular migration in comparison to photons. We therefore set out to compare the effect of proton beam irradiation and X-rays on the survival and long-term migratory properties of two cell lines: uveal melanoma Mel270 and skin melanoma BLM. Materials and methods Cells treated with either proton beam or X-rays were analyzed for their survival using clonogenic assay and MTT test. Long-term migratory properties were assessed with time-lapse monitoring of individual cell movements, wound test and transpore migration, while the expression of the related proteins was measured with western blot. Results Exposure to proton beam and X-rays led to similar survival but the quality of the cell colonies was markedly different. More paraclones with a low proliferative activity and fewer highly-proliferative holoclones were found after proton beam irradiation in comparison to X-rays. At 20 or 40 days post-irradiation, migratory capacity was decreased more by proton beam than by X-rays. The beta-1-integrin level was decreased in Mel270 cells after both types of radiation, while vimentin, a marker of EMT, was increased in BLM cells only. Conclusions We conclude that proton beam irradiation induced long-term inhibition of cellular motility, as well as changes in the level of beta-1 integrin and vimentin. If confirmed, the change in the quality, but not in the number of colonies after proton beam irradiation might favor tumor growth inhibition after fractionated proton therapy.
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Affiliation(s)
| | - Katarzyna Pochylczuk
- Department of Biophysics, Faculty of Biochemistry, Biophysics and Biotechnology, Cracow, Poland
| | - Elżbieta Czajka
- Department of Biophysics, Faculty of Biochemistry, Biophysics and Biotechnology, Cracow, Poland
| | - Marta Michalik
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Cracow, Poland
| | - Bożena Romanowska-Dixon
- Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Medical College, Cracow, Poland
| | - Jan Swakoń
- Institute of Nuclear Physics, PAS, Cracow, Poland
| | - Krystyna Urbańska
- Department of Biophysics, Faculty of Biochemistry, Biophysics and Biotechnology, Cracow, Poland
| | - Martyna Elas
- Department of Biophysics, Faculty of Biochemistry, Biophysics and Biotechnology, Cracow, Poland
- * E-mail:
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131
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Stokkevåg CH, Schneider U, Muren LP, Newhauser W. Radiation-induced cancer risk predictions in proton and heavy ion radiotherapy. Phys Med 2017; 42:259-262. [DOI: 10.1016/j.ejmp.2017.04.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 04/01/2017] [Accepted: 04/19/2017] [Indexed: 12/20/2022] Open
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132
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Abstract ID: 164 Detector MC study for measurement of nuclear reaction cross section relevant in particle therapy. Phys Med 2017. [DOI: 10.1016/j.ejmp.2017.09.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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133
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Buthut M, Haussmann R, Seidlitz A, Krause M, Donix M. [Cognitive deficits following brain tumor radiation therapy]. DER NERVENARZT 2017; 89:423-430. [PMID: 28932944 DOI: 10.1007/s00115-017-0423-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Brain radiation is an important treatment option for malignant and benign brain diseases. The possible acute or chronic impact of radiation therapy on cognitive performance is important for daily functioning and quality of life. A detailed evaluation of cognitive impairment is important in the context of how to control disease progression. The susceptibility of the hippocampus to radiation-induced neuronal damage and its important role in memory highlight that therapeutic strategies require precision medicine.
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Affiliation(s)
- M Buthut
- Neurologische Klinik (Neustadt/Trachau), Städtisches Klinikum Dresden, Industriestr. 40, 01129, Dresden, Deutschland
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - R Haussmann
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - A Seidlitz
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, OncoRay - Nationales Zentrum für Strahlenforschung in der Onkologie, Medizinische Fakultät und Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - M Krause
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, OncoRay - Nationales Zentrum für Strahlenforschung in der Onkologie, Medizinische Fakultät und Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
- Deutsches Konsortium für Translationale Krebsforschung (DKTK), Dresden, Deutschland
- Nationales Centrum für Tumorerkrankungen (NCT), Dresden, Deutschland
- Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
- Institut für Radioonkologie - OncoRay, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Deutschland
| | - M Donix
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Standort Dresden, Arnoldstr. 18, 01307, Dresden, Deutschland.
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134
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Bettega D, Calzolari P, Ciocca M, Facoetti A, Lafiandra M, Marchesini R, Molinelli S, Pignoli E, Vischioni B. Combining proton or photon irradiation with epothilone B. An
in vitro
study of cytotoxicity in human cancer cells. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa818f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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135
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Seo SJ, Jeon JK, Han SM, Kim JK. Reactive oxygen species-based measurement of the dependence of the Coulomb nanoradiator effect on proton energy and atomic Z value. Int J Radiat Biol 2017; 93:1239-1247. [PMID: 28752783 DOI: 10.1080/09553002.2017.1361556] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE The Coulomb nanoradiator (CNR) effect produces the dose enhancement effects from high-Z nanoparticles under irradiation with a high-energy ion beam. To gain insight into the radiation dose and biological significance of the CNR effect, the enhancement of reactive oxygen species (ROS) production from iron oxide or gold NPs (IONs or AuNPs, respectively) in water was investigated using traversing proton beams. METHODS AND MATERIALS The dependence of nanoradiator-enhanced ROS production on the atomic Z value and proton energy was investigated. Two biologically important ROS species were measured using fluorescent probes specific to •OH or [Formula: see text] in a series of water phantoms containing either AuNPs or IONs under irradiation with a 45- or 100-MeV proton beam. RESULTS The enhanced generation of hydroxyl radicals (•OH) and superoxide anions ([Formula: see text]) was determined to be caused by the dependence on the NP concentration and proton energy. The proton-induced Au or iron oxide nanoradiators exhibited different ROS enhancement rates depending on the proton energy, suggesting that the CNR radiation varied. The curve of the superoxide anion production from the Au-nanoradiator showed strong non-linearity, unlike the linear behavior observed for hydroxyl radical production and the X-ray photoelectric nanoradiator. In addition, the 45-MeV proton-induced Au nanoradiator exhibited an ROS enhancement ratio of 8.54/1.50 ([Formula: see text] / •OH), similar to that of the 100-KeV X-ray photoelectric Au nanoradiator (7.68/1.46). CONCLUSIONS The ROS-based detection of the CNR effect revealed its dependence on the proton beam energy, dose and atomic Z value and provided insight into the low-linear energy transfer (LET) CNR radiation, suggesting that these factors may influence the therapeutic efficacy via chemical reactivities, transport behaviors, and intracellular oxidative stress.
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Affiliation(s)
- Seung-Jun Seo
- a Department of Biomedical Engineering and Radiology, School of Medicine , Catholic University of Daegu , Daegu City , South Korea
| | - Jae-Kun Jeon
- a Department of Biomedical Engineering and Radiology, School of Medicine , Catholic University of Daegu , Daegu City , South Korea
| | - Sung-Mi Han
- b Department of Anatomy, School of Medicine , Catholic University of Daegu , Daegu City , South Korea
| | - Jong-Ki Kim
- a Department of Biomedical Engineering and Radiology, School of Medicine , Catholic University of Daegu , Daegu City , South Korea
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136
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Henthorn NT, Warmenhoven JW, Sotiropoulos M, Mackay RI, Kirkby KJ, Merchant MJ. Nanodosimetric Simulation of Direct Ion-Induced DNA Damage Using Different Chromatin Geometry Models. Radiat Res 2017; 188:690-703. [PMID: 28792846 DOI: 10.1667/rr14755.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Monte Carlo based simulation has proven useful in investigating the effect of proton-induced DNA damage and the processes through which this damage occurs. Clustering of ionizations within a small volume can be related to DNA damage through the principles of nanodosimetry. For simulation, it is standard to construct a small volume of water and determine spatial clusters. More recently, realistic DNA geometries have been used, tracking energy depositions within DNA backbone volumes. Traditionally a chromatin fiber is built within the simulation and identically replicated throughout a cell nucleus, representing the cell in interphase. However, the in vivo geometry of the chromatin fiber is still unknown within the literature, with many proposed models. In this work, the Geant4-DNA toolkit was used to build three chromatin models: the solenoid, zig-zag and cross-linked geometries. All fibers were built to the same chromatin density of 4.2 nucleosomes/11 nm. The fibers were then irradiated with protons (LET 5-80 keV/μm) or alpha particles (LET 63-226 keV/μm). Nanodosimetric parameters were scored for each fiber after each LET and used as a comparator among the models. Statistically significant differences were observed in the double-strand break backbone size distributions among the models, although nonsignificant differences were noted among the nanodosimetric parameters. From the data presented in this article, we conclude that selection of the solenoid, zig-zag or cross-linked chromatin model does not significantly affect the calculated nanodosimetric parameters. This allows for a simulation-based cell model to make use of any of these chromatin models for the scoring of direct ion-induced DNA damage.
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Affiliation(s)
- N T Henthorn
- a Division of Molecular and Clinical Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
| | - J W Warmenhoven
- a Division of Molecular and Clinical Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
| | - M Sotiropoulos
- a Division of Molecular and Clinical Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
| | - R I Mackay
- b Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, United Kingdom; and
| | - K J Kirkby
- a Division of Molecular and Clinical Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom.,c The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - M J Merchant
- a Division of Molecular and Clinical Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom.,c The Christie NHS Foundation Trust, Manchester, United Kingdom
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137
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Hojo H, Dohmae T, Hotta K, Kohno R, Motegi A, Yagishita A, Makinoshima H, Tsuchihara K, Akimoto T. Difference in the relative biological effectiveness and DNA damage repair processes in response to proton beam therapy according to the positions of the spread out Bragg peak. Radiat Oncol 2017; 12:111. [PMID: 28673358 PMCID: PMC5494883 DOI: 10.1186/s13014-017-0849-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/28/2017] [Indexed: 12/25/2022] Open
Abstract
Background Cellular responses to proton beam irradiation are not yet clearly understood, especially differences in the relative biological effectiveness (RBE) of high-energy proton beams depending on the position on the Spread-Out Bragg Peak (SOBP). Towards this end, we investigated the differences in the biological effect of a high-energy proton beam on the target cells placed at different positions on the SOBP, using two human esophageal cancer cell lines with differing radiosensitivities. Methods Two human esophageal cancer cell lines (OE21, KYSE450) with different radiosensitivities were irradiated with a 235-MeV proton beam at 4 different positions on the SOBP (position #1: At entry; position #2: At the proximal end of the SOBP; position #3: Center of the SOBP; position #4: At the distal end of the SOBP), and the cell survivals were assessed by the clonogenic assay. The RBE10 for each position of the target cell lines on the SOBP was determined based on the results of the cell survival assay conducted after photon beam irradiation. In addition, the number of DNA double-strand breaks was estimated by quantitating the number of phospho-histone H2AX (γH2AX) foci formed in the nuclei by immunofluorescence analysis. Results In regard to differences in the RBE of a proton beam according to the position on the SOBP, the RBE value tended to increase as the position on the SOBP moved distally. Comparison of the residual number of γH2AX foci at the end 24 h after the irradiation revealed, for both cell lines, a higher number of foci in the cells irradiated at the distal end of the SOPB than in those irradiated at the proximal end or center of the SOBP. Conclusions The results of this study demonstrate that the RBE of a high-energy proton beam and the cellular responses, including the DNA damage repair processes, to high-energy proton beam irradiation, differ according to the position on the SOBP, irrespective of the radiosensitivity levels of the cell lines. Electronic supplementary material The online version of this article (doi:10.1186/s13014-017-0849-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hidehiro Hojo
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
| | - Takeshi Dohmae
- High Energy Accelerator Research Organization, 1-1 Oho, Tsukuba, Ibaraki, 305-0801, Japan
| | - Kenji Hotta
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Ryosuke Kohno
- Department of Radiation Physics, The University of Texas M.D. Anderson Cancer Center, 1840 Old Spanish Trail, Houston, TX, 77054, USA
| | - Atsushi Motegi
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Atsushi Yagishita
- Division of Translational Research, EPOC, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Hideki Makinoshima
- Division of Translational Research, EPOC, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Katsuya Tsuchihara
- Division of Translational Research, EPOC, National Cancer Center, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tetsuo Akimoto
- Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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138
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Dewey S, Burigo L, Pshenichnov I, Mishustin I, Bleicher M. Lateral variations of radiobiological properties of therapeutic fields of 1H, 4He, 12C and 16O ions studied with Geant4 and microdosimetric kinetic model. Phys Med Biol 2017; 62:5884-5907. [PMID: 28557800 DOI: 10.1088/1361-6560/aa75b2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
As known, in cancer therapy with ion beams the relative biological effectiveness (RBE) of ions changes in the course of their propagation in tissues. Such changes are caused not only by increasing the linear energy transfer (LET) of beam particles with the penetration depth towards the Bragg peak, but also by nuclear reactions induced by beam nuclei leading to the production of various secondary particles. Although the changes of RBE along the beam axis have been studied quite well, much less attention has been paid to the evolution of RBE in the transverse direction, perpendicular to the beam axis. In order to fill this gap, we simulated radiation fields of 1H, 4He, 12C and 16O nuclei of 20 mm in diameter by means of a Geant4-based Monte Carlo model for heavy-ion therapy connected with the modified microdosimetric kinetic model to describe the response of normal ([Formula: see text] Gy) and early-responding ([Formula: see text] Gy) tissues. Depth and radial distributions of saturation-corrected dose-mean lineal energy, RBE and RBE-weighted dose are investigated for passive beam shaping and active beam scanning. The field of 4He has a small lateral spread as compared with 1H field, and it is characterised by a modest lateral variation of RBE suggesting the use of fixed RBE values across the field transverse cross section at each depth. Reduced uncertainties of RBE on the boundary of a 4He treatment field can be advantageous in a specific case of an organ at risk located in lateral proximity to the target volume. It is found that the lateral distributions of RBE calculated for 12C and 16O fields demonstrate fast variations in the radial direction due to changes of dose and composition of secondary fragments in the field penumbra. Nevertheless, the radiation fields of all four projectiles at radii larger than 20 mm can be characterized by a common RBE value defined by tissue radiosensitivity. These findings can help, in particular, in accessing the transverse homogeneity of radiation fields of ions used in studies in vitro.
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Affiliation(s)
- Sophie Dewey
- Frankfurt Institute for Advanced Studies, Johann Wolfgang Goethe University, 60438 Frankfurt am Main, Germany
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139
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Embriaco A, Bellinzona VE, Fontana A, Rotondi A. An accurate model for the computation of the dose of protons in water. Phys Med 2017; 38:66-75. [PMID: 28610699 DOI: 10.1016/j.ejmp.2017.05.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 04/15/2017] [Accepted: 05/04/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- A Embriaco
- Dipartimento di Fisica, Università di Pavia, Pavia, Italy; Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, Pavia, Italy
| | - V E Bellinzona
- Dipartimento di Fisica, Università di Pavia, Pavia, Italy; Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, Pavia, Italy; Department of Medical Physics, Ludwig-Maximilians-Universität München, Munich, Germany
| | - A Fontana
- Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, Pavia, Italy.
| | - A Rotondi
- Dipartimento di Fisica, Università di Pavia, Pavia, Italy; Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, Pavia, Italy
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140
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Miousse IR, Kutanzi KR, Koturbash I. Effects of ionizing radiation on DNA methylation: from experimental biology to clinical applications. Int J Radiat Biol 2017; 93:457-469. [PMID: 28134023 PMCID: PMC5411327 DOI: 10.1080/09553002.2017.1287454] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Ionizing radiation (IR) is a ubiquitous environmental stressor with genotoxic and epigenotoxic capabilities. Terrestrial IR, predominantly a low-linear energy transfer (LET) radiation, is being widely utilized in medicine, as well as in multiple industrial applications. Additionally, an interest in understanding the effects of high-LET irradiation is emerging due to the potential of exposure during space missions and the growing utilization of high-LET radiation in medicine. CONCLUSIONS In this review, we summarize the current knowledge of the effects of IR on DNA methylation, a key epigenetic mechanism regulating the expression of genetic information. We discuss global, repetitive elements and gene-specific DNA methylation in light of exposure to high and low doses of high- or low-LET IR, fractionated IR exposure, and bystander effects. Finally, we describe the mechanisms of IR-induced alterations to DNA methylation and discuss ways in which that understanding can be applied clinically, including utilization of DNA methylation as a predictor of response to radiotherapy and in the manipulation of DNA methylation patterns for tumor radiosensitization.
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Affiliation(s)
- Isabelle R Miousse
- a Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health , University of Arkansas for Medical Sciences , Little Rock , AR , USA
| | - Kristy R Kutanzi
- a Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health , University of Arkansas for Medical Sciences , Little Rock , AR , USA
| | - Igor Koturbash
- a Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health , University of Arkansas for Medical Sciences , Little Rock , AR , USA
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141
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Underwood TSA, Sung W, McFadden CH, McMahon SJ, Hall DC, McNamara AL, Paganetti H, Sawakuchi GO, Schuemann J. Comparing stochastic proton interactions simulated using TOPAS-nBio to experimental data from fluorescent nuclear track detectors. Phys Med Biol 2017; 62:3237-3249. [PMID: 28350546 PMCID: PMC8627280 DOI: 10.1088/1361-6560/aa6429] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Whilst Monte Carlo (MC) simulations of proton energy deposition have been well-validated at the macroscopic level, their microscopic validation remains lacking. Equally, no gold-standard yet exists for experimental metrology of individual proton tracks. In this work we compare the distributions of stochastic proton interactions simulated using the TOPAS-nBio MC platform against confocal microscope data for Al2O3:C,Mg fluorescent nuclear track detectors (FNTDs). We irradiated [Formula: see text] mm3 FNTD chips inside a water phantom, positioned at seven positions along a pristine proton Bragg peak with a range in water of 12 cm. MC simulations were implemented in two stages: (1) using TOPAS to model the beam properties within a water phantom and (2) using TOPAS-nBio with Geant4-DNA physics to score particle interactions through a water surrogate of Al2O3:C,Mg. The measured median track integrated brightness (IB) was observed to be strongly correlated to both (i) voxelized track-averaged linear energy transfer (LET) and (ii) frequency mean microdosimetric lineal energy, [Formula: see text], both simulated in pure water. Histograms of FNTD track IB were compared against TOPAS-nBio histograms of the number of terminal electrons per proton, scored in water with mass-density scaled to mimic Al2O3:C,Mg. Trends between exposure depths observed in TOPAS-nBio simulations were experimentally replicated in the study of FNTD track IB. Our results represent an important first step towards the experimental validation of MC simulations on the sub-cellular scale and suggest that FNTDs can enable experimental study of the microdosimetric properties of individual proton tracks.
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Affiliation(s)
- T S A Underwood
- Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America. Department of Medical Engineering and Physics, University College London, London, United Kingdom
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142
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Quantification of the uncertainties of a biological model and their impact on variable RBE proton treatment plan optimization. Phys Med 2017; 36:91-102. [PMID: 28410691 DOI: 10.1016/j.ejmp.2017.03.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 03/14/2017] [Accepted: 03/20/2017] [Indexed: 01/12/2023] Open
Abstract
PURPOSE In proton radiation therapy, a relative biological effectiveness (RBE) equal to 1.1 is currently assumed, although biological experiments show that it is not constant. The purpose of this study was to quantify the uncertainties of a published biological model and explore their impact on variable RBE treatment plan (TP) optimization. METHODS Two patient cases with a high and a low (α/β)x tumor were investigated. Firstly, intensity modulated proton therapy TPs assuming constant RBE were derived, and subsequently the variable RBE weighted dose (RWD), including the uncertainty originating in the fit to the experimental data and the uncertainty of the (α/β)x, were calculated. Secondly, TPs optimized for uniform biological effect assuming a variable RBE were created using the worst case tissue specific (α/β)x. RESULTS For the nasopharyngeal cancer patient, the uncertainty of (α/β)x corresponded to a CTV D98 confidence interval (CI) of (-2, +4)% while for the fit parameter CI was (-2,+1)%. For the standard fractionation prostate case the (α/β)x CI was (-7,+5)% and the fit parameter CI was (-3,+3)%. For the hypofractionated case both CIs were (-1,+1)%. In both patient cases, the RBE in most organs at risk (OARs) was significantly underestimated by the constant RBE approximation, whereas the situation was not as definite in the target volumes. Overdosage of OARs was reduced by using the biological effect optimization. CONCLUSION For the two patient cases, the RWD uncertainty from the fit parameter in the biological model contributed non-negligibly to the total uncertainty, depending on the patient case and the organ. The presented optimization strategy is a basic method for robust biological effect optimization to reduce potential consequences caused by the (α/β)x uncertainty.
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143
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Durante M, Orecchia R, Loeffler JS. Charged-particle therapy in cancer: clinical uses and future perspectives. Nat Rev Clin Oncol 2017; 14:483-495. [DOI: 10.1038/nrclinonc.2017.30] [Citation(s) in RCA: 241] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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144
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Abstract
OBJECTIVE This article considered why the proton therapy (PT) relative biological effect (RBE) should be a variable rather than a constant. METHODS The reasons for a variable proton RBE are enumerated, with qualitative and quantitative arguments. The heterogeneous data sets collated by Paganetti et al (2002) and the more homogeneous data of Britten et al (2013) are further analyzed using linear regression fitting and RBE-inclusive adaptations of the linear-quadratic (LQ) radiation model. RESULTS The in vitro data show RBE increasing as dose per fraction is lowered. In the Paganetti et al (2002) data sets, the differences between observed and expected effects are smaller when the LQ model is used, but with such data heterogeneity, firm statistical conclusions cannot be obtained. The more homogeneous data set shows an unequivocal variation in RBE with dose per faction. The in vivo data are inappropriate for assessments of late normal tissue effects in radiotherapy. Also, if there is the same degree of uncertainty in an RBE of 1.1 or in an RBE of 2-3 for C ions, the fractional and biological effective doses can vary considerably and be greater in the proton case. So, errors in RBE assignment are important for protons, just as with C ions. CONCLUSION Further experimental programmes are proposed, including late normal tissue end points. Better RBE allocations might further improve PT outcomes. ADVANCES IN KNOWLEDGE This study provides a rigorous critique of the 1.1 RBE used for protons, from theoretical and practical standpoints. Data analysis shows that the LQ model is more appropriate than simple linear regression. Comprehensive research programmes are suggested.
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Affiliation(s)
- Bleddyn Jones
- Gray Laboratory, CRUK/MRC Oxford Oncology Institute, University of Oxford, Oxford, UK
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145
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146
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Kunz-Schughart LA, Dubrovska A, Peitzsch C, Ewe A, Aigner A, Schellenburg S, Muders MH, Hampel S, Cirillo G, Iemma F, Tietze R, Alexiou C, Stephan H, Zarschler K, Vittorio O, Kavallaris M, Parak WJ, Mädler L, Pokhrel S. Nanoparticles for radiooncology: Mission, vision, challenges. Biomaterials 2016; 120:155-184. [PMID: 28063356 DOI: 10.1016/j.biomaterials.2016.12.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/08/2016] [Accepted: 12/09/2016] [Indexed: 12/29/2022]
Abstract
Cancer is one of the leading non-communicable diseases with highest mortality rates worldwide. About half of all cancer patients receive radiation treatment in the course of their disease. However, treatment outcome and curative potential of radiotherapy is often impeded by genetically and/or environmentally driven mechanisms of tumor radioresistance and normal tissue radiotoxicity. While nanomedicine-based tools for imaging, dosimetry and treatment are potential keys to the improvement of therapeutic efficacy and reducing side effects, radiotherapy is an established technique to eradicate the tumor cells. In order to progress the introduction of nanoparticles in radiooncology, due to the highly interdisciplinary nature, expertise in chemistry, radiobiology and translational research is needed. In this report recent insights and promising policies to design nanotechnology-based therapeutics for tumor radiosensitization will be discussed. An attempt is made to cover the entire field from preclinical development to clinical studies. Hence, this report illustrates (1) the radio- and tumor-biological rationales for combining nanostructures with radiotherapy, (2) tumor-site targeting strategies and mechanisms of cellular uptake, (3) biological response hypotheses for new nanomaterials of interest, and (4) challenges to translate the research findings into clinical trials.
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Affiliation(s)
- Leoni A Kunz-Schughart
- OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Anna Dubrovska
- OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Claudia Peitzsch
- OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Alexander Ewe
- Rudolf-Boehm-Institute for Pharmacology and Toxicology, Clinical Pharmacology, University of Leipzig, Germany
| | - Achim Aigner
- Rudolf-Boehm-Institute for Pharmacology and Toxicology, Clinical Pharmacology, University of Leipzig, Germany
| | - Samuel Schellenburg
- Institute of Pathology, University Hospital, Carl Gustav Carus, TU Dresden, Germany
| | - Michael H Muders
- Institute of Pathology, University Hospital, Carl Gustav Carus, TU Dresden, Germany
| | - Silke Hampel
- Leibniz Institute of Solid State and Material Research Dresden, 01171 Dresden, Germany
| | - Giuseppe Cirillo
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, CS, Italy
| | - Francesca Iemma
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, CS, Italy
| | - Rainer Tietze
- ENT-Department, Section for Experimental Oncology and Nanomedicine (SEON), Else Kröner-Fresenius Professorship, University Hospital Erlangen, Erlangen, Germany
| | - Christoph Alexiou
- ENT-Department, Section for Experimental Oncology and Nanomedicine (SEON), Else Kröner-Fresenius Professorship, University Hospital Erlangen, Erlangen, Germany
| | - Holger Stephan
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, 01314 Dresden, Germany
| | - Kristof Zarschler
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, 01314 Dresden, Germany
| | - Orazio Vittorio
- Children's Cancer Institute Australia, ARC Centre of Excellence in Convergent Bio-Nano Science and Technology and Australian Centre for NanoMedicine, Sydney, UNSW, Australia
| | - Maria Kavallaris
- Children's Cancer Institute Australia, ARC Centre of Excellence in Convergent Bio-Nano Science and Technology and Australian Centre for NanoMedicine, Sydney, UNSW, Australia
| | - Wolfgang J Parak
- Fachbereich Physik, Philipps Universität Marburg, 35037 Marburg, Germany; CIC Biomagune, 20009 San Sebastian, Spain
| | - Lutz Mädler
- Foundation Institute of Materials Science (IWT), Department of Production Engineering, University of Bremen, 28359 Bremen, Germany
| | - Suman Pokhrel
- Foundation Institute of Materials Science (IWT), Department of Production Engineering, University of Bremen, 28359 Bremen, Germany.
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147
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Doyen J, Bondiau PY, Benezery K, Thariat J, Vidal M, Gérard A, Hérault J, Carrie C, Hannoun-Lévi JM. [Indications and results for protontherapy in cancer treatments]. Cancer Radiother 2016; 20:513-8. [PMID: 27614508 DOI: 10.1016/j.canrad.2016.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 06/10/2016] [Indexed: 12/16/2022]
Abstract
Purpose was to summarize results for proton therapy in cancer treatment. A systematic review has been done by selecting studies on the website www.pubmed.com (Medline) and using the following keywords: proton therapy, radiation therapy, cancer, chordoma, chondrosarcoma, uveal melanoma, retinoblastoma, meningioma, glioma, neurinoma, pituitary adenoma, medulloblastoma, ependymoma, craniopharyngioma and nasal cavity. There are several retrospective studies reporting results for proton therapy in cancer treatments in the following indications: ocular tumors, nasal tumors, skull-based tumors, pediatric tumors. There is no prospective study except one phase II trial in medulloblastoma. The use of proton therapy for these indications is due to dosimetric advantages offering better tumor coverage and organ at risk sparing in comparison with photon therapy. Clinical results are historically at least as efficient as photon therapy with a better toxicity profile in pediatric tumors (cognitive and endocrine functions, radiation-induced cancer) and a better tumoral control in tumors of the nasal cavity. Clinical advantages of proton therapy counterbalance its cost especially in pediatric tumors. Proton therapy could be used in other types of cancer. Proton therapy showed good outcome in ocular, nasal tumors, pediatric, skull-based and paraspinal tumors. Because of some dosimetric advantages, proton therapy could be proposed for other indications in cancer treatments.
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Affiliation(s)
- J Doyen
- Centre Antoine-Lacassagne, radiation oncology, 33, avenue de Valombrose, 06189 Nice, France.
| | - P-Y Bondiau
- Centre Antoine-Lacassagne, radiation oncology, 33, avenue de Valombrose, 06189 Nice, France
| | - K Benezery
- Centre Antoine-Lacassagne, radiation oncology, 33, avenue de Valombrose, 06189 Nice, France
| | - J Thariat
- Centre Antoine-Lacassagne, radiation oncology, 33, avenue de Valombrose, 06189 Nice, France
| | - M Vidal
- Centre Antoine-Lacassagne, radiation oncology, 33, avenue de Valombrose, 06189 Nice, France
| | - A Gérard
- Centre Antoine-Lacassagne, radiation oncology, 33, avenue de Valombrose, 06189 Nice, France
| | - J Hérault
- Centre Antoine-Lacassagne, radiation oncology, 33, avenue de Valombrose, 06189 Nice, France
| | - C Carrie
- Centre Léon-Bérard, radiation oncology, 28, rue Laennec, 69008 Lyon, France
| | - J-M Hannoun-Lévi
- Centre Antoine-Lacassagne, radiation oncology, 33, avenue de Valombrose, 06189 Nice, France
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Durante M, Paganetti H. Nuclear physics in particle therapy: a review. REPORTS ON PROGRESS IN PHYSICS. PHYSICAL SOCIETY (GREAT BRITAIN) 2016; 79:096702. [PMID: 27540827 DOI: 10.1088/0034-4885/79/9/096702] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Charged particle therapy has been largely driven and influenced by nuclear physics. The increase in energy deposition density along the ion path in the body allows reducing the dose to normal tissues during radiotherapy compared to photons. Clinical results of particle therapy support the physical rationale for this treatment, but the method remains controversial because of the high cost and of the lack of comparative clinical trials proving the benefit compared to x-rays. Research in applied nuclear physics, including nuclear interactions, dosimetry, image guidance, range verification, novel accelerators and beam delivery technologies, can significantly improve the clinical outcome in particle therapy. Measurements of fragmentation cross-sections, including those for the production of positron-emitting fragments, and attenuation curves are needed for tuning Monte Carlo codes, whose use in clinical environments is rapidly increasing thanks to fast calculation methods. Existing cross sections and codes are indeed not very accurate in the energy and target regions of interest for particle therapy. These measurements are especially urgent for new ions to be used in therapy, such as helium. Furthermore, nuclear physics hardware developments are frequently finding applications in ion therapy due to similar requirements concerning sensors and real-time data processing. In this review we will briefly describe the physics bases, and concentrate on the open issues.
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Affiliation(s)
- Marco Durante
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute of Nuclear Physics (INFN), University of Trento, Via Sommarive 14, 38123 Povo (TN), Italy. Department of Physics, University Federico II, Naples, Italy
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149
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Orlandi E, Iacovelli NA, Bonora M, Cavallo A, Fossati P. Salivary Gland. Photon beam and particle radiotherapy: Present and future. Oral Oncol 2016; 60:146-56. [PMID: 27394087 DOI: 10.1016/j.oraloncology.2016.06.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 06/20/2016] [Accepted: 06/27/2016] [Indexed: 12/12/2022]
Abstract
Salivary gland cancers (SGCs) are rare diseases and their treatment depends upon histology, stage and site of origin. Radical surgery is the mainstay of treatment but radiotherapy (RT) plays a key role in both the postoperative and the inoperable setting, as well as in recurrent disease. In the absence of prospective randomized trials, a wide retrospective literature suggests postoperative RT (PORT) in patients with high risk pathological features. SGCs, and adenoid cystic carcinoma (ACC) in particular, are known to be radio-resistant tumors and should therefore respond well to particle beam therapy. Recently, excellent outcome has been reported with radical carbon ion RT (CIRT) in particular for ACC. Both modern photon- and hadron-based treatments are effective and are characterized by a favourable toxicity profile. But it is not clear whether one modality is superior to the other for disease control, due to the differences in patients' selection, techniques, fractionation schedules and outcome measurements among clinical experiences. In this paper, we review the role of photon and particle RT for malignant SGCs, discussing the difference between modalities in terms of biological and technical characteristics. RT dose and target volumes for different histologies (ACC versus non-ACC) have also been taken into consideration.
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Affiliation(s)
- Ester Orlandi
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | | | - Maria Bonora
- Clinical Department, CNAO (National Center for Oncological Hadrontherapy), Pavia, Italy
| | - Anna Cavallo
- Medical Physics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Piero Fossati
- Clinical Department, CNAO (National Center for Oncological Hadrontherapy), Pavia, Italy; Radiotherapy Division, European Institute of Oncology, Milan, Italy
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150
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Gameiro SR, Malamas AS, Bernstein MB, Tsang KY, Vassantachart A, Sahoo N, Tailor R, Pidikiti R, Guha CP, Hahn SM, Krishnan S, Hodge JW. Tumor Cells Surviving Exposure to Proton or Photon Radiation Share a Common Immunogenic Modulation Signature, Rendering Them More Sensitive to T Cell-Mediated Killing. Int J Radiat Oncol Biol Phys 2016; 95:120-130. [PMID: 27084634 PMCID: PMC4834148 DOI: 10.1016/j.ijrobp.2016.02.022] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/06/2016] [Accepted: 02/05/2016] [Indexed: 01/09/2023]
Abstract
PURPOSE To provide the foundation for combining immunotherapy to induce tumor antigen-specific T cells with proton radiation therapy to exploit the activity of those T cells. METHODS AND MATERIALS Using cell lines of tumors frequently treated with proton radiation, such as prostate, breast, lung, and chordoma, we examined the effect of proton radiation on the viability and induction of immunogenic modulation in tumor cells by flow cytometric and immunofluorescent analysis of surface phenotype and the functional immune consequences. RESULTS These studies show for the first time that (1) proton and photon radiation induced comparable up-regulation of surface molecules involved in immune recognition (histocompatibility leukocyte antigen, intercellular adhesion molecule 1, and the tumor-associated antigens carcinoembryonic antigen and mucin 1); (2) proton radiation mediated calreticulin cell-surface expression, increasing sensitivity to cytotoxic T-lymphocyte killing of tumor cells; and (3) cancer stem cells, which are resistant to the direct cytolytic activity of proton radiation, nonetheless up-regulated calreticulin after radiation in a manner similar to non-cancer stem cells. CONCLUSIONS These findings offer a rationale for the use of proton radiation in combination with immunotherapy, including for patients who have failed radiation therapy alone or have limited treatment options.
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Affiliation(s)
- Sofia R Gameiro
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Anthony S Malamas
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Michael B Bernstein
- Division of Radiation Oncology, M. D. Anderson Cancer Center, Houston, Texas
| | - Kwong Y Tsang
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - April Vassantachart
- Division of Radiation Oncology, M. D. Anderson Cancer Center, Houston, Texas
| | - Narayan Sahoo
- Division of Radiation Oncology, M. D. Anderson Cancer Center, Houston, Texas
| | - Ramesh Tailor
- Division of Radiation Oncology, M. D. Anderson Cancer Center, Houston, Texas
| | - Rajesh Pidikiti
- Division of Radiation Oncology, M. D. Anderson Cancer Center, Houston, Texas
| | - Chandan P Guha
- Department of Radiation Oncology, Montefiore Medical Center, Bronx, New York
| | - Stephen M Hahn
- Division of Radiation Oncology, M. D. Anderson Cancer Center, Houston, Texas
| | - Sunil Krishnan
- Division of Radiation Oncology, M. D. Anderson Cancer Center, Houston, Texas
| | - James W Hodge
- Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
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