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Zhu Z, Gong G, Wang L, Su Y, Lu J, Dong G, Yin Y. Dose-Painting Proton Radiotherapy Guided by Functional MRI in Non-enhancing High-Grade Gliomas. Clin Oncol (R Coll Radiol) 2024:S0936-6555(24)00187-0. [PMID: 38876805 DOI: 10.1016/j.clon.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/16/2024]
Abstract
AIMS This study aimed to demonstrate the feasibility and evaluate the dosimetric effect and clinical impact of dose-painting proton radiotherapy (PRT) guided by functional MRI in non-enhancing high-grade gliomas (NE-HGGs). MATERIALS AND METHODS The 3D-ASL and T2 FLAIR MR images of ten patients with NE-HGGs before radiotherapy were studied retrospectively. The hyperintensity on T2 FLAIR was used to generate the planning target volume (PTV), and the high-perfusion volume on 3D-ASL (PTV-ASL) was used to generate the simultaneous integrated boost (SIB) volume. Each patient received pencil beam scanning PRT and photon intensity-modulated radiotherapy (IMRT). There were five plans in each modality: (1) Uniform plans (IMRT60 vs. PRT60): 60Gy in 30 fractions to the PTV. (2)-(5) SIB plans (IMRT72, 84, 96, 108 vs. PRT72, 84, 96, 108): Uniform plan plus additional dose boost to PTV-ASL in 30 fractions to 72, 84, 96, 108 Gy. The dosimetric differences between various plans were compared. The clinical effects of target volume and organs at risk (OARs) were assessed using biological models for both tumor control probability (TCP) and normal tissue complication probability (NTCP). RESULTS Compared with the IMRT plan, the D2 and D50 of the PRT plans with the same prescription dose increased by 1.27-4.12% and 0.64-2.01%, respectively; the R30 decreased by > 32%; the dose of brainstem and chiasma decreased by > 27% and >32%; and the dose of normal brain tissue (Br-PTV), optic nerves, eyeballs, lens, cochlea, spinal cord, and hippocampus decreased by > 50% (P < 0.05). The maximum necessary dose was 96GyE to achieve >98% TCP for PRT, and it was 84Gy to achieve >91% TCP for IMRT. The average NTCP of Br-PTV was 1.30% and 1.90% for PRT and IMRT at the maximum dose escalation, respectively. The NTCP values of the remaining OARs approached zero in all PRT plans. CONCLUSION The functional MRI-guided dose escalation using PRT is feasible while sparing the OARs constraints and demonstrates a potential clinical benefit by improving TCP with no or minimal increase in NCTP for tissues outside the PTV. This retrospective study suggested that the use of PRT-based SIB guided by functional MRI may represent a strategy to provide benefits for patients with NE-HGGs.
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Affiliation(s)
- Z Zhu
- Harbin Medical University, No.157, Baojian Road, Nangang District, Harbin City, 150081, Heilongjiang Province, China; Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China
| | - G Gong
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China
| | - L Wang
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China
| | - Y Su
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China
| | - J Lu
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China
| | - G Dong
- Harbin Medical University, No.157, Baojian Road, Nangang District, Harbin City, 150081, Heilongjiang Province, China.
| | - Y Yin
- Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440 Jiyan Road, Huaiyin District, Jinan City, 250117, Shandong Province, China.
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Peng H, Deng J, Jiang S, Timmerman R. Rethinking the potential role of dose painting in personalized ultra-fractionated stereotactic adaptive radiotherapy. Front Oncol 2024; 14:1357790. [PMID: 38571510 PMCID: PMC10987838 DOI: 10.3389/fonc.2024.1357790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/21/2024] [Indexed: 04/05/2024] Open
Abstract
Fractionated radiotherapy was established in the 1920s based upon two principles: (1) delivering daily treatments of equal quantity, unless the clinical situation requires adjustment, and (2) defining a specific treatment period to deliver a total dosage. Modern fractionated radiotherapy continues to adhere to these century-old principles, despite significant advancements in our understanding of radiobiology. At UT Southwestern, we are exploring a novel treatment approach called PULSAR (Personalized Ultra-Fractionated Stereotactic Adaptive Radiotherapy). This method involves administering tumoricidal doses in a pulse mode with extended intervals, typically spanning weeks or even a month. Extended intervals permit substantial recovery of normal tissues and afford the tumor and tumor microenvironment ample time to undergo significant changes, enabling more meaningful adaptation in response to the evolving characteristics of the tumor. The notion of dose painting in the realm of radiation therapy has long been a subject of contention. The debate primarily revolves around its clinical effectiveness and optimal methods of implementation. In this perspective, we discuss two facets concerning the potential integration of dose painting with PULSAR, along with several practical considerations. If successful, the combination of the two may not only provide another level of personal adaptation ("adaptive dose painting"), but also contribute to the establishment of a timely feedback loop throughout the treatment process. To substantiate our perspective, we conducted a fundamental modeling study focusing on PET-guided dose painting, incorporating tumor heterogeneity and tumor control probability (TCP).
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Affiliation(s)
- Hao Peng
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Medical Artificial Intelligence and Automation Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jie Deng
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Medical Artificial Intelligence and Automation Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Steve Jiang
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Medical Artificial Intelligence and Automation Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Robert Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Laprie A, Tensaouti F, Cohen-Jonathan Moyal E. [Radiation dose intensification for glioblastoma]. Cancer Radiother 2022; 26:894-898. [PMID: 36085279 DOI: 10.1016/j.canrad.2022.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 10/14/2022]
Abstract
Glioblastoma is the most common brain tumor in adults; its treatment includes surgical excision or biopsy followed by radio-chemotherapy. Even if radiotherapy increases the survival of all patients regardless of their age or their general condition, there are always sources of radioresistance, where relapses occur and therefore treatment fails. Indeed, these foci result in a local relapse, which is observed in 95% of cases in the irradiation fields. We will describe here the current approaches to overcome this radioresistance by dose escalation, without or with guidance by metabolic and functional imaging (dose-painting). We will detail several prospective trials including the French phase III trial, SPECTRO-GLIO, randomizing the use of an integrated boost guided by spectrometric magnetic resonance imaging and similar trials developed across the Atlantic. We will also discuss approaches using different PET markers as well as diffusion or perfusion magnetic resonance imaging.
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Affiliation(s)
- A Laprie
- Département d'oncologie radiothérapie, institut universitaire du cancer de Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex, France; Inserm Toulouse neuroimaging center (Tonic), place Baylac, 31000 Toulouse, France.
| | - F Tensaouti
- Département d'oncologie radiothérapie, institut universitaire du cancer de Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex, France; Inserm Toulouse neuroimaging center (Tonic), place Baylac, 31000 Toulouse, France
| | - E Cohen-Jonathan Moyal
- Département d'oncologie radiothérapie, institut universitaire du cancer de Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex, France; Inserm Radopt, CRCT, Centre de recherche en cancérologie de Toulouse, 2, avenue Hubert-Curien, 31100 Toulouse, France
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Mokoala KMG, Lawal IO, Maserumule LC, Hlongwa KN, Ndlovu H, Reed J, Bida M, Maes A, van de Wiele C, Mahapane J, Davis C, Jeong JM, Popoola G, Vorster M, Sathekge MM. A Prospective Investigation of Tumor Hypoxia Imaging with 68Ga-Nitroimidazole PET/CT in Patients with Carcinoma of the Cervix Uteri and Comparison with 18F-FDG PET/CT: Correlation with Immunohistochemistry. J Clin Med 2022; 11:jcm11040962. [PMID: 35207237 PMCID: PMC8876585 DOI: 10.3390/jcm11040962] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/26/2022] Open
Abstract
Hypoxia in cervical cancer has been associated with a poor prognosis. Over the years 68Ga labelled nitroimidazoles have been studied and have shown improved kinetics. We present our initial experience of hypoxia Positron Emission Tomography (PET) imaging in cervical cancer with 68Ga-Nitroimidazole derivative and the correlation with 18F-FDG PET/CT and immunohistochemistry. Twenty women with cervical cancer underwent both 18F-FDG and 68Ga-Nitroimidazole PET/CT imaging. Dual-point imaging was performed for 68Ga-Nitroimidazole PET. Immunohistochemical analysis was performed with hypoxia inducible factor-1α (HIF-1α). We documented SUVmax, SUVmean of the primary lesions as well as tumor to muscle ratio (TMR), tumor to blood (TBR), metabolic tumor volume (MTV) and hypoxic tumor volume (HTV). There was no significant difference in the uptake of 68Ga-Nitroimidazole between early and delayed imaging. Twelve patients had uptake on 68Ga-Nitroimidazole PET. Ten patients demonstrated varying intensities of HIF-1α expression and six of these also had uptake on 68Ga-Nitroimidazole PET. We found a strong negative correlation between HTV and immunohistochemical staining (r = −0.660; p = 0.019). There was no correlation between uptake on PET imaging and immunohistochemical analysis with HIF-1α. Two-thirds of the patients demonstrated hypoxia on 68Ga-Nitroimidazole PET imaging.
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Affiliation(s)
- Kgomotso M. G. Mokoala
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
| | - Ismaheel O. Lawal
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa
| | - Letjie C. Maserumule
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
| | - Khanyisile N. Hlongwa
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
| | - Honest Ndlovu
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
| | - Janet Reed
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
| | - Meshack Bida
- Department of Anatomical Pathology, National Health Laboratory Services, Pretoria 0001, South Africa;
| | - Alex Maes
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
- Department of Nuclear Medicine, Katholieke University Leuven, 8500 Kortrijk, Belgium
| | - Christophe van de Wiele
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
- Department of Radiology and Nuclear Medicine, University of Ghent, 9000 Ghent, Belgium
| | - Johncy Mahapane
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
| | - Cindy Davis
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
| | - Jae Min Jeong
- Radiation Applied Life Sciences, Department of Nuclear Medicine, Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 03080, Korea;
- Cancer Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Gbenga Popoola
- Department of Epidemiology and Community Health, University of Ilorin, Ilorin 240102, Nigeria;
| | - Mariza Vorster
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa
| | - Mike M. Sathekge
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa; (K.M.G.M.); (I.O.L.); (L.C.M.); (K.N.H.); (H.N.); (J.R.); (A.M.); (C.v.d.W.); (J.M.); (C.D.); (M.V.)
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa
- Correspondence:
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5
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Abgral R, Bourhis D, Calais J, Lucia F, Leclère JC, Salaün PY, Vera P, Schick U. Correlation between fluorodeoxyglucose hotspots on preradiotherapy PET/CT and areas of cancer local relapse: Systematic review of literature. Cancer Radiother 2020; 24:444-452. [DOI: 10.1016/j.canrad.2020.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
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6
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Giraud N, Popinat G, Regaieg H, Tonnelet D, Vera P. Positron-emission tomography-guided radiation therapy: Ongoing projects and future hopes. Cancer Radiother 2020; 24:437-443. [PMID: 32247689 DOI: 10.1016/j.canrad.2020.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 02/06/2020] [Indexed: 02/08/2023]
Abstract
Radiation therapy has undergone significant advances these last decades, particularly thanks to technical improvements, computer science and a better ability to define the target volumes via morphological and functional imaging breakthroughs. Imaging contributes to all three stages of patient care in radiation oncology: before, during and after treatment. Before the treatment, the choice of optimal imaging type and, if necessary, the adequate functional tracer will allow a better definition of the volume target. During radiation therapy, image-guidance aims at locating the tumour target and tailoring the volume target to anatomical and tumoral variations. Imaging systems are now integrated with conventional accelerators, and newer accelerators have techniques allowing tumour tracking during the irradiation. More recently, MRI-guided systems have been developed, and are already active in a few French centres. Finally, after radiotherapy, imaging plays a major role in most patients' monitoring, and must take into account post-radiation tissue modification specificities. In this review, we will focus on the ongoing projects of nuclear imaging in oncology, and how they can help the radiation oncologist to better treat patients. To this end, a literature review including the terms "Radiotherapy", "Radiation Oncology" and "PET-CT" was performed in August 2019 on Medline and ClinicalTrials.gov. We chose to review successively these novelties organ-by-organ, focusing on the most promising advances. As a conclusion, the help of modern functional imaging thanks to a better definition and new specific radiopharmaceuticals tracers could allow even more precise treatments and enhanced surveillance. Finally, it could provide determinant information to artificial intelligence algorithms in "-omics" models.
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Affiliation(s)
- N Giraud
- Radiation Oncology Department, hôpital Haut-Lévêque, CHU de Bordeaux, avenue Magellan, 33600 Pessac, France.
| | - G Popinat
- Nuclear Medicine Department, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France
| | - H Regaieg
- Nuclear Medicine Department, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France
| | - D Tonnelet
- Nuclear Medicine Department, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France
| | - P Vera
- Nuclear Medicine Department, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France
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Supiot S, Rousseau C, Dore M, Chèze-Le-Rest C, Kandel-Aznar C, Potiron V, Guerif S, Paris F, Ferrer L, Campion L, Meingan P, Delpon G, Hatt M, Visvikis D. Reoxygenation during radiotherapy in intermediate-risk prostate cancer. Radiother Oncol 2019; 133:16-19. [PMID: 30935573 DOI: 10.1016/j.radonc.2018.12.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 10/27/2022]
Abstract
Hypoxia is a major risk factor of prostate cancer radioresistance. We evaluated hypoxia non-invasively, using 18F-Misonidazole PET/CT prior to radiotherapy and after a dose of 20 Gy in intermediate-risk prostate cancer patients. Decreased hypoxic volumes were observed in all patients, suggesting that radiotherapy induces early prostate tumor reoxygenation.
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Affiliation(s)
- Stéphane Supiot
- Institut de Cancérologie de l'Ouest, Nantes-Saint Herblain, France; Centre de Recherche en Cancéro-Immunologie Nantes/Angers (CRCINA, UMR 892 INSERM), Institut de Recherche en Santé de l'Université de Nantes, Nantes CEDEX 1, France.
| | - Caroline Rousseau
- Institut de Cancérologie de l'Ouest, Nantes-Saint Herblain, France; Centre de Recherche en Cancéro-Immunologie Nantes/Angers (CRCINA, UMR 892 INSERM), Institut de Recherche en Santé de l'Université de Nantes, Nantes CEDEX 1, France
| | - Mélanie Dore
- Institut de Cancérologie de l'Ouest, Nantes-Saint Herblain, France; Centre de Recherche en Cancéro-Immunologie Nantes/Angers (CRCINA, UMR 892 INSERM), Institut de Recherche en Santé de l'Université de Nantes, Nantes CEDEX 1, France
| | | | | | - Vincent Potiron
- Institut de Cancérologie de l'Ouest, Nantes-Saint Herblain, France; Centre de Recherche en Cancéro-Immunologie Nantes/Angers (CRCINA, UMR 892 INSERM), Institut de Recherche en Santé de l'Université de Nantes, Nantes CEDEX 1, France
| | | | - François Paris
- Institut de Cancérologie de l'Ouest, Nantes-Saint Herblain, France; Centre de Recherche en Cancéro-Immunologie Nantes/Angers (CRCINA, UMR 892 INSERM), Institut de Recherche en Santé de l'Université de Nantes, Nantes CEDEX 1, France
| | - Ludovic Ferrer
- Institut de Cancérologie de l'Ouest, Nantes-Saint Herblain, France; Centre de Recherche en Cancéro-Immunologie Nantes/Angers (CRCINA, UMR 892 INSERM), Institut de Recherche en Santé de l'Université de Nantes, Nantes CEDEX 1, France
| | - Loïc Campion
- Institut de Cancérologie de l'Ouest, Nantes-Saint Herblain, France; Centre de Recherche en Cancéro-Immunologie Nantes/Angers (CRCINA, UMR 892 INSERM), Institut de Recherche en Santé de l'Université de Nantes, Nantes CEDEX 1, France
| | - Philippe Meingan
- Institut de Cancérologie de l'Ouest, Nantes-Saint Herblain, France
| | - Grégory Delpon
- Institut de Cancérologie de l'Ouest, Nantes-Saint Herblain, France; Centre de Recherche en Cancéro-Immunologie Nantes/Angers (CRCINA, UMR 892 INSERM), Institut de Recherche en Santé de l'Université de Nantes, Nantes CEDEX 1, France
| | - Mathieu Hatt
- Laboratoire de Traitement de l'Information Médicale (LATIM), INSERM, UMR 1101, Université de Bretagne Occidentale, IBSAM, faculté de médecine, 29238 Brest CEDEX, France
| | - Dimitris Visvikis
- Laboratoire de Traitement de l'Information Médicale (LATIM), INSERM, UMR 1101, Université de Bretagne Occidentale, IBSAM, faculté de médecine, 29238 Brest CEDEX, France
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8
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Melsens E, De Vlieghere E, Descamps B, Vanhove C, Kersemans K, De Vos F, Goethals I, Brans B, De Wever O, Ceelen W, Pattyn P. Hypoxia imaging with 18F-FAZA PET/CT predicts radiotherapy response in esophageal adenocarcinoma xenografts. Radiat Oncol 2018. [PMID: 29514673 PMCID: PMC5842657 DOI: 10.1186/s13014-018-0984-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Esophageal cancer is an aggressive disease with poor survival rates. A more patient-tailored approach based on predictive biomarkers could improve outcome. We aimed to predict radiotherapy (RT) response by imaging tumor hypoxia with 18F-FAZA PET/CT in an esophageal adenocarcinoma (EAC) mouse model. Additionally, we investigated the radiosensitizing effect of the hypoxia modifier nimorazole in vitro and in vivo. Methods In vitro MTS cell proliferation assays (OACM5 1.C SC1, human EAC cell line) were performed under normoxic and hypoxic (< 1%) conditions: control (100 μL PBS), nimorazole, irradiation (5, 10 or 20 Gy) with or without nimorazole. In vivo, subcutaneous xenografts were induced in nude mice (OACM5 1.C SC1). Treatment was given daily for 5 consecutive days: (A) control (600 μl NaCl 0.9% intraperitoneally (IP)) (N = 5, n = 7), (B) RT (5 Gy/d) (N = 11, n = 20), (C) combination (nimorazole (200 mg/kg/d IP) 30 min before RT) (N = 13, n = 21). N = number of mice, n = number of tumors. 18F-FAZA PET/CT was performed before treatment and tumor to background (T/B) ratios were calculated. Relative tumor growth was calculated and tumor sections were examined histologically (hypoxia, proliferation). Results A T/B ≥ 3.59 on pre-treatment 18F-FAZA PET/CT was predictive for worse RT response (sensitivity 92.3%, specificity 71.4%). Radiation was less effective in hypoxic tumors (T/B ≥ 3.59) compared to normoxic tumors (T/B < 3.59) (P = 0.0025). In vitro, pre-treatment with nimorazole significantly decreased hypoxic radioresistance (P < 0.01) while in vivo, nimorazole enhanced the efficacy of RT to suppress cancer cell proliferation in hypoxic tumor areas (Ki67, P = 0.064), but did not affect macroscopic tumor growth. Conclusions Tumor tissue hypoxia as measured with 18F-FAZA PET/CT is predictive for RT response in an EAC xenograft model. The radiosensitizing effect of nimorazole was questionable and requires further investigation. Electronic supplementary material The online version of this article (10.1186/s13014-018-0984-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elodie Melsens
- Laboratory of Experimental Surgery, Department of Gastro- Intestinal Surgery, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.
| | - Elly De Vlieghere
- Laboratory of Experimental Cancer Research, Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium.,Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
| | - Benedicte Descamps
- Infinity (IBiTech-MEDISIP), Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Christian Vanhove
- Infinity (IBiTech-MEDISIP), Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Ken Kersemans
- Department of Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Filip De Vos
- Department of Pharmaceutical Analysis, Ghent University, Ghent, Belgium
| | - Ingeborg Goethals
- Department of Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Boudewijn Brans
- Department of Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
| | - Olivier De Wever
- Laboratory of Experimental Cancer Research, Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium.,Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
| | - Wim Ceelen
- Laboratory of Experimental Surgery, Department of Gastro- Intestinal Surgery, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.,Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
| | - Piet Pattyn
- Laboratory of Experimental Surgery, Department of Gastro- Intestinal Surgery, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.,Cancer Research Institute Ghent (CRIG), Ghent University, Ghent, Belgium
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Evaluation of tumor hypoxia prior to radiotherapy in intermediate-risk prostate cancer using 18F-fluoromisonidazole PET/CT: a pilot study. Oncotarget 2018. [PMID: 29515786 PMCID: PMC5839367 DOI: 10.18632/oncotarget.24234] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose Hypoxia is a major factor in prostate cancer aggressiveness and radioresistance. Predicting which patients might be bad candidates for radiotherapy may help better personalize treatment decisions in intermediate-risk prostate cancer patients. We assessed spatial distribution of 18F-Misonidazole (FMISO) PET/CT uptake in the prostate prior to radiotherapy treatment. Materials and Methods Intermediate-risk prostate cancer patients about to receive high-dose (>74 Gy) radiotherapy to the prostate without hormonal treatment were prospectively recruited between 9/2012 and 10/2014. Prior to radiotherapy, all patients underwent a FMISO PET/CT as well as a MRI and 18F-choline-PET. 18F-choline and FMISO-positive volumes were semi-automatically determined using the fuzzy locally adaptive Bayesian (FLAB) method. In FMISO-positive patients, a dynamic analysis of early tumor uptake was performed. Group differences were assessed using the Wilcoxon signed rank test. Parameters were correlated using Spearman rank correlation. Results Of 27 patients (median age 76) recruited to the study, 7 and 9 patients were considered positive at 2.5h and 3.5h FMISO PET/CT respectively. Median SUVmax and SUVmax tumor to muscle (T/M) ratio were respectively 3.4 and 3.6 at 2.5h, and 3.2 and 4.4 at 3.5h. The median FMISO-positive volume was 1.1 ml. Conclusions This is the first study regarding hypoxia imaging using FMISO in prostate cancer showing that a small FMISO-positive volume was detected in one third of intermediate-risk prostate cancer patients.
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Séhédic D, Chourpa I, Tétaud C, Griveau A, Loussouarn C, Avril S, Legendre C, Lepareur N, Wion D, Hindré F, Davodeau F, Garcion E. Locoregional Confinement and Major Clinical Benefit of 188Re-Loaded CXCR4-Targeted Nanocarriers in an Orthotopic Human to Mouse Model of Glioblastoma. Am J Cancer Res 2017; 7:4517-4536. [PMID: 29158842 PMCID: PMC5695146 DOI: 10.7150/thno.19403] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/11/2017] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Gold standard beam radiation for glioblastoma (GBM) treatment is challenged by resistance phenomena occurring in cellular populations well prepared to survive or to repair damage caused by radiation. Among signals that have been linked with radio-resistance, the SDF1/CXCR4 axis, associated with cancer stem-like cell, may be an opportune target. To avoid the problem of systemic toxicity and blood-brain barrier crossing, the relevance and efficacy of an original system of local brain internal radiation therapy combining a radiopharmaceutical with an immuno-nanoparticle was investigated. EXPERIMENT DESIGN The nanocarrier combined lipophilic thiobenzoate complexes of rhenium-188 loaded in the core of a lipid nanocapsule (LNC188Re) with a function-blocking antibody, 12G5 directed at the CXCR4, on its surface. The efficiency of 12G5-LNC188Re was investigated in an orthotopic and xenogenic GBM model of CXCR4-positive U87MG cells implanted in the striatum of Scid mice. RESULTS We demonstrated that 12G5-LNC188Re single infusion treatment by convection-enhanced delivery resulted in a major clinical improvement in median survival that was accompanied by locoregional effects on tumor development including hypovascularization and stimulation of the recruitment of bone marrow derived CD11b- or CD68-positive cells as confirmed by immunohistochemistry analysis. Interestingly, thorough analysis by spectral imaging in a chimeric U87MG GBM model containing CXCR4-positive/red fluorescent protein (RFP)-positive- and CXCR4-negative/RFP-negative-GBM cells revealed greater confinement of DiD-labeled 12G5-LNCs than control IgG2a-LNCs in RFP compartments. Main conclusion: These findings on locoregional impact and targeting of disseminated cancer cells in tumor margins suggest that intracerebral active targeting of nanocarriers loaded with radiopharmaceuticals may have considerable benefits in clinical applications.
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Paumier A, Marquis A, Trémolières P, Lacombe M, Capitain O, Septans AL, Peyraga G, Gustin P, Vénara A, Ménager É, Visvikis D, Couturier O, Rio E, Hatt M. [Prognostic value of the metabolically active tumour volume]. Cancer Radiother 2016; 20:24-9. [PMID: 26762703 DOI: 10.1016/j.canrad.2015.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/09/2015] [Accepted: 09/08/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to assess the prognostic value of different parameters on pretreatment fluorodeoxyglucose [((18)F)-FDG] positron emission tomography-computed tomography (PET-CT) in patients with localized oesophageal cancer. PATIENTS AND METHOD We retrospectively reviewed 83 cases of localised oesophageal cancer treated in our institution. Patients were treated with curative intent and have received chemoradiotherapy alone or followed by surgery. Different prognostic parameters were correlated to survival: cancer-related factors, patient-related factors and parameters derived from PET-CT (maximum standardized uptake value [SUV max], metabolically active tumor volume either measured with an automatic segmentation software ["fuzzy locally adaptive bayesian": MATVFLAB] or with an adaptive threshold method [MATVseuil] and total lesion glycolysis [TLGFLAB and TLGseuil]). RESULTS The median follow-up was 21.8 months (range: 0.16-104). The median overall survival was 22 months (95% confidence interval [95%CI]: 15.2-28.9). There were 67 deaths: 49 associated with cancer and 18 from intercurrent causes. None of the tested factors was significant on overall survival. In univariate analysis, the following three factors affected the specific survival: MATVFLAB (P=0.025), TLGFLAB (P=0.04) and TLGseuil (P=0.04). In multivariate analysis, only MATVFLAB had a significant impact on specific survival (P=0.049): MATVFLAB<18 cm(3): 31.2 months (95%CI: 21.7-not reached) and MATVFLAB>18 cm(3): 20 months (95%CI: 11.1-228.9). CONCLUSION The metabolically active tumour volume measured with the automatic segmentation software FLAB on baseline PET-CT was a significant prognostic factor, which should be tested on a larger cohort.
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Affiliation(s)
- A Paumier
- Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France.
| | - A Marquis
- Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France
| | - P Trémolières
- Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France
| | - M Lacombe
- Service de médecine nucléaire, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France
| | - O Capitain
- Service d'oncologie médicale, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France
| | - A-L Septans
- Département de recherche clinique, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France
| | - G Peyraga
- Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France
| | - P Gustin
- Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France
| | - A Vénara
- Service de chirurgie viscérale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - É Ménager
- Service d'hépatogastroentérologie, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - D Visvikis
- Inserm, UMR 1101, Laboratoire de traitement de l'information médicale (Latim), 2, avenue Maréchal-Foch, 29200 Brest, France; UMR 1101, CHRU Morvan, 2, avenue Maréchal-Foch, 29200 Brest, France
| | - O Couturier
- Service de médecine nucléaire, CHU d'Angers, 4, rue Larrey, 49100 Angers, France
| | - E Rio
- Service de radiothérapie, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain, France
| | - M Hatt
- Inserm, UMR 1101, Laboratoire de traitement de l'information médicale (Latim), 2, avenue Maréchal-Foch, 29200 Brest, France; UMR 1101, CHRU Morvan, 2, avenue Maréchal-Foch, 29200 Brest, France
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Laprie A, Hu Y, Alapetite C, Carrie C, Habrand JL, Bolle S, Bondiau PY, Ducassou A, Huchet A, Bertozzi AI, Perel Y, Moyal É, Balosso J. Paediatric brain tumours: A review of radiotherapy, state of the art and challenges for the future regarding protontherapy and carbontherapy. Cancer Radiother 2015; 19:775-89. [PMID: 26548600 DOI: 10.1016/j.canrad.2015.05.028] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 05/18/2015] [Accepted: 05/21/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Brain tumours are the most frequent solid tumours in children and the most frequent radiotherapy indications in paediatrics, with frequent late effects: cognitive, osseous, visual, auditory and hormonal. A better protection of healthy tissues by improved beam ballistics, with particle therapy, is expected to decrease significantly late effects without decreasing local control and survival. This article reviews the scientific literature to advocate indications of protontherapy and carbon ion therapy for childhood central nervous system cancer, and estimate the expected therapeutic benefits. MATERIALS AND METHODS A systematic review was performed on paediatric brain tumour treatments using Medline (from 1966 to March of 2014). To be included, clinical trials had to meet the following criteria: age of patients 18 years or younger, treated with radiation, and report of survival. Studies were also selected according to the evidence level. A secondary search of cited references found other studies about cognitive functions, quality of life, the comparison of photon and proton dosimetry showing potential dose escalation and/or sparing of organs at risk with protontherapy; and studies on dosimetric and technical issues related to protontherapy. RESULTS A total of 7051 primary references published were retrieved, among which 40 clinical studies and 60 papers about quality of life, dose distribution and dosimetry were analysed, as well as the ongoing clinical trials. These papers have been summarized and reported in a specific document made available to the participants of a final 1-day workshop. Tumours of the meningeal envelop and bony cranial structures were excluded from the analysis. Protontherapy allows outstanding ballistics to target the tumour area, while substantially decreasing radiation dose to the normal tissues. There are many indications of protontherapy for paediatric brain tumours in curative intent, either for localized treatment of ependymomas, germ-cell tumours, craniopharyngiomas, low-grade gliomas; or panventricular irradiation of pure non-secreting germinoma; or craniospinal irradiation of medulloblastomas and metastatic pure germinomas. Carbon ion therapy is just emerging and may be studied for highly aggressive and radioresistant tumours, as an initial treatment for diffuse brainstem gliomas, and for relapse of high-grade gliomas. CONCLUSION Both protontherapy and carbon ion therapy are promising for paediatric brain tumours. The benefit of decreasing late effects without altering survival has been described for most paediatric brain tumours with protontherapy and is currently assessed in ongoing clinical trials with up-to-date proton devices. Unfortunately, in 2015, only a minority of paediatric patients in France can receive protontherapy due to the lack of equipment.
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Affiliation(s)
- A Laprie
- Université Paul-Sabatier, Toulouse, France; Institut Claudius-Regaud, institut universitaire du cancer de Toulouse (IUCT)-Oncopole, radiation oncology, 1, avenue Irene-Joliot-Curie, 31059 Toulouse, France; Périclès-France-Hadron, Toulouse, France.
| | - Y Hu
- GCS-Étoile-France-Hadron, Lyon, France
| | - C Alapetite
- Institut Curie Paris Orsay (ICPO)-France-Hadron, Orsay, France
| | - C Carrie
- GCS-Étoile-France-Hadron, Lyon, France; Centre Léon-Bérard, Lyon, France
| | - J-L Habrand
- Institut Curie Paris Orsay (ICPO)-France-Hadron, Orsay, France; Université Paris Sud, Orsay, France; Archade-France-Hadron, Caen, France; Centre François-Baclesse, Caen, France; Gustave-Roussy, Villejuif, France
| | - S Bolle
- Institut Curie Paris Orsay (ICPO)-France-Hadron, Orsay, France; Impact-France-Hadron, Nice, France
| | - P-Y Bondiau
- Centre Antoine-Lacassagne, Nice, France; CHU de Bordeaux, Bordeaux, France
| | - A Ducassou
- Institut Claudius-Regaud, institut universitaire du cancer de Toulouse (IUCT)-Oncopole, radiation oncology, 1, avenue Irene-Joliot-Curie, 31059 Toulouse, France; Périclès-France-Hadron, Toulouse, France
| | - A Huchet
- Hôpital des Enfants, Toulouse, France
| | - A-I Bertozzi
- Périclès-France-Hadron, Toulouse, France; Université Grenoble Alpes, Grenoble, France
| | - Y Perel
- Université Grenoble Alpes, Grenoble, France
| | - É Moyal
- Université Paul-Sabatier, Toulouse, France; Institut Claudius-Regaud, institut universitaire du cancer de Toulouse (IUCT)-Oncopole, radiation oncology, 1, avenue Irene-Joliot-Curie, 31059 Toulouse, France; Périclès-France-Hadron, Toulouse, France
| | - J Balosso
- GCS-Étoile-France-Hadron, Lyon, France; CHU de Grenoble, Grenoble, France
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Legendre C, Garcion E. Iron metabolism: a double-edged sword in the resistance of glioblastoma to therapies. Trends Endocrinol Metab 2015; 26:322-31. [PMID: 25936466 DOI: 10.1016/j.tem.2015.03.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/27/2015] [Accepted: 03/30/2015] [Indexed: 12/12/2022]
Abstract
Glioblastoma (GBM), the deadliest primary tumor of the central nervous system (CNS), is a clear illustration of the resistance of cancer cells to conventional therapies. Application of combinatorial strategies able to overcome pivotal factors of GBM resistance, particularly within the resection margins, represents an essential issue. This review focuses on the role of iron metabolism in GBM progression and resistance to therapy, and the impact of its pharmaceutical modulation on the disease. Iron, through its involvement in many biological processes, is a key factor in the control of cell behavior and cancer biology. Therefore, targeting cellular iron signaling or taking advantage of its dysregulation in cancer cells may lead to new opportunities for improving treatments and drug delivery in GBM.
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Affiliation(s)
- Claire Legendre
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1066, Bio-Inspired Micro and Nanomedicines (MINT), Angers, France; L'Université Nantes Angers Le Mans (LUNAM), Université d'Angers, Angers, France
| | - Emmanuel Garcion
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1066, Bio-Inspired Micro and Nanomedicines (MINT), Angers, France; L'Université Nantes Angers Le Mans (LUNAM), Université d'Angers, Angers, France.
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[Metabolic tailoring in radiotherapy for head and neck cancer]. Cancer Radiother 2014; 18:565-71. [PMID: 25179254 DOI: 10.1016/j.canrad.2014.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 05/26/2014] [Accepted: 05/28/2014] [Indexed: 11/22/2022]
Abstract
Radiotherapy based on functional imaging consists to deliver a heterogeneity dose based on biological proprieties. This approach is termed biologically conformal radiotherapy or dose painting with biological target volume inside the gross tumor volume. Diffusion-weighted magnetic resonance imaging (MRI) and dynamic contrast-enhanced MRI can also be used to define a specific biological target volume. Three main tracers are used: ((18)F)-fluorodeoxyglucose to target the hypermetabolism, ((18)F)-fluoromizonidazole and ((18)F)- fluoroazomycin arabinoside to target areas of hypoxia. In this review, we give a practical approach to achieving a treatment-guided radiotherapy molecular and the main issues raised by this imaging technique. Despite the provision of all the technological tools to the radiotherapist, this new therapeutic approach is still evaluated in clinical studies to demonstrate a real clinical benefit compared to radiotherapy based on anatomic imaging.
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Graff P, Huger S, Kirby N, Pouliot J. Radiothérapie adaptative ORL. Cancer Radiother 2013; 17:513-22. [DOI: 10.1016/j.canrad.2013.06.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 06/23/2013] [Indexed: 11/29/2022]
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Radiothérapie et imagerie : 100 ans de progrès. Bull Cancer 2013. [DOI: 10.1684/bdc.2013.1819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Martin V, Moyal É, Delannes M, Padovani L, Sunyach MP, Feuvret L, Dhermain F, Noël G, Laprie A. Radiothérapie des tumeurs cérébrales : quelles marges ? Cancer Radiother 2013; 17:434-43. [DOI: 10.1016/j.canrad.2013.07.136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 07/09/2013] [Indexed: 01/15/2023]
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Potiron VA, Abderrahmani R, Abderrhamani R, Giang E, Chiavassa S, Di Tomaso E, Maira SM, Paris F, Supiot S. Radiosensitization of prostate cancer cells by the dual PI3K/mTOR inhibitor BEZ235 under normoxic and hypoxic conditions. Radiother Oncol 2013; 106:138-46. [PMID: 23321494 DOI: 10.1016/j.radonc.2012.11.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Revised: 10/11/2012] [Accepted: 11/08/2012] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND PURPOSE Despite appropriate radiotherapy, high-risk prostate cancer patients often experience local relapse and progression to metastatic disease. Radioresistance may be due to tumor-hypoxia but also due to the PTEN mutation/deletion present in 70% prostate cancers. We investigated whether the novel PI3K/mTOR inhibitor BEZ235 might sensitize prostate cancer cells to radiation and reduce hypoxia-induced radioresistance. MATERIALS AND METHODS The potential radiosensitizing properties of BEZ235 were investigated in vitro and in vivo using two prostate cancer cell lines, PC3 (PTEN(-/-)) and DU145 (PTEN(+/+)), under normoxic (21% O(2)) and hypoxic (0.5% O(2)) conditions. RESULTS BEZ235 rapidly inhibited PI3K and mTOR signaling in a dose dependent manner and limited tumor cell proliferation and clonogenic survival in both cell lines independently of PTEN status. In vivo, BEZ235 pretreatment enhanced the efficacy of radiation therapy on PC3 xenograft tumors in mice without inducing intestinal radiotoxicity. In culture, BEZ235 radiosensitized both cell lines in a comparable manner. Moreover, BEZ235 inhibited PI3K/mTOR activation and radiosensitized both cell lines under normoxia and hypoxia. BEZ235 radiosensitizing effects correlated with a decrease in γH2AX foci repair and increased G2/M cell cycle arrest. CONCLUSIONS BEZ235 is a potent radiosensitizer of normoxic and hypoxic prostate cancer cells.
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Moncharmont C, Levy A, Gilormini M, Bertrand G, Chargari C, Alphonse G, Ardail D, Rodriguez-Lafrasse C, Magné N. Targeting a cornerstone of radiation resistance: cancer stem cell. Cancer Lett 2012; 322:139-47. [PMID: 22459349 DOI: 10.1016/j.canlet.2012.03.024] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 03/18/2012] [Accepted: 03/21/2012] [Indexed: 12/26/2022]
Abstract
In radiation oncology, cancer stem cells (CSCs) have become an important research field. In fact, it appears that most cancer types contain populations of cells that exhibit stem-cell properties. CSCs have the ability to renew indefinitely, which can drive tumor development and metastatic invasion. As those cells are classically resistant to conventional chemotherapy and to radiation therapy, they may contribute to treatment failure and relapse. Over past decades, preclinical research has highlighted that variations in the CSCs content within tumor could affect their radiocurability by interfering with mechanisms of DNA repair, redistribution in the cell cycle, tumor cells repopulation, and hypoxia. It is now possible to isolate particular cells expressing specific surface markers and thus better investigating CSCs pathways. Numerous inhibitory agents targeting these specific signaling pathways, such as Notch and Wnt/B-catenin, are currently evaluated in early clinical trials. By targeting CSCs, tumor radioresistance could be potentially overcome to improve outcome for patients with solid malignancies. Radiation therapy using ion particles (proton and carbon) may be also more effective than classic photon on CSCs. This review presents the major pathophysiological mechanisms involved in CSCs radioresistance and recent developments for targeted strategies.
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Affiliation(s)
- Coralie Moncharmont
- Laboratoire de Radiobiologie Cellulaire et Moléculaire, Faculté de Médecine Lyon-Sud, Université de Lyon, Oullins, France
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Hatt M, Boussion N, Cheze-Le Rest C, Visvikis D, Pradier O. [Metabolically active volumes automatic delineation methodologies in PET imaging: review and perspectives]. Cancer Radiother 2011; 16:70-81; quiz 82, 84. [PMID: 22041031 DOI: 10.1016/j.canrad.2011.07.243] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 05/31/2011] [Accepted: 07/04/2011] [Indexed: 12/26/2022]
Abstract
PET imaging is now considered a gold standard tool in clinical oncology, especially for diagnosis purposes. More recent applications such as therapy follow-up or tumor targeting in radiotherapy require a fast, accurate and robust metabolically active tumor volumes delineation on emission images, which cannot be obtained through manual contouring. This clinical need has sprung a large number of methodological developments regarding automatic methods to define tumor volumes on PET images. This paper reviews most of the methodologies that have been recently proposed and discusses their framework and methodological and/or clinical validation. Perspectives regarding the future work to be done are also suggested.
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Affiliation(s)
- M Hatt
- Inserm U650 LaTIM, CHU Morvan, 5, avenue Foch, 29609 Brest, France.
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Supiot S, Rio E, Clément-Colmou K, Bouchot O, Rigaud J. Suivi après la radiothérapie des cancers de la prostate : bases scientifiques, rapport coût–bénéfice. Cancer Radiother 2011; 15:540-5. [DOI: 10.1016/j.canrad.2011.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 05/23/2011] [Indexed: 01/21/2023]
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