Phantom design and dosimetric characterization for multiple simultaneous cell irradiations with active pencil beam scanning

Evaluation of in vitro irradiation setup: Designed for the horizontal beamline at the Danish Centre for Particle Therapy

BACKGROUND

Radiobiological experimental setups are challenged by precise sample positioning along depth dose profile, scattering conditions, and practical difficulties that must be addressed in individual designs. The aim of this study was to produce cell survival curves with several irradiation modalities, by using a setup designed at the Danish Centre for Particle Therapy (DCPT) for in vitro proton irradiations using a horizontal beam line and thereby evaluating the setups use for in vitro irradiations experiments.

MATERIALS AND METHODS

The setup is a water phantom suitable for in vitro research with multiple irradiation modalities, in particular the pencil scanning proton beam available from a horizontal experimental beamline. The phantom included a water tank of 39.0 × 17.0 × 20.5 cm. Cell survival-curves were produced using the cell line V79 Chinese hamster lung fibroblast cells (V79s) in biological triplicates of clonogenic assays. Cell survival curves were produced with both a 18 MeV electron beam, 6 MV photon beam, and a Spread-Out Bragg Peak (SOBP) proton beam formed by pristine energies of 85-111 MeV where three positions were examined.

RESULTS

Survival curves with uncertainty areas were made for all modalities. Dosimetric uncertainty amounted to, respectively, 4%, 3% and 3% for proton, electron, and high energy photon irradiations. Cell survival fraction uncertainty was depicted as the standard deviation between replications of the experiment.

CONCLUSION

Cell survival curves could be produced with acceptable uncertainties using this novel water phantom and cellular laboratory workflow. The setup is useful for future in vitro irradiation experiments.

Characterization of GafChromic EBT2 film dose measurements using a tissue-equivalent water phantom for a Theratron® Equinox Cobalt-60 teletherapy machine

Purpose

In vivo dosimetry is a quality assurance tool that provides post-treatment measurement of the absorbed dose as delivered to the patient. This dosimetry compares the prescribed and measured dose delivered to the target volume. In this study, a tissue-equivalent water phantom provided the simulation of the human environment. The skin and entrance doses were measured using GafChromic EBT2 film for a Theratron® Equinox Cobalt-60 teletherapy machine.

Methods

We examined the behaviors of unencapsulated films and custom-made film encapsulation. Films were cut to 1 cm × 1 cm, calibrated, and used to assess skin dose depositions and entrance dose. We examined the response of the film for variations in field size, source to skin distance (SSD), gantry angle and wedge angle.

Results

The estimated uncertainty in EBT2 film for absorbed dose measurement in phantom was ±1.72%. Comparison of the measurements of the two film configurations for the various irradiation parameters were field size (p = 0.0193, α = 0.05, n = 11), gantry angle (p = 0.0018, α = 0.05, n = 24), SSD (p = 0.1802, α = 0.05, n = 11) and wedge angle (p = 0.6834, α = 0.05, n = 4). For a prescribed dose of 200 cGy and at reference conditions (open field 10 cm x 10 cm, SSD = 100 cm, and gantry angle = 0º), the measured skin dose using the encapsulation material was 70% while that measured with the unencapsulated film was 24%. At reference irradiation conditions, the measured skin dose using the unencapsulated film was higher for open field configurations (24%) than wedged field configurations (19%). Estimation of the entrance dose using the unencapsulated film was within 3% of the prescribed dose.

Conclusions

GafChromic EBT2 film measurements were significantly affected at larger field sizes and gantry angles. Furthermore, we determined a high accuracy in entrance dose estimations using the film.

Ganetespib selectively sensitizes cancer cells for proximal and distal spread-out Bragg peak proton irradiation

Objective

Hypersensitivity towards proton versus photon irradiation was demonstrated in homologous recombination repair (HRR)-deficient cell lines. Hence, combined treatment concepts targeting HRR provide a rational for potential pharmaceutical exploitation. The HSP90 inhibitor ganetespib (STA-9090) downregulates a multitude of HRR-associated proteins and sensitizes for certain chemotherapeutics. Thus, the radiosensitizing effect of HSP90-inhibiting ganetespib was investigated for reference photon irradiation and proton irradiation at a proximal and distal position in a spread-out Bragg peak (SOBP).

Methods

A549 and FaDu cells were treated with low-dose (2 nM resp. 1 nM) ganetespib and irradiated with 200 kV photons. Proton irradiation was performed at a proximal and a distal position within a SOBP, with corresponding dose-averaged linear-energy transfer (LET_D) values of 2.1 and 4.5 keV/µm, respectively. Cellular survival data was fitted to the linear-quadratic model to calculate relative biological effectiveness (RBE) and the dose-modifying factor (DMF). Additionally, A549 cells were treated with increasing doses of ganetespib and investigated by flow cytometry, immunoblotting, and immunofluorescence microscopy to investigate cell cycle distribution, Rad51 protein levels, and γH2AX foci, respectively.

Results

Low-dosed ganetespib significantly sensitized both cancer cell lines exclusively for proton irradiation at both investigated LET_D, resulting in increased RBE values of 10–40%. In comparison to photon irradiation, the fraction of cells in S/G2/M phase was elevated in response to proton irradiation with 10 nM ganetespib consistently reducing this population. No changes in cell cycle distribution were detected in unirradiated cells by ganetespib alone. Protein levels of Rad51 are downregulated in irradiated A549 cells by 10 nM and also 2 nM ganetespib within 24 h. Immunofluorescence staining demonstrated similar induction and removal of γH2AX foci, irrespective of irradiation type or ganetespib administration.

Conclusion

Our findings illustrate a proton-specific sensitizing effect of low-dosed ganetespib in both employed cell lines and at both investigated SOBP positions. We provide additional experimental data on cellular response and a rational for future combinatorial approaches with proton radiotherapy.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13014-022-02036-z.

Activation of efficient DNA repair mechanisms after photon and proton irradiation of human chondrosarcoma cells

Although particle therapy with protons has proven to be beneficial in the treatment of chondrosarcoma compared to photon-based (X-ray) radiation therapy, the cellular and molecular mechanisms have not yet been sufficiently investigated. Cell viability and colony forming ability were analyzed after X-ray and proton irradiation (IR). Cell cycle was analyzed using flow cytometry and corresponding regulator genes and key players of the DNA repair mechanisms were measured using next generation sequencing, protein expression and immunofluorescence staining. Changes in metabolic phenotypes were determined with nuclear magnetic resonance spectroscopy. Both X-ray and proton IR resulted in reduced cell survival and a G2/M phase arrest of the cell cycle. Especially 1 h after IR, a significant dose-dependent increase of phosphorylated γH2AX foci was observed. This was accompanied with a reprogramming in cellular metabolism. Interestingly, within 24 h the majority of clearly visible DNA damages were repaired and the metabolic phenotype restored. Involved DNA repair mechanisms are, besides the homology directed repair (HDR) and the non-homologous end-joining (NHEJ), especially the mismatch mediated repair (MMR) pathway with the key players EXO1, MSH3, and PCNA. Chondrosarcoma cells regenerates the majority of DNA damages within 24 h. These molecular mechanisms represent an important basis for an improved therapy.

Simulation of dose distribution and secondary particle production in proton therapy of brain tumor

Aim

The aim of this study is simulation of the proton depth-dose distribution and dose evaluation of secondary particles in proton therapy of brain tumor using the GEANT4 and FLUKA Monte Carlo codes.

Background

Proton therapy is a treatment method for variety of tumors such as brain tumor. The most important feature of high energy proton beams is the energy deposition as a Bragg curve and the possibility of creating the spread out Bragg peak (SOBP) for full coverage of the tumor.

Materials and methods

A spherical tumor with the radius of 1 cm in the brain is considered. A SNYDER head phantom has been irradiated with 30-130 MeV proton beam energy. A PMMA modulator wheel is used for covering the tumor. The simulations are performed using the GEANT4 and FLUKA codes.

Results

Using a modulator wheel, the Spread Out Bragg Peak longitudinally and laterally covers the tumor. Flux and absorbed dose of secondary particles produced by nuclear interactions of protons with elements in the head are considerably small compared to protons.

Conclusions

Using 76.85 MeV proton beam and a modulator wheel, the tumor can be treated accurately in the 3-D, so that the distribution of proton dose in the surrounding tissues is very low. The results show that more than 99% of the total dose of secondary particles and protons is absorbed in the tumor.

Investigating the impact of alpha/beta and LETd on relative biological effectiveness in scanned proton beams: An in vitro study based on human cell lines

PURPOSE

A relative biological effectiveness (RBE) of 1.1 is commonly used in clinical proton therapy, irrespective of tissue type and depth. This in vitro study was conducted to quantify the RBE of scanned protons as a function of the dose-averaged linear energy transfer (LET_d ) and the sensitivity factor (α/ß)_X . Additionally, three phenomenological models (McNamara, Rørvik, and Jones) and one mechanistic model (repair-misrepair-fixation, RMF) were applied to the experimentally derived data.

METHODS

Four human cell lines (FaDu, HaCat, Du145, SKMel) with differential (α/ß)_X ratios were irradiated in a custom-designed irradiation setup with doses between 0 and 6 Gy at proximal, central, and distal positions of a 80 mm spread-out Bragg peak (SOBP) centered at 80 mm (setup A: proton energies 66.5-135.6 MeV) and 155 mm (setup B: proton energies 127.2-185.9 MeV) depth, respectively. LET_d values at the respective cell positions were derived from Monte Carlo simulations performed with the treatment planning system (TPS, RayStation). Dosimetric measurements were conducted to verify dose homogeneity and dose delivery accuracy. RBE values were derived for doses that resulted in 90 % (RBE₉₀ ) and 10 % (RBE₁₀ ) of cell survival, and survival after a 0.5 Gy dose (RBE_0.5Gy ), 2 Gy dose (RBE_2Gy ), and 6 Gy dose (RBE_6Gy ).

RESULTS

LET_d values at sample positions were 1.9, 2.1, 2.5, 2.8, 4.1, and 4.5 keV/µm. For the cell lines with high (α/ß)_X ratios (FaDu, HaCat), the LET_d did not impact on the RBE. For low (α/ß)_X cell lines (Du145, SKMel), LQ-derived survival curves indicated a clear correlation of LET_d and RBE. RBE₉₀ values up to 2.9 and RBE₁₀ values between 1.4 and 1.8 were obtained. Model-derived RBE predictions slightly overestimated the RBE for the high (α/ß)_X cell lines, although all models except the Jones model provided RBE values within the experimental uncertainty. For low (α/ß)_X cell lines, no agreement was found between experiments and model predictions, that is, all models underestimated the measured RBE.

CONCLUSIONS

The sensitivity parameter (α/ß)_X was observed to be a major influencing factor for the RBE of protons and its sensitivity toward LET_d changes. RBE prediction models are applicable for high (α/ß)_X cell lines but do not estimate RBE values with sufficient accuracy in low (α/ß)_X cell lines.

Dose- rather than fluence-averaged LET should be used as a single-parameter descriptor of proton beam quality for radiochromic film dosimetry

PURPOSE

The dose response of Gafchromic EBT3 films exposed to proton beams depends on the dose, and additionally on the beam quality, which is often quantified with the linear energy transfer (LET) and, hence, also referred to as LET quenching. Fundamentally different methods to determine correction factors for this LET quenching effect have been reported in literature and a new method using the local proton fluence distribution differential in LET is presented. This method was exploited to investigate whether a more practical correction based on the dose- or fluence-averaged LET is feasible in a variety of clinically possible beam arrangements.

METHODS

The relative effectiveness (RE) was characterized within a high LET spread-out Bragg peak (SOBP) in water made up by the six lowest available energies (62.4-67.5 MeV, configuration " b 1 ") resulting in one of the highest clinically feasible dose-averaged LET distributions. Additionally, two beams were measured where a low LET proton beam (252.7 MeV) was superimposed on " b 1 ", which contributed either 50% of the initial particle fluence or 50% of the dose in the SOBP, referred to as configuration " b 2 " and " b 3 ," respectively. The proton LET spectrum was simulated with GATE/Geant4 at all measurement positions. The net optical density change differential in LET was integrated over the local proton spectrum to calculate the net optical density and therefrom the beam quality correction factor. The LET dependence of the film response was accounted for by an LET dependence of one of the three parameters in the calibration function and was determined from inverse optimization using measurement " b 1 ." This method was then validated on the measurements of " b 2 " and " b 3 " and subsequently used to calculate the RE at 900 positions in nine clinically relevant beams. The extrapolated RE set was used to derive a simple linear correction function based on dose-averaged LET ( L d ) and verify the validity in all points of the comprehensive RE set.

RESULTS

The uncorrected film dose deviated up to 26% from the reference dose, whereas the corrected film dose agreed within 3% in all three beams in water (" b 1 ", " b 2 " and " b 3 "). The LET dependence of the calibration function started to strongly increase around 5 keV/μm and flatten out around 30 keV/μm. All REs calculated from the proton fluence in the nine simulated beams could be approximated with a linear function of dose-averaged LET (RE = 1.0258-0.0211 μm/keV L d ). However, no functional relationship of RE- and fluence-averaged LET could be found encompassing all beam energies and modulations.

CONCLUSIONS

The film quenching was found to be nonlinear as a function of proton LET as well as of the dose-averaged LET. However, the linear relation of RE on dose-averaged LET was a good approximation in all cases. In contrast to dose-averaged LET, fluence-averaged LET could not describe the RE when multiple beams were applied.