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Kelleter L, Marek L, Echner G, Ochoa-Parra P, Winter M, Harrabi S, Jakubek J, Jäkel O, Debus J, Martisikova M. An in-vivo treatment monitoring system for ion-beam radiotherapy based on 28 Timepix3 detectors. Sci Rep 2024; 14:15452. [PMID: 38965349 PMCID: PMC11224389 DOI: 10.1038/s41598-024-66266-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 07/01/2024] [Indexed: 07/06/2024] Open
Abstract
Ion-beam radiotherapy is an advanced cancer treatment modality offering steep dose gradients and a high biological effectiveness. These gradients make the therapy vulnerable to patient-setup and anatomical changes between treatment fractions, which may go unnoticed. Charged fragments from nuclear interactions of the ion beam with the patient tissue may carry information about the treatment quality. Currently, the fragments escape the patient undetected. Inter-fractional in-vivo treatment monitoring based on these charged nuclear fragments could make ion-beam therapy safer and more efficient. We developed an ion-beam monitoring system based on 28 hybrid silicon pixel detectors (Timepix3) to measure the distribution of fragment origins in three dimensions. The system design choices as well as the ion-beam monitoring performance measurements are presented in this manuscript. A spatial resolution of 4 mm along the beam axis was achieved for the measurement of individual fragment origins. Beam-range shifts of1.5 mm were identified in a clinically realistic treatment scenario with an anthropomorphic head phantom. The monitoring system is currently being used in a prospective clinical trial at the Heidelberg Ion Beam Therapy Centre for head-and-neck as well as central nervous system cancer patients.
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Affiliation(s)
- Laurent Kelleter
- Heidelberg Institute for Radiation Oncology (HIRO) and National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany.
- Division of Medical Physics in Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany.
- National Center for Tumor Diseases (NCT), NCT Heidelberg, A Partnership Between DKFZ and University Medical Center Heidelberg, Heidelberg, Germany.
| | | | - Gernot Echner
- Heidelberg Institute for Radiation Oncology (HIRO) and National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany
- Division of Medical Physics in Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Pamela Ochoa-Parra
- Heidelberg Institute for Radiation Oncology (HIRO) and National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany
- Division of Medical Physics in Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
- Department of Physics and Astronomy, Heidelberg University, Heidelberg, Germany
| | - Marcus Winter
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - Semi Harrabi
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Oliver Jäkel
- Heidelberg Institute for Radiation Oncology (HIRO) and National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany
- Division of Medical Physics in Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), NCT Heidelberg, A Partnership Between DKFZ and University Medical Center Heidelberg, Heidelberg, Germany
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Debus
- Division of Medical Physics in Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), NCT Heidelberg, A Partnership Between DKFZ and University Medical Center Heidelberg, Heidelberg, Germany
- Heidelberg Ion-Beam Therapy Centre (HIT), Department of Radiation Oncology Heidelberg University Hospital, Heidelberg, Germany
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Maria Martisikova
- Heidelberg Institute for Radiation Oncology (HIRO) and National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany
- Division of Medical Physics in Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), NCT Heidelberg, A Partnership Between DKFZ and University Medical Center Heidelberg, Heidelberg, Germany
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Salomon N, Helm A, Selmi A, Fournier C, Diken M, Schrörs B, Scholz M, Kreiter S, Durante M, Vascotto F. Carbon Ion and Photon Radiation Therapy Show Enhanced Antitumoral Therapeutic Efficacy With Neoantigen RNA-LPX Vaccines in Preclinical Colon Carcinoma Models. Int J Radiat Oncol Biol Phys 2024; 119:936-945. [PMID: 38163521 DOI: 10.1016/j.ijrobp.2023.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/07/2023] [Accepted: 12/27/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE Personalized liposome-formulated mRNA vaccines (RNA-LPX) are a powerful new tool in cancer immunotherapy. In preclinical tumor models, RNA-LPX vaccines are known to achieve potent results when combined with conventional X-ray radiation therapy (XRT). Densely ionizing radiation used in carbon ion radiation therapy (CIRT) may induce distinct effects in combination with immunotherapy compared with sparsely ionizing X-rays. METHODS AND MATERIALS Within this study, we investigate the potential of CIRT and isoeffective doses of XRT to mediate tumor growth inhibition and survival in murine colon adenocarcinoma models in conjunction with neoantigen (neoAg)-specific RNA-LPX vaccines encoding both major histocompatibility complex (MHC) class I- and class II-restricted tumor-specific neoantigens. We characterize tumor immune infiltrates and antigen-specific T cell responses by flow cytometry and interferon-γ enzyme-linked immunosorbent spot (ELISpot) analyses, respectively. RESULTS NeoAg RNA-LPX vaccines significantly potentiate radiation therapy-mediated tumor growth inhibition. CIRT and XRT alone marginally prime neoAg-specific T cell responses detected in the tumors but not in the blood or spleens of mice. Infiltration and cytotoxicity of neoAg-specific T cells is strongly driven by RNA-LPX vaccines and is accompanied by reduced expression of the inhibitory markers PD-1 and Tim-3 on these cells. The neoAg RNA-LPX vaccine shows similar overall therapeutic efficacy in combination with both CIRT and XRT, even if the physical radiation dose is lower for carbon ions than for X-rays. CONCLUSIONS We hence conclude that the combination of CIRT and neoAg RNA-LPX vaccines is a promising strategy for the treatment of radioresistant tumors.
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Affiliation(s)
- Nadja Salomon
- TRON gGmbH, Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Alexander Helm
- GSI Helmholtzzentrum for Heavy Ion Research GmbH, Darmstadt, Germany
| | - Abderaouf Selmi
- TRON gGmbH, Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Claudia Fournier
- GSI Helmholtzzentrum for Heavy Ion Research GmbH, Darmstadt, Germany
| | - Mustafa Diken
- TRON gGmbH, Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Barbara Schrörs
- TRON gGmbH, Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Scholz
- GSI Helmholtzzentrum for Heavy Ion Research GmbH, Darmstadt, Germany
| | - Sebastian Kreiter
- TRON gGmbH, Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marco Durante
- GSI Helmholtzzentrum for Heavy Ion Research GmbH, Darmstadt, Germany; Technical University Darmstadt, Institute of Condensed Matter Physics, Darmstadt, Germany; University Federico II, Department of Physics "Ettore Pancini", Naples, Italy
| | - Fulvia Vascotto
- TRON gGmbH, Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
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Li Y, Guan X, Xing X, Hu C. Survival outcomes and toxicity profiles among patients with nonmetastatic nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT) versus IMRT + carbon-ion radiotherapy: A propensity score-matched analysis. Head Neck 2024; 46:1766-1776. [PMID: 38591178 DOI: 10.1002/hed.27771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVES To compare survival outcomes and toxic effects among patients with newly diagnosed nonmetastatic nasopharyngeal carcinoma (NPC) when treated with intensity-modulated radiotherapy (IMRT) versus IMRT + carbon-ion radiotherapy (CIRT). METHODS We performed a retrospective propensity score matching analysis (1:1) of patients treated with IMRT and IMRT + CIRT. Descriptive statistics were used to examine the baseline characteristics of the patients. Survival was estimated using the Kaplan-Meier method. Univariate and multivariable logistic regression analysis were used to identify the independent predictors of survival. We examined the association between risk factors and adverse events (AEs) using chi-square tests. Cox model and logistic regression were used to analyze AEs. RESULTS Hundred and nine patients who received IMRT + CIRT were included and the median follow-up time was 20.6 months (range: 4.6-82 months). There were no statistically significant differences in locoregional failure-free survival, distant metastasis-free survival, disease-free survival, or overall survival between the two groups, but potentially better in IMRT + CIRT group (p > 0.05, respectively). Nodal boost was the only significant factor associated with LRFS and DFS on multivariable analysis. Thirty-seven patients (34.0%) developed grade 3 acute OMs and no grade 4 acute OMs were observed in IMRT + CIRT group. All patients in IMRT + CIRT group developed grade 1 dermatitis; while in the match group, 76 patients developed grade 1 dermatitis, 27 patients developed grade 2 dermatitis, 5 patients developed grade 3 dermatitis, 1 patient developed grade 4 dermatitis. IMRT + CIRT treatment was associated with a significant trend of lower grades of OM and dermatitis (p < 0.05, respectively). Any severe (i.e., grade 3) chronic AEs, such as xerostomia, skin fibrosis, temporal lobe necrosis, osteoradionecrosis, or radiation-induced optic neuropathy, was not observed. CONCLUSIONS In this study, IMRT + CIRT was associated with significantly reduced acute toxicity burden compared with full course of IMRT, with excellent survival outcomes. Patients with persistent disease after treatment and treated with nodal boost had a worse outcome. More accurate assessments of IMRT + CIRT to primary nonmetastatic NPC patients will be imperative.
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Affiliation(s)
- Yujiao Li
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Shanghai, China
| | - Xiyin Guan
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
| | - Xing Xing
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Shanghai, China
| | - Chaosu Hu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Shanghai, China
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Li Y, Guan X, Hu C. Impact of dose volume parameters and clinical characteristics on radiation-induced acute oral mucositis for head and neck cancer patients treated with carbon-ion radiotherapy dose volume outcome analysis. Strahlenther Onkol 2024:10.1007/s00066-024-02255-1. [PMID: 38926185 DOI: 10.1007/s00066-024-02255-1] [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: 03/27/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES To assess the predictive value of different dosimetric parameters for acute radiation oral mucositis (ROM) in head and neck cancer (HNCs) patients treated with carbon-ion radiotherapy (CIRT). METHODS 44 patients with HNCs treated with CIRT were evaluated for acute ROM which was defined as severe when the score ≥3 (acute ROM was scored prospectively using the Radiation Therapy Oncology Group (RTOG) score system). Predictive dosimetric factors were identified by using univariate and multivariate analysis. RESULTS Male gender, weight loss >5%, and total dose/fractions were related factors to severe ROM. In multivariate analysis, grade ≥3 ROM was significantly related to the Dmax, D10, D15, and D20 (P < 0.05, respectively). As the receiver operating characteristics (ROC) curve shows, the area under the curve (AUC) for D10 was 0.77 (p = 0.003), and the cutoff value was 51.06 Gy (RBE); The AUC for D15 was 0.75 (p = 0.006), and the cutoff value was 42.82 Gy (RBE); The AUC for D20 was 0.74 (p = 0.009), and the cutoff value was 30.45 Gy (RBE); The AUC for Dmax was 0.81 (p < 0.001), and the cutoff value was 69.33 Gy (RBE). CONCLUSION Male gender, weight loss, and total dose/fractions were significantly association with ROM. Dmax, D10, D15 and D20 were identified as the most valuable predictor and we suggest a Dmax limit of 69.33 Gy (RBE), D10 limit of 51.06 Gy (RBE), D15 limit of 42.82 Gy (RBE), and D20 limit of 30.45 Gy (RBE) and for oral mucosa.
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Affiliation(s)
- Yujiao Li
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Shanghai, China
| | - Xiyin Guan
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Chaosu Hu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China.
- Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
- Department of Oncology, Shanghai Medical College, Shanghai, China.
- Shanghai Proton and Heavy Ion Center, 4365 Kangxin Rd, Pudong, 201321, Shanghai, China.
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Hu W, Hu J, Huang Q, Gao J, Zhang H, Kong L. Long-term outcomes after particle radiation therapy in patients with nasopharyngeal adenoid cystic carcinoma. BMC Cancer 2024; 24:742. [PMID: 38890585 PMCID: PMC11186262 DOI: 10.1186/s12885-024-12471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Nasopharyngeal adenoid cystic carcinoma (NACC) is a relatively rare salivary gland tumor that is generally associated with poor outcomes. High-dose radiotherapy is a key treatment for patients with NACC. This study reported the long-term efficacy and safety of particle beam radiation therapy (PBRT) for NACC. METHODS AND MATERIALS Twenty-six patients with nonmetastatic NACC who received definitive PBRT alone were included in this retrospective study. The majority of patients (92.3%) had locally advanced disease. Twenty-five (96.15%) patients received intensity-modulated proton radiotherapy (IMPT) followed by a carbon ion radiotherapy (CIRT) boost, and one patient received CIRT alone. Overall survival (OS), local control (LC), regional control (RC), and distant metastasis control (DMC) rates were calculated via the Kaplan-Meier method. RESULTS The median follow-up time was 46.95 months for the entire cohort. Seven patients experienced local recurrence, and one patient experience neck lymph node recurrence. The 3- and 4-year OS, LC, RC, and DMC rates were 100% and 91.7%, 92.3% and 84.6%, 95.8% and 87.8%, and 90.2% and 71.3%, respectively. A total of 91.3% of the patients achieved complete remission of gross tumors at 1 year after PBRT. Severe acute toxicity was observed in only two patients. A grade 4 decrease in visual acuity was observed in one patient with orbital apex invasion. No late grade 3 or 5 toxicity was observed. CONCLUSION Definitive PBRT provided a satisfactory 4-year OS for patients with locally advanced NACC. The toxicity was acceptable and mild. Further follow-up is necessary to confirm the efficacy and safety of definitive PBRT for patients with NACC.
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Affiliation(s)
- Weixu Hu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201315, China
- Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai, 201315, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201315, China
| | - Jiyi Hu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201315, China
- Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai, 201315, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201315, China
| | - Qingting Huang
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201315, China
- Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai, 201315, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201315, China
| | - Jing Gao
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201315, China
- Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai, 201315, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201315, China
| | - Haojiong Zhang
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201315, China
- Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai, 201315, China
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201315, China
| | - Lin Kong
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, 201315, China.
- Shanghai Key Laboratory of radiation oncology (20dz2261000), Shanghai, 201315, China.
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201315, China.
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Chacon A, Rutherford H, Hamato A, Nitta M, Nishikido F, Iwao Y, Tashima H, Yoshida E, Akamatsu G, Takyu S, Kang HG, Franklin DR, Parodi K, Yamaya T, Rosenfeld A, Guatelli S, Safavi-Naeini M. A quantitative assessment of Geant4 for predicting the yield and distribution of positron-emitting fragments in ion beam therapy. Phys Med Biol 2024; 69:125015. [PMID: 38776943 DOI: 10.1088/1361-6560/ad4f48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/22/2024] [Indexed: 05/25/2024]
Abstract
Objective.To compare the accuracy with which different hadronic inelastic physics models across ten Geant4 Monte Carlo simulation toolkit versions can predict positron-emitting fragments produced along the beam path during carbon and oxygen ion therapy.Approach.Phantoms of polyethylene, gelatin, or poly(methyl methacrylate) were irradiated with monoenergetic carbon and oxygen ion beams. Post-irradiation, 4D PET images were acquired and parent11C,10C and15O radionuclides contributions in each voxel were determined from the extracted time activity curves. Next, the experimental configurations were simulated in Geant4 Monte Carlo versions 10.0 to 11.1, with three different fragmentation models-binary ion cascade (BIC), quantum molecular dynamics (QMD) and the Liege intranuclear cascade (INCL++) - 30 model-version combinations. Total positron annihilation and parent isotope production yields predicted by each simulation were compared between simulations and experiments using normalised mean squared error and Pearson cross-correlation coefficient. Finally, we compared the depth of the maximum positron annihilation yield and the distal point at which the positron yield decreases to 50% of peak between each model and the experimental results.Main results.Performance varied considerably across versions and models, with no one version/model combination providing the best prediction of all positron-emitting fragments in all evaluated target materials and irradiation conditions. BIC in Geant4 10.2 provided the best overall agreement with experimental results in the largest number of test cases. QMD consistently provided the best estimates of both the depth of peak positron yield (10.4 and 10.6) and the distal 50%-of-peak point (10.2), while BIC also performed well and INCL generally performed the worst across most Geant4 versions.Significance.The best predictions of the spatial distribution of positron annihilations and positron-emitting fragment production along the beam path during carbon and oxygen ion therapy was obtained using Geant4 10.2.p03 with BIC or QMD. These version/model combinations are recommended for future heavy ion therapy research.
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Affiliation(s)
- Andrew Chacon
- Australian Nuclear Science and Technology Organisation (ANSTO), Lucas Heights, NSW, Australia
| | - Harley Rutherford
- Australian Nuclear Science and Technology Organisation (ANSTO), Lucas Heights, NSW, Australia
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Akram Hamato
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Munetaka Nitta
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | | | - Yuma Iwao
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Hideaki Tashima
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Eiji Yoshida
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Go Akamatsu
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Sodai Takyu
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Han Gyu Kang
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Daniel R Franklin
- School of Electrical and Data Engineering, University of Technology Sydney, Ultimo, Australia
| | - Katia Parodi
- Department of Medical Physics, Faculty of Physics, Garching b, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Taiga Yamaya
- National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Anatoly Rosenfeld
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Susanna Guatelli
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Mitra Safavi-Naeini
- Australian Nuclear Science and Technology Organisation (ANSTO), Lucas Heights, NSW, Australia
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
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Malouff TD, Newpower M, Bush A, Seneviratne D, Ebner DK. A Practical Primer on Particle Therapy. Pract Radiat Oncol 2024:S1879-8500(24)00137-1. [PMID: 38844118 DOI: 10.1016/j.prro.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE Particle therapy is a promising treatment technique that is becoming more commonly used. Although proton beam therapy remains the most commonly used particle therapy, multiple other heavier ions have been used in the preclinical and clinical settings, each with its own unique properties. This practical review aims to summarize the differences between the studied particles, discussing their radiobiological and physical properties with additional review of the available clinical data. METHODS AND MATERIALS A search was carried out on the PubMed databases with search terms related to each particle. Relevant radiobiology, physics, and clinical studies were included. The articles were summarized to provide a practical resource for practicing clinicians. RESULTS A total of 113 articles and texts were included in our narrative review. Currently, proton beam therapy has the most data and is the most widely used, followed by carbon, helium, and neutrons. Although oxygen, neon, silicon, and argon have been used clinically, their future use will likely remain limited as monotherapy. CONCLUSIONS This review summarizes the properties of each of the clinically relevant particles. Protons, helium, and carbon will likely remain the most commonly used, although multi-ion therapy is an emerging technique.
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Affiliation(s)
- Timothy D Malouff
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
| | - Mark Newpower
- Department of Radiation Oncology, University of Oklahoma, OU Health Stephenson Cancer Center, Oklahoma City, Oklahoma
| | - Aaron Bush
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida
| | - Danushka Seneviratne
- Department of Radiation Oncology, University of Oklahoma, OU Health Stephenson Cancer Center, Oklahoma City, Oklahoma
| | - Daniel K Ebner
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
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Mi Z, Bian H, Yang C, Dou Y, Bettiol AA, Liu X. Real-time single-proton counting with transmissive perovskite nanocrystal scintillators. NATURE MATERIALS 2024; 23:803-809. [PMID: 38191632 DOI: 10.1038/s41563-023-01782-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/06/2023] [Indexed: 01/10/2024]
Abstract
High-sensitivity radiation detectors for energetic particles are essential for advanced applications in particle physics, astronomy and cancer therapy. Current particle detectors use bulk crystals, and thin-film organic scintillators have low light yields and limited radiation tolerance. Here we present transmissive thin scintillators made from CsPbBr3 nanocrystals, designed for real-time single-proton counting. These perovskite scintillators exhibit exceptional sensitivity, with a high light yield (~100,000 photons per MeV) when subjected to proton beams. This enhanced sensitivity is attributed to radiative emission from biexcitons generated through proton-induced upconversion and impact ionization. These scintillators can detect as few as seven protons per second, a sensitivity level far below the rates encountered in clinical settings. The combination of rapid response (~336 ps) and pronounced ionostability enables diverse applications, including single-proton tracing, patterned irradiation and super-resolution proton imaging. These advancements have the potential to improve proton dosimetry in proton therapy and radiography.
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Affiliation(s)
- Zhaohong Mi
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai, China.
- Centre for Ion Beam Applications, Department of Physics, National University of Singapore, Singapore, Singapore.
| | - Hongyu Bian
- Department of Chemistry, National University of Singapore, Singapore, Singapore
| | - Chengyuan Yang
- Centre for Ion Beam Applications, Department of Physics, National University of Singapore, Singapore, Singapore
| | - Yanxin Dou
- Centre for Ion Beam Applications, Department of Physics, National University of Singapore, Singapore, Singapore
| | - Andrew A Bettiol
- Centre for Ion Beam Applications, Department of Physics, National University of Singapore, Singapore, Singapore.
- Division of Science, Yale-NUS College, Singapore, Singapore.
| | - Xiaogang Liu
- Department of Chemistry, National University of Singapore, Singapore, Singapore.
- SZU-NUS Collaborative Innovation Center for Optoelectronic Science & Technology, Shenzhen University, Shenzhen, China.
- Institute of Materials Research and Engineering, Agency for Science, Technology and Research, Singapore, Singapore.
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Yun JE, Kim S, Park KY, Lee W. Effectiveness and Safety of Carbon Ion Radiotherapy in Solid Tumors: A Systematic Review and Meta-Analysis. Yonsei Med J 2024; 65:332-340. [PMID: 38804027 PMCID: PMC11130593 DOI: 10.3349/ymj.2023.0439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 05/29/2024] Open
Abstract
PURPOSE This systematic review and meta-analysis aimed to investigate the effectiveness of carbon ion radiotherapy (CIRT) compared to that of conventional radiotherapy in patients with various types of solid tumors. MATERIALS AND METHODS We systematically searched eight electronic databases from inception until August 2022 in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The comparative effectiveness of the different treatment options was assessed by a random-effects meta-analysis. RESULTS This review included 34 comparative studies and three treatment groups. Overall, the meta-analysis indicated comparable local control rates between the CIRT and control groups [pooled risk ratio (RR)=1.02, 95% confidence interval (CI) 0.90-1.15]. The local control rate in the CIRT group was higher than that in the photon therapy group, but slightly lower than that in the proton radiation therpy (PRT) group. Additionally, the CIRT group had significantly higher overall survival (OS) (RR=1.19, 95% CI=1.01-1.42) and progression-free survival (PFS) (RR=1.50, 95% CI=1.01-2.21) rates compared to the control group. In the subgroup analysis, survival rates were similar between the CIRT and PRT groups. CONCLUSION CIRT was associated with improved toxicity, local tumor control, OS, and PFS compared to conventional treatments. Therefore, CIRT was found to be a safe and effective option for achieving local control in patients with solid tumors.
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Affiliation(s)
- Ji Eun Yun
- Division of Healthcare Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Sujin Kim
- Division of New Health Technology Assessment, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
- College of Nursing, Korea University, Seoul, Korea
| | - Keun Young Park
- Division of New Health Technology Assessment, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Worlsook Lee
- Division of New Health Technology Assessment, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea.
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10
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Matias F, Silva TF, Koval NE, Pereira JJN, Antunes PCG, Siqueira PTD, Tabacniks MH, Yoriyaz H, Shorto JMB, Grande PL. Efficient computational modeling of electronic stopping power of organic polymers for proton therapy optimization. Sci Rep 2024; 14:9868. [PMID: 38684890 PMCID: PMC11058815 DOI: 10.1038/s41598-024-60651-0] [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: 02/05/2024] [Accepted: 04/25/2024] [Indexed: 05/02/2024] Open
Abstract
This comprehensive study delves into the intricate interplay between protons and organic polymers, offering insights into proton therapy in cancer treatment. Focusing on the influence of the spatial electron density distribution on stopping power estimates, we employed real-time time-dependent density functional theory coupled with the Penn method. Surprisingly, the assumption of electron density homogeneity in polymers is fundamentally flawed, resulting in an overestimation of stopping power values at energies below 2 MeV. Moreover, the Bragg rule application in specific compounds exhibited significant deviations from experimental data around the stopping maximum, challenging established norms.
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Affiliation(s)
- F Matias
- Instituto de Pesquisas Energéticas e Nucleares, Av. Professor Lineu Prestes, São Paulo, 05508-000, Brazil.
| | - T F Silva
- Instituto de Física da Universidade de São Paulo, Rua do Matão, trav. R187, São Paulo, 05508-090, Brazil
| | - N E Koval
- Centro de Física de Materiales, Paseo Manuel de Lardizabal 5, Donostia-San Sebastián, 20018, Spain
| | - J J N Pereira
- Instituto de Pesquisas Energéticas e Nucleares, Av. Professor Lineu Prestes, São Paulo, 05508-000, Brazil
| | - P C G Antunes
- Instituto de Pesquisas Energéticas e Nucleares, Av. Professor Lineu Prestes, São Paulo, 05508-000, Brazil
| | - P T D Siqueira
- Instituto de Pesquisas Energéticas e Nucleares, Av. Professor Lineu Prestes, São Paulo, 05508-000, Brazil
| | - M H Tabacniks
- Instituto de Física da Universidade de São Paulo, Rua do Matão, trav. R187, São Paulo, 05508-090, Brazil
| | - H Yoriyaz
- Instituto de Pesquisas Energéticas e Nucleares, Av. Professor Lineu Prestes, São Paulo, 05508-000, Brazil
| | - J M B Shorto
- Instituto de Pesquisas Energéticas e Nucleares, Av. Professor Lineu Prestes, São Paulo, 05508-000, Brazil
| | - P L Grande
- Instituto de Física da Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, Porto Alegre, 9500, Brazil
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11
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Thwaites DI, Prokopovich DA, Garrett RF, Haworth A, Rosenfeld A, Ahern V. The rationale for a carbon ion radiation therapy facility in Australia. J Med Radiat Sci 2024; 71 Suppl 2:59-76. [PMID: 38061984 PMCID: PMC11011608 DOI: 10.1002/jmrs.744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/17/2023] [Indexed: 04/13/2024] Open
Abstract
Australia has taken a collaborative nationally networked approach to achieve particle therapy capability. This supports the under-construction proton therapy facility in Adelaide, other potential proton centres and an under-evaluation proposal for a hybrid carbon ion and proton centre in western Sydney. A wide-ranging overview is presented of the rationale for carbon ion radiation therapy, applying observations to the case for an Australian facility and to the clinical and research potential from such a national centre.
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Affiliation(s)
- David I. Thwaites
- Institute of Medical Physics, School of PhysicsUniversity of SydneySydneyNew South WalesAustralia
- Department of Radiation OncologySydney West Radiation Oncology NetworkWestmeadNew South WalesAustralia
- Radiotherapy Research Group, Institute of Medical ResearchSt James's Hospital and University of LeedsLeedsUK
| | | | - Richard F. Garrett
- Australian Nuclear Science and Technology OrganisationLucas HeightsNew South WalesAustralia
| | - Annette Haworth
- Institute of Medical Physics, School of PhysicsUniversity of SydneySydneyNew South WalesAustralia
- Department of Radiation OncologySydney West Radiation Oncology NetworkWestmeadNew South WalesAustralia
| | - Anatoly Rosenfeld
- Centre for Medical Radiation Physics, School of PhysicsUniversity of WollongongSydneyNew South WalesAustralia
| | - Verity Ahern
- Department of Radiation OncologySydney West Radiation Oncology NetworkWestmeadNew South WalesAustralia
- Westmead Clinical School, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
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12
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Sedmidubská B, Kočišek J. Interaction of low-energy electrons with radiosensitizers. Phys Chem Chem Phys 2024; 26:9112-9136. [PMID: 38376461 DOI: 10.1039/d3cp06003a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
We provide an experimentalist's perspective on the present state-of-the-art in the studies of low-energy electron interactions with common radiosensitizers, including compounds used in combined chemo-radiation therapy and their model systems. Low-energy electrons are important secondary species formed during the interaction of ionizing radiation with matter. Their role in the radiation chemistry of living organisms has become an important topic for more than 20 years. With the increasing number of works and reviews in the field, we would like to focus here on a very narrow area of compounds that have been shown to have radio-sensitizing properties on the one hand, and high reactivity towards low-energy electrons on the other hand. Gas phase experiments studying electron attachment to isolated molecules and environmental effects on reaction dynamics are reviewed for modified DNA components, nitroimidazoles, and organometallics. In the end, we provide a perspective on the future directions that may be important for transferring the fundamental knowledge about the processes induced by low-energy electrons into practice in the field of rational design of agents for concomitant chemo-radiation therapy.
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Affiliation(s)
- Barbora Sedmidubská
- J. Heyrovský Institute of Physical Chemistry of the CAS, Dolejškova 3, 182223 Prague, Czech Republic.
- Department of Nuclear Chemistry, Faculty of Nuclear Sciences and Physical Engineering, Břehová 7, 11519 Prague, Czech Republic
- Institut de Chimie Physique, UMR 8000 CNRS and Faculté des sciences d'Orsay, Université Paris Saclay, F-91405 Orsay Cedex, France
| | - Jaroslav Kočišek
- J. Heyrovský Institute of Physical Chemistry of the CAS, Dolejškova 3, 182223 Prague, Czech Republic.
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13
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Miyazawa Y, Koike H, Oka D, Kawamura H, Kubo N, Miyasaka Y, Onishi M, Syuto T, Sekine Y, Matsui H, Ohno T, Suzuki K. Comparison of sexual function after robot-assisted radical prostatectomy and carbon-ion radiotherapy for Japanese prostate cancer patients using propensity score matching. BMC Cancer 2024; 24:300. [PMID: 38443871 PMCID: PMC10916055 DOI: 10.1186/s12885-024-12062-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The quality of life of patients is an important consideration when selecting treatments for localized prostate cancer (PCa). We retrospectively compared sexual function after robot-assisted radical prostatectomy (RARP) and carbon-ion radiotherapy (CIRT) using propensity score matching. METHODS In total, 127 Japanese PCa patients treated with RARP and 190 treated with CIRT monotherapy were evaluated. We evaluated the Expanded Prostate Cancer Index Composite (EPIC) score before treatment and 12 and 24 months after treatment. After propensity score matching, data from 101 patients from each group were analyzed. The study protocol was approved by the Institutional Review Board of Gunma University Hospital (no. IRB2020-050, 1839). RESULTS After propensity score matching, the mean EPIC sexual function summary scores in the RARP and CIRT groups were 46.4 and 48.2, respectively. At 12 and 24 months after treatment, these scores were 27.9 (39.9% decrease) and 28.2 (39.2% decrease) in the RARP group and 41.4 (14.1% decrease) and 41.6 (13.7% decrease) in the CIRT group, respectively. Both groups demonstrated significantly decreased scores after 12 and 24 months of treatment compared to before treatment (all p < 0.05). At 12 and 24 months, the sexual function summary score was significantly higher in the CIRT group than in the RARP group (p < 0.001). CONCLUSIONS There was a smaller decrease in the EPIC sexual function score in the CIRT group than in the RARP group. These results provide useful information for treatment decision-making of Japanese PCa patients.
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Affiliation(s)
- Yoshiyuki Miyazawa
- Department of Urology, Gunma University Graduate School of Medicine & Gunma University Hospital, 3-39-22 Showa-Machi, 3718511, Maebashi, Gunma, Japan.
| | - Hidekazu Koike
- Department of Urology, Gunma University Graduate School of Medicine & Gunma University Hospital, 3-39-22 Showa-Machi, 3718511, Maebashi, Gunma, Japan
| | | | - Hidemasa Kawamura
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Nobuteru Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Yuhei Miyasaka
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Masahiro Onishi
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | | | - Yoshitaka Sekine
- Department of Urology, Gunma University Graduate School of Medicine & Gunma University Hospital, 3-39-22 Showa-Machi, 3718511, Maebashi, Gunma, Japan
| | - Hiroshi Matsui
- Department of Urology, Gunma University Graduate School of Medicine & Gunma University Hospital, 3-39-22 Showa-Machi, 3718511, Maebashi, Gunma, Japan
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Tatsuya Ohno
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Kazuhiro Suzuki
- Department of Urology, Gunma University Graduate School of Medicine & Gunma University Hospital, 3-39-22 Showa-Machi, 3718511, Maebashi, Gunma, Japan
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
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14
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Cogno N, Bauer R, Durante M. Mechanistic model of radiotherapy-induced lung fibrosis using coupled 3D agent-based and Monte Carlo simulations. COMMUNICATIONS MEDICINE 2024; 4:16. [PMID: 38336802 PMCID: PMC10858213 DOI: 10.1038/s43856-024-00442-w] [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: 07/14/2023] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Mechanistic modelling of normal tissue toxicities is unfolding as an alternative to the phenomenological normal tissue complication probability models. The latter, currently used in the clinics, rely exclusively on limited patient data and neglect spatial dose distribution information. Among the various approaches, agent-based models are appealing as they provide the means to include patient-specific parameters and simulate long-term effects in complex systems. However, Monte Carlo tools remain the state-of-the-art for modelling radiation transport and provide measurements of the delivered dose with unmatched precision. METHODS In this work, we develop and characterize a coupled 3D agent-based - Monte Carlo model that mechanistically simulates the onset of the radiation-induced lung fibrosis in an alveolar segment. To the best of our knowledge, this is the first such model. RESULTS Our model replicates extracellular matrix patterns, radiation-induced lung fibrosis severity indexes and functional subunits survivals that show qualitative agreement with experimental studies and are consistent with our past results. Moreover, in accordance with experimental results, higher functional subunits survival and lower radiation-induced lung fibrosis severity indexes are achieved when a 5-fractions treatment is simulated. Finally, the model shows increased sensitivity to more uniform protons dose distributions with respect to more heterogeneous ones from photon irradiation. CONCLUSIONS This study lays thus the groundwork for further investigating the effects of different radiotherapeutic treatments on the onset of radiation-induced lung fibrosis via mechanistic modelling.
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Affiliation(s)
- Nicolò Cogno
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
- Institute for Condensed Matter Physics, Technische Universität Darmstadt, 64289, Darmstadt, Germany
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Roman Bauer
- Department of Computer Science, University of Surrey, Guildford, GU2 7XH, UK
| | - Marco Durante
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany.
- Institute for Condensed Matter Physics, Technische Universität Darmstadt, 64289, Darmstadt, Germany.
- Department of Physics "Ettore Pancini", University Federico II, Naples, Italy.
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15
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Cartechini G, Missiaggia M, Scifoni E, La Tessa C, Cordoni FG. Integrating microdosimetric in vitroRBE models for particle therapy into TOPAS MC using the MicrOdosimetry-based modeliNg for RBE ASsessment (MONAS) tool. Phys Med Biol 2024; 69:045005. [PMID: 38211313 DOI: 10.1088/1361-6560/ad1d66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/11/2024] [Indexed: 01/13/2024]
Abstract
Objective.In this paper, we present MONAS (MicrOdosimetry-based modelliNg for relative biological effectiveness (RBE) ASsessment) toolkit. MONAS is a TOPAS Monte Carlo extension, that combines simulations of microdosimetric distributions with radiobiological microdosimetry-based models for predicting cell survival curves and dose-dependent RBE.Approach.MONAS expands TOPAS microdosimetric extension, by including novel specific energy scorers to calculate the single- and multi-event specific energy microdosimetric distributions at different micrometer scales. These spectra are used as physical input to three different formulations of themicrodosimetric kinetic model, and to thegeneralized stochastic microdosimetric model(GSM2), to predict dose-dependent cell survival fraction and RBE. MONAS predictions are then validated against experimental microdosimetric spectra andin vitrosurvival fraction data. To show the MONAS features, we present two different applications of the code: (i) the depth-RBE curve calculation from a passively scattered proton SOBP and monoenergetic12C-ion beam by using experimentally validated spectra as physical input, and (ii) the calculation of the 3D RBE distribution on a real head and neck patient geometry treated with protons.Main results.MONAS can estimate dose-dependent RBE and cell survival curves from experimentally validated microdosimetric spectra with four clinically relevant radiobiological models. From the radiobiological characterization of a proton SOBP and12C fields, we observe the well-known trend of increasing RBE values at the distal edge of the radiation field. The 3D RBE map calculated confirmed the trend observed in the analysis of the SOBP, with the highest RBE values found in the distal edge of the target.Significance.MONAS extension offers a comprehensive microdosimetry-based framework for assessing the biological effects of particle radiation in both research and clinical environments, pushing closer the experimental physics-based description to the biological damage assessment, contributing to bridging the gap between a microdosimetric description of the radiation field and its application in proton therapy treatment with variable RBE.
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Affiliation(s)
- Giorgio Cartechini
- Department of Radiation Oncology, University of Miami Miller School of Medicine, 1550 NW 10th Avenue, 33126, Miami (FL), United States of America
- Trento Institute for Fundamental Physics and Application (TIFPA), via Sommarive 15, I-38123, Trento, Italy
| | - Marta Missiaggia
- Department of Radiation Oncology, University of Miami Miller School of Medicine, 1550 NW 10th Avenue, 33126, Miami (FL), United States of America
- Trento Institute for Fundamental Physics and Application (TIFPA), via Sommarive 15, I-38123, Trento, Italy
| | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Application (TIFPA), via Sommarive 15, I-38123, Trento, Italy
| | - Chiara La Tessa
- Department of Radiation Oncology, University of Miami Miller School of Medicine, 1550 NW 10th Avenue, 33126, Miami (FL), United States of America
- Trento Institute for Fundamental Physics and Application (TIFPA), via Sommarive 15, I-38123, Trento, Italy
- Department of Physics, University of Trento, via Sommarive 14, I-38123, Trento, Italy
| | - Francesco G Cordoni
- Trento Institute for Fundamental Physics and Application (TIFPA), via Sommarive 15, I-38123, Trento, Italy
- Department of Civil, Environmental and Mechanical Engineering, University of Trento, via Mesiano 77, I-38123, Trento, Italy
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16
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Baran J, Borys D, Brzeziński K, Gajewski J, Silarski M, Chug N, Coussat A, Czerwiński E, Dadgar M, Dulski K, Eliyan KV, Gajos A, Kacprzak K, Kapłon Ł, Klimaszewski K, Konieczka P, Kopeć R, Korcyl G, Kozik T, Krzemień W, Kumar D, Lomax AJ, McNamara K, Niedźwiecki S, Olko P, Panek D, Parzych S, Perez Del Rio E, Raczyński L, Simbarashe M, Sharma S, Shivani, Shopa RY, Skóra T, Skurzok M, Stasica P, Stępień EŁ, Tayefi K, Tayefi F, Weber DC, Winterhalter C, Wiślicki W, Moskal P, Ruciński A. Feasibility of the J-PET to monitor the range of therapeutic proton beams. Phys Med 2024; 118:103301. [PMID: 38290179 DOI: 10.1016/j.ejmp.2024.103301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/01/2024] Open
Abstract
PURPOSE The aim of this work is to investigate the feasibility of the Jagiellonian Positron Emission Tomography (J-PET) scanner for intra-treatment proton beam range monitoring. METHODS The Monte Carlo simulation studies with GATE and PET image reconstruction with CASToR were performed in order to compare six J-PET scanner geometries. We simulated proton irradiation of a PMMA phantom with a Single Pencil Beam (SPB) and Spread-Out Bragg Peak (SOBP) of various ranges. The sensitivity and precision of each scanner were calculated, and considering the setup's cost-effectiveness, we indicated potentially optimal geometries for the J-PET scanner prototype dedicated to the proton beam range assessment. RESULTS The investigations indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for clinical application. We found that the scanner sensitivity is of the order of 10-5 coincidences per primary proton, while the precision of the range assessment for both SPB and SOBP irradiation plans was found below 1 mm. Among the scanners with the same number of detector modules, the best results are found for the triple-layer dual-head geometry. The results indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for the clinical application, CONCLUSIONS:: We performed simulation studies demonstrating that the feasibility of the J-PET detector for PET-based proton beam therapy range monitoring is possible with reasonable sensitivity and precision enabling its pre-clinical tests in the clinical proton therapy environment. Considering the sensitivity, precision and cost-effectiveness, the double-layer cylindrical and triple-layer dual-head J-PET geometry configurations seem promising for future clinical application.
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Affiliation(s)
- Jakub Baran
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland.
| | - Damian Borys
- Silesian University of Technology, Department of Systems Biology and Engineering, Gliwice, Poland; Biotechnology Centre, Silesian University of Technology, Gliwice, Poland; Institute of Nuclear Physics Polish Academy of Sciences, 31-342, Kraków, Poland
| | - Karol Brzeziński
- Institute of Nuclear Physics Polish Academy of Sciences, 31-342, Kraków, Poland; Instituto de Física Corpuscular (IFIC), CSIC-UV, Valencia, Spain
| | - Jan Gajewski
- Institute of Nuclear Physics Polish Academy of Sciences, 31-342, Kraków, Poland
| | - Michał Silarski
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Neha Chug
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Aurélien Coussat
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Eryk Czerwiński
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Meysam Dadgar
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Kamil Dulski
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Kavya V Eliyan
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Aleksander Gajos
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Krzysztof Kacprzak
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Łukasz Kapłon
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Konrad Klimaszewski
- Department of Complex Systems, National Centre for Nuclear Research, Otwock-Świerk, Poland
| | - Paweł Konieczka
- Department of Complex Systems, National Centre for Nuclear Research, Otwock-Świerk, Poland
| | - Renata Kopeć
- Institute of Nuclear Physics Polish Academy of Sciences, 31-342, Kraków, Poland
| | - Grzegorz Korcyl
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Tomasz Kozik
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Wojciech Krzemień
- High Energy Physics Division, National Centre for Nuclear Research, Otwock-Świerk, Poland
| | - Deepak Kumar
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Antony J Lomax
- Centre for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland; Physics Department, ETH Zürich, Zürich, Switzerland
| | - Keegan McNamara
- Centre for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland; Physics Department, ETH Zürich, Zürich, Switzerland
| | - Szymon Niedźwiecki
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Paweł Olko
- Institute of Nuclear Physics Polish Academy of Sciences, 31-342, Kraków, Poland
| | - Dominik Panek
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Szymon Parzych
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Elena Perez Del Rio
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Lech Raczyński
- Department of Complex Systems, National Centre for Nuclear Research, Otwock-Świerk, Poland
| | - Moyo Simbarashe
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Sushil Sharma
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Shivani
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Roman Y Shopa
- Department of Complex Systems, National Centre for Nuclear Research, Otwock-Świerk, Poland
| | - Tomasz Skóra
- National Oncology Institute, National Research Institute, Krakow Branch, Krakow, Poland
| | - Magdalena Skurzok
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Paulina Stasica
- Institute of Nuclear Physics Polish Academy of Sciences, 31-342, Kraków, Poland
| | - Ewa Ł Stępień
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Keyvan Tayefi
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Faranak Tayefi
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Damien C Weber
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Radiation Oncology, University Hospital of Zürich, Zürich Switzerland; Centre for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Carla Winterhalter
- Centre for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland; Physics Department, ETH Zürich, Zürich, Switzerland
| | - Wojciech Wiślicki
- Department of Complex Systems, National Centre for Nuclear Research, Otwock-Świerk, Poland
| | - Paweł Moskal
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, 11 Łojasiewicza St 30-348 Kraków, Poland; Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348 Kraków, Poland; Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Antoni Ruciński
- Institute of Nuclear Physics Polish Academy of Sciences, 31-342, Kraków, Poland
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17
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Guerra Liberal FDC, Parsons JL, McMahon SJ. Most DNA repair defects do not modify the relationship between relative biological effectiveness and linear energy transfer in CRISPR-edited cells. Med Phys 2024; 51:591-600. [PMID: 37753877 DOI: 10.1002/mp.16764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Cancer is a highly heterogeneous disease, driven by frequent genetic alterations which have significant effects on radiosensitivity. However, radiotherapy for a given cancer type is typically given with a standard dose determined from population-level trials. As a result, a proportion of patients are under- or over-dosed, reducing the clinical benefit of radiotherapy. Biological optimization would not only allow individual dose prescription but also a more efficient allocation of limited resources, such as proton and carbon ion therapy. Proton and ion radiotherapy offer an advantage over photons due to their elevated Relative Biological Effectiveness (RBE) resulting from their elevated Linear Energy Transfer (LET). Despite significant interest in optimizing LET by tailoring radiotherapy plans, RBE's genetic dependence remains unclear. PURPOSE The aim of this study is to better define the RBE/LET relationship in a panel of cell lines with different defects in DSB repair pathways, but otherwise identical biological features and genetic background to isolate these effects. METHODS Normal human cells (RPE1), genetically modified to introduce defects in DNA double-strand break (DSB) repair genes, ATM, BRCA1, DCLRE1C, LIG4, PRKDC and TP53, were used to map the RBE-LET relationship. Cell survival was measured with clonogenic assays after exposure to photons, protons (LET 1 and 12 keV/µm) and alpha particles (129 keV/µm). Gene knockout sensitizer enhancement ratio (SER) values were calculated as the ratio of the mean inactivation dose (MID) of wild-type cells to repair-deficient cells, and RBE values were calculated as the ratio of the MID of X-ray and particle irradiated cells. 53BP1 foci were used to quantify radiation-induced DSBs and their repair following irradiation. RESULTS Deletion of NHEJ genes had the greatest impact on photon sensitivity (ATM-/- SER = 2.0 and Lig4-/- SER = 1.8), with genes associated with HR having smaller effects (BRCA1-/- SER = 1.2). Wild-type cells showed RBEs of 1.1, 1.3, 5.0 for low- and high-LET protons and alpha particles respectively. SERs for different genes were independent of LET, apart from NHEJ knockouts which proved to be markedly hypersensitive across all tested LETs. Due to this hypersensitivity, the impact of high LET was reduced in cell models lacking the NHEJ repair pathway. HR-defective cells had moderately increased sensitivity across all tested LETs, but, notably, the contribution of HR pathway to survival appeared independent of LET. Analysis of 53BP1 foci shows that NHEJ-defective cells had the least DSB repair capacity after low LET exposure, and no visible repair after high LET exposure. HR-defective cells also had slower repair kinetics, but the impact of HR defects is not as severe as NHEJ defects. CONCLUSIONS DSB repair defects, particularly in NHEJ, conferred significant radiosensitivity across all LETs. This sensitization appeared independent of LET, suggesting that the contribution of different DNA repair pathways to survival does not depend on radiation quality.
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Affiliation(s)
| | - Jason L Parsons
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Stephen J McMahon
- The Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
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18
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Uematsu M, Nakajima H, Hosono A, Kiyohara H, Hirota A, Takahashi N, Fukuda M, Kusuhara S, Nakao T, Funasaka C, Kondoh C, Harano K, Matsubara N, Naito Y, Akimoto T, Mukohara T. Safety of immune checkpoint inhibitors after proton beam therapy in head and neck mucosal melanoma: a case series. Melanoma Res 2023; 33:547-552. [PMID: 37696254 DOI: 10.1097/cmr.0000000000000924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Proton beam therapy (PBT) has shown promising efficacy in treating locally advanced head and neck mucosal melanoma despite its poor prognosis. Although PBT may improve the efficacy of subsequent immune checkpoint inhibitors (ICIs), the safety of ICIs in patients who have previously received PBT has not been established. Hence, this study evaluated the safety of ICIs in patients who had recurrent mucosal melanoma after PBT. Between April 2013 and June 2022, we retrospectively reviewed the medical records of patients diagnosed with cutaneous or mucosal melanoma at the National Cancer Center Hospital East. Seven patients were treated with ICIs after their head and neck mucosal melanoma (HNMM) recurred after PBT. Four of the seven patients experienced grade immune-related adverse events (irAEs). Due to irAE in the irradiation field, two patients had grade 3 hypopituitarism. Other grade 3 or higher irAEs included an increase in serum alanine aminotransferase in two patients and gastritis in one, and two patients discontinued ICI due to the irAEs. All irAEs were resolved with appropriate management. Although administering ICIs after PBT may increase the risk of irAEs, especially in the irradiation field, they appear manageable. These findings could help in the development of a treatment strategy for locally advanced HNMM that includes PBT and subsequent ICIs.
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Affiliation(s)
- Mao Uematsu
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo
- Department of Medical Oncology, National Cancer Center Hospital East
| | - Hiromichi Nakajima
- Department of Medical Oncology, National Cancer Center Hospital East
- Department of Experimental Therapeutics, National Cancer Center Hospital East
| | - Ako Hosono
- Department of Medical Oncology, National Cancer Center Hospital East
- Department of Pediatric Oncology, National Cancer Center Hospital East
| | - Hikari Kiyohara
- Department of Medical Oncology, National Cancer Center Hospital East
| | - Akira Hirota
- Department of Medical Oncology, National Cancer Center Hospital East
| | | | - Misao Fukuda
- Department of Medical Oncology, National Cancer Center Hospital East
| | - Shota Kusuhara
- Department of Medical Oncology, National Cancer Center Hospital East
| | - Takehiro Nakao
- Department of Medical Oncology, National Cancer Center Hospital East
| | - Chikako Funasaka
- Department of Medical Oncology, National Cancer Center Hospital East
- Department of Experimental Therapeutics, National Cancer Center Hospital East
| | - Chihiro Kondoh
- Department of Medical Oncology, National Cancer Center Hospital East
| | - Kenichi Harano
- Department of Medical Oncology, National Cancer Center Hospital East
- Department of Experimental Therapeutics, National Cancer Center Hospital East
| | - Nobuaki Matsubara
- Department of Medical Oncology, National Cancer Center Hospital East
| | - Yoichi Naito
- Department of Medical Oncology, National Cancer Center Hospital East
- Department of Experimental Therapeutics, National Cancer Center Hospital East
- Department of General Internal Medicine, National Cancer Center Hospital East
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Toru Mukohara
- Department of Medical Oncology, National Cancer Center Hospital East
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19
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Monaco V, Ali OH, Bersani D, Abujami M, Boscardin M, Cartiglia N, Betta GFD, Data E, Donetti M, Ferrero M, Ficorella F, Giordanengo S, Villarreal OAM, Milian FM, Mohammadian-Behbahani MR, Olivares DM, Pullia M, Tommasino F, Verroi E, Vignati A, Cirio R, Sacchi R. Performance of LGAD strip detectors for particle counting of therapeutic proton beams. Phys Med Biol 2023; 68:235009. [PMID: 37827167 DOI: 10.1088/1361-6560/ad02d5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/12/2023] [Indexed: 10/14/2023]
Abstract
Objective. The performance of silicon detectors with moderate internal gain, named low-gain avalanche diodes (LGADs), was studied to investigate their capability to discriminate and count single beam particles at high fluxes, in view of future applications for beam characterization and on-line beam monitoring in proton therapy.Approach. Dedicated LGAD detectors with an active thickness of 55μm and segmented in 2 mm2strips were characterized at two Italian proton-therapy facilities, CNAO in Pavia and the Proton Therapy Center of Trento, with proton beams provided by a synchrotron and a cyclotron, respectively. Signals from single beam particles were discriminated against a threshold and counted. The number of proton pulses for fixed energies and different particle fluxes was compared with the charge collected by a compact ionization chamber, to infer the input particle rates.Main results. The counting inefficiency due to the overlap of nearby signals was less than 1% up to particle rates in one strip of 1 MHz, corresponding to a mean fluence rate on the strip of about 5 × 107p/(cm2·s). Count-loss correction algorithms based on the logic combination of signals from two neighboring strips allow to extend the maximum counting rate by one order of magnitude. The same algorithms give additional information on the fine time structure of the beam.Significance. The direct counting of the number of beam protons with segmented silicon detectors allows to overcome some limitations of gas detectors typically employed for beam characterization and beam monitoring in particle therapy, providing faster response times, higher sensitivity, and independence of the counts from the particle energy.
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Affiliation(s)
- Vincenzo Monaco
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Omar Hammad Ali
- Fondazione Bruno Kessler, Center for Sensors & Devices , Trento, Italy
| | - Davide Bersani
- Istituto Nazionale di Fisica Nucleare, sezione di Pisa, Italy
| | - Mohammed Abujami
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Maurizio Boscardin
- Fondazione Bruno Kessler, Center for Sensors & Devices , Trento, Italy
- Trento Institute for Fundamental Physics and Applications, Povo, Trento, Italy
| | | | - Gian Franco Dalla Betta
- Trento Institute for Fundamental Physics and Applications, Povo, Trento, Italy
- Università degli Studi di Trento, Trento, Italy
| | - Emanuele Data
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Marco Donetti
- CNAO, Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - Marco Ferrero
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | | | | | | | - Felix Mas Milian
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
- Universidade Estadual de Santa Cruz, Department of Exact and Technological Sciences, Ilhéus, Brazil
| | | | - Diango Montalvan Olivares
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Marco Pullia
- CNAO, Centro Nazionale di Adroterapia Oncologica, Pavia, Italy
| | - Francesco Tommasino
- Trento Institute for Fundamental Physics and Applications, Povo, Trento, Italy
- Università degli Studi di Trento, Trento, Italy
| | - Enrico Verroi
- Trento Institute for Fundamental Physics and Applications, Povo, Trento, Italy
| | - Anna Vignati
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Roberto Cirio
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
| | - Roberto Sacchi
- Università degli Studi di Torino, via Pietro Giuria 1, I-10125 Torino, Italy
- Istituto Nazionale di Fisica Nucleare, sezione di Torino, Italy
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20
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Purushothaman S, Kostyleva D, Dendooven P, Haettner E, Geissel H, Schuy C, Weber U, Boscolo D, Dickel T, Graeff C, Hornung C, Kazantseva E, Kuzminchuk-Feuerstein N, Mukha I, Pietri S, Roesch H, Tanaka YK, Zhao J, Durante M, Parodi K, Scheidenberger C. Quasi-real-time range monitoring by in-beam PET: a case for 15O. Sci Rep 2023; 13:18788. [PMID: 37914762 PMCID: PMC10620432 DOI: 10.1038/s41598-023-45122-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
A fast and reliable range monitoring method is required to take full advantage of the high linear energy transfer provided by therapeutic ion beams like carbon and oxygen while minimizing damage to healthy tissue due to range uncertainties. Quasi-real-time range monitoring using in-beam positron emission tomography (PET) with therapeutic beams of positron-emitters of carbon and oxygen is a promising approach. The number of implanted ions and the time required for an unambiguous range verification are decisive factors for choosing a candidate isotope. An experimental study was performed at the FRS fragment-separator of GSI Helmholtzzentrum für Schwerionenforschung GmbH, Germany, to investigate the evolution of positron annihilation activity profiles during the implantation of [Formula: see text]O and [Formula: see text]O ion beams in a PMMA phantom. The positron activity profile was imaged by a dual-panel version of a Siemens Biograph mCT PET scanner. Results from a similar experiment using ion beams of carbon positron-emitters [Formula: see text]C and [Formula: see text]C performed at the same experimental setup were used for comparison. Owing to their shorter half-lives, the number of implanted ions required for a precise positron annihilation activity peak determination is lower for [Formula: see text]C compared to [Formula: see text]C and likewise for [Formula: see text]O compared to [Formula: see text]O, but their lower production cross-sections make it difficult to produce them at therapeutically relevant intensities. With a similar production cross-section and a 10 times shorter half-life than [Formula: see text]C, [Formula: see text]O provides a faster conclusive positron annihilation activity peak position determination for a lower number of implanted ions compared to [Formula: see text]C. A figure of merit formulation was developed for the quantitative comparison of therapy-relevant positron-emitting beams in the context of quasi-real-time beam monitoring. In conclusion, this study demonstrates that among the positron emitters of carbon and oxygen, [Formula: see text]O is the most feasible candidate for quasi-real-time range monitoring by in-beam PET that can be produced at therapeutically relevant intensities. Additionally, this study demonstrated that the in-flight production and separation method can produce beams of therapeutic quality, in terms of purity, energy, and energy spread.
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Affiliation(s)
- S Purushothaman
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany.
| | - D Kostyleva
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
| | - P Dendooven
- Department of Radiation Oncology, Particle Therapy Research Center (PARTREC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E Haettner
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
| | - H Geissel
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
- II. Physikalisches Institut, Justus-Liebig-Universität, Gießen, Germany
| | - C Schuy
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
| | - U Weber
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
| | - D Boscolo
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
| | - T Dickel
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
- II. Physikalisches Institut, Justus-Liebig-Universität, Gießen, Germany
| | - C Graeff
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
- Department of Electrical Engineering and Information Technology, Technische Universität Darmstadt, Darmstadt, Germany
| | - C Hornung
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
| | - E Kazantseva
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
| | | | - I Mukha
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
| | - S Pietri
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
| | - H Roesch
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
- Institute for Nuclear Physics, Technische Universität Darmstadt, Darmstadt, Germany
| | - Y K Tanaka
- RIKEN Cluster for Pioneering Research, RIKEN, Wako, Japan
| | - J Zhao
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
- School of Physics, Beihang University, Beijing, China
| | - M Durante
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany.
- Department of Condensed Matter Physics, Technische Universität Darmstadt, Darmstadt, Germany.
| | - K Parodi
- Department of Medical Physics, Faculty of Physics, Ludwig-Maximilians Universität München, Munich, Germany
| | - C Scheidenberger
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Darmstadt, Germany
- II. Physikalisches Institut, Justus-Liebig-Universität, Gießen, Germany
- Helmholtz Forschungsakademie Hessen für FAIR (HFHF), Campus Gießen, Gießen, Germany
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21
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Durante M, Bender T, Schickel E, Mayer M, Debus J, Grosshans D, Schroeder I. Aberrant choroid plexus formation in human cerebral organoids exposed to radiation. RESEARCH SQUARE 2023:rs.3.rs-3445801. [PMID: 37886443 PMCID: PMC10602134 DOI: 10.21203/rs.3.rs-3445801/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Brain tumor patients are commonly treated with radiotherapy, but the efficacy of the treatment is limited by its toxicity, particularly the risk of radionecrosis. We used human cerebral organoids to investigate the mechanisms and nature of postirradiation brain image changes commonly linked to necrosis. Irradiation of cerebral organoids lead to increased formation of ZO1+/AQP1+/CLN3+-choroid plexus (CP) structures. Increased CP formation was triggered by radiation via the NOTCH/WNT signaling pathways and associated with delayed growth and neural stem cell differentiation, but not necrosis. The effect was more pronounced in immature than in mature organoids, reflecting the clinically-observed increased radiosensitivity of the pediatric brain. Protons were more effective than X-rays at the same dose, as also observed in clinical treatments. We conclude that radiation-induced brain image-changes can be attributed to aberrant CP formation, providing a new cellular mechanism and strategy for possible countermeasures.
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22
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Chen W, He X, Yan Z, Lin X, Bai G. Predicting metastasis at initial diagnosis and radiotherapy effectiveness in patients with metastatic osteosarcoma. J Cancer Res Clin Oncol 2023; 149:9587-9595. [PMID: 37222812 PMCID: PMC10423143 DOI: 10.1007/s00432-023-04869-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 05/19/2023] [Indexed: 05/25/2023]
Abstract
Osteosarcoma is a primary malignant bone tumor affecting mostly children and adolescents. The overall 10 year survivals of patients with metastatic osteosarcoma are typically less than 20% in the literature and remain concerning. We aimed to develop a nomogram for predicting the risk of metastasis at initial diagnosis in patients with osteosarcoma and evaluate the effectiveness of radiotherapy in patients with metastatic osteosarcoma. Clinical and demographic data of patients with osteosarcoma were collected from the surveillance, epidemiology, and end results database. We randomly split our analytical sample into the training and validation cohorts, then established and validated a nomogram for predicting the risk of osteosarcoma metastasis at initial diagnosis. The effectiveness of radiotherapy was evaluated by performing propensity score matching in patients underwent surgery + chemotherapy and those underwent surgery + chemotherapy + radiotherapy, among patients with metastatic osteosarcoma. 1439 patients met the inclusion criteria and were included in this study. 343 of 1439 had osteosarcoma metastasis by the time of initial presentation. A nomogram for predicting the likelihood of osteosarcoma metastasis by the time of initial presentation was developed. In both unmatched and matched samples, the radiotherapy group demonstrated a superior survival profile comparing with the non-radiotherapy group. Our study established a novel nomogram to evaluate the risk of osteosarcoma with metastasis, and demonstrated that radiotherapy combined with chemotherapy and surgical resection could improve 10-year survival in patients with metastasis. These findings may guide the clinical decision-making for orthopedic surgeons.
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Affiliation(s)
- Wenhao Chen
- Department of Orthopedic Surgery, National Children's Regional Medical Center, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou, 310052, Zhejiang, China.
| | - Xinyu He
- Department of Child Health Care, National Children's Regional Medical Center, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou, 310052, Zhejiang, China
| | - Zhiyu Yan
- Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Xiuquan Lin
- Department for Chronic and Non-Communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, 386 Chong'an Road, Fuzhou, 350012, Fujian, China.
- The School of Public Health, Fujian Medical University, 1 North Xuefu Road, Fuzhou, 350122, Fujian, China.
| | - Guannan Bai
- Department of Child Health Care, National Children's Regional Medical Center, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou, 310052, Zhejiang, China.
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23
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Dasgupta A, Saifuddin M, McNabb E, Ho L, Lu L, Vesprini D, Karam I, Soliman H, Chow E, Gandhi S, Trudeau M, Tran W, Curpen B, Stanisz G, Sahgal A, Kolios M, Czarnota GJ. Novel MRI-guided focussed ultrasound stimulated microbubble radiation enhancement treatment for breast cancer. Sci Rep 2023; 13:13566. [PMID: 37604988 PMCID: PMC10442356 DOI: 10.1038/s41598-023-40551-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/12/2023] [Indexed: 08/23/2023] Open
Abstract
Preclinical studies have demonstrated focused ultrasound (FUS) stimulated microbubble (MB) rupture leads to the activation of acid sphingomyelinase-ceramide pathway in the endothelial cells. When radiotherapy (RT) is delivered concurrently with FUS-MB, apoptotic pathway leads to increased cell death resulting in potent radiosensitization. Here we report the first human trial of using magnetic resonance imaging (MRI) guided FUS-MB treatment in the treatment of breast malignancies. In the phase 1 prospective interventional study, patients with breast cancer were treated with fractionated RT (5 or 10 fractions) to the disease involving breast or chest wall. FUS-MB treatment was delivered before 1st and 5th fractions of RT (within 1 h). Eight patients with 9 tumours were treated. All 7 evaluable patients with at least 3 months follow-up treated for 8 tumours had a complete response in the treated site. The maximum acute toxicity observed was grade 2 dermatitis in 1 site, and grade 1 in 8 treated sites, at one month post RT, which recovered at 3 months. No RT-related late effect or FUS-MB related toxicity was noted. This study demonstrated safety of combined FUS-MB and RT treatment. Promising response rates suggest potential strong radiosensitization effects of the investigational modality.Trial registration: clinicaltrials.gov, identifier NCT04431674.
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Affiliation(s)
- Archya Dasgupta
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
- Physical Sciences, Sunnybrook Research Institute, Toronto, Canada
| | | | - Evan McNabb
- Physical Sciences, Sunnybrook Research Institute, Toronto, Canada
| | - Ling Ho
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada
| | - Lin Lu
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada
| | - Danny Vesprini
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Irene Karam
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Hany Soliman
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Edward Chow
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Sonal Gandhi
- Department of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Maureen Trudeau
- Department of Medical Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - William Tran
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Belinda Curpen
- Department of Medical Imaging, Sunnybrook Health Sciences, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Greg Stanisz
- Physical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Department of Biophysics, University of Toronto, Toronto, Canada
- Canada Research Chair in Cancer Imaging, Canadian Institutes of Health Research, Toronto, Canada
| | - Arjun Sahgal
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | | | - Gregory J Czarnota
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, T2, Toronto, ON, M4N3M5, Canada.
- Department of Radiation Oncology, University of Toronto, Toronto, Canada.
- Physical Sciences, Sunnybrook Research Institute, Toronto, Canada.
- Department of Biophysics, University of Toronto, Toronto, Canada.
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Liang X, Beltran CJ, Liu C, Park C, Lu B, Yaddanapudi S, Tan J, Furutani KM. Selecting Optimal Proton Pencil Beam Scanning Plan Parameters to Reduce Dose Discrepancy between Discrete Spot Plan and Continuous Scanning: A Proof-of-Concept Study. Cancers (Basel) 2023; 15:4084. [PMID: 37627112 PMCID: PMC10452710 DOI: 10.3390/cancers15164084] [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: 05/24/2023] [Revised: 07/25/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Pencil beam scanning delivered with continuous scanning has several advantages over conventional discrete spot scanning. Such advantages include improved beam delivery efficiency and reduced beam delivery time. However, a move dose is delivered between consecutive spots with continuous scanning, and current treatment planning systems do not take this into account. Therefore, continuous scanning and discrete spot plans have an inherent dose discrepancy. Using the operating parameters of the state-of-the-art particle therapy system, we conducted a proof-of-concept study in which we systematically generated 28 plans for cubic targets with different combinations of plan parameters and simulated the dose discrepancies between continuous scanning and a planned one. A nomograph to guide the selection of plan parameters was developed to reduce the dose discrepancy. The effectiveness of the nomograph was evaluated with two clinical cases (one prostate and one liver). Plans with parameters guided by the nomograph decreased dose discrepancy than those used standard plan parameters. Specifically, the 2%/2 mm gamma passing rate increased from 96.3% to 100% for the prostate case and from 97.8% to 99.7% for the liver case. The CTV DVH root mean square error decreased from 2.2% to 0.2% for the prostate case and from 1.8% to 0.9% for the liver case. The decreased dose discrepancy may allow the relaxing of the delivery constraint for some cases, leading to greater benefits in continuous scanning. Further investigation is warranted.
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Affiliation(s)
- Xiaoying Liang
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Chris J. Beltran
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Chunbo Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Chunjoo Park
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Bo Lu
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Jun Tan
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Keith M. Furutani
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA
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25
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Zavestovskaya IN, Popov AL, Kolmanovich DD, Tikhonowski GV, Pastukhov AI, Savinov MS, Shakhov PV, Babkova JS, Popov AA, Zelepukin IV, Grigoryeva MS, Shemyakov AE, Klimentov SM, Ryabov VA, Prasad PN, Deyev SM, Kabashin AV. Boron Nanoparticle-Enhanced Proton Therapy for Cancer Treatment. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:2167. [PMID: 37570485 PMCID: PMC10421420 DOI: 10.3390/nano13152167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023]
Abstract
Proton therapy is one of the promising radiotherapy modalities for the treatment of deep-seated and unresectable tumors, and its efficiency can further be enhanced by using boron-containing substances. Here, we explore the use of elemental boron (B) nanoparticles (NPs) as sensitizers for proton therapy enhancement. Prepared by methods of pulsed laser ablation in water, the used B NPs had a mean size of 50 nm, while a subsequent functionalization of the NPs by polyethylene glycol improved their colloidal stability in buffers. Laser-synthesized B NPs were efficiently absorbed by MNNG/Hos human osteosarcoma cells and did not demonstrate any remarkable toxicity effects up to concentrations of 100 ppm, as followed from the results of the MTT and clonogenic assay tests. Then, we assessed the efficiency of B NPs as sensitizers of cancer cell death under irradiation by a 160.5 MeV proton beam. The irradiation of MNNG/Hos cells at a dose of 3 Gy in the presence of 80 and 100 ppm of B NPs led to a 2- and 2.7-fold decrease in the number of formed cell colonies compared to control samples irradiated in the absence of NPs. The obtained data unambiguously evidenced the effect of a strong proton therapy enhancement mediated by B NPs. We also found that the proton beam irradiation of B NPs leads to the generation of reactive oxygen species (ROS), which evidences a possible involvement of the non-nuclear mechanism of cancer cell death related to oxidative stress. Offering a series of advantages, including a passive targeting option and the possibility of additional theranostic functionalities based on the intrinsic properties of B NPs (e.g., photothermal therapy or neutron boron capture therapy), the proposed concept promises a major advancement in proton beam-based cancer treatment.
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Affiliation(s)
- Irina N. Zavestovskaya
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Leninsky Prospect 53, 119991 Moscow, Russia; (A.L.P.); (D.D.K.); (M.S.G.); (A.E.S.); (V.A.R.)
- Bionanophotonics Laboratory, Institute of Engineering Physics for Biomedicine (PhysBio), National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe Shosse 31, 115409 Moscow, Russia; (G.V.T.); (M.S.S.); (P.V.S.); (J.S.B.); (A.A.P.); (S.M.K.); (P.N.P.); (S.M.D.)
| | - Anton L. Popov
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Leninsky Prospect 53, 119991 Moscow, Russia; (A.L.P.); (D.D.K.); (M.S.G.); (A.E.S.); (V.A.R.)
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, 3 Institutskaya St., 142290 Pushchino, Russia
| | - Danil D. Kolmanovich
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Leninsky Prospect 53, 119991 Moscow, Russia; (A.L.P.); (D.D.K.); (M.S.G.); (A.E.S.); (V.A.R.)
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, 3 Institutskaya St., 142290 Pushchino, Russia
| | - Gleb V. Tikhonowski
- Bionanophotonics Laboratory, Institute of Engineering Physics for Biomedicine (PhysBio), National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe Shosse 31, 115409 Moscow, Russia; (G.V.T.); (M.S.S.); (P.V.S.); (J.S.B.); (A.A.P.); (S.M.K.); (P.N.P.); (S.M.D.)
| | | | - Maxim S. Savinov
- Bionanophotonics Laboratory, Institute of Engineering Physics for Biomedicine (PhysBio), National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe Shosse 31, 115409 Moscow, Russia; (G.V.T.); (M.S.S.); (P.V.S.); (J.S.B.); (A.A.P.); (S.M.K.); (P.N.P.); (S.M.D.)
| | - Pavel V. Shakhov
- Bionanophotonics Laboratory, Institute of Engineering Physics for Biomedicine (PhysBio), National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe Shosse 31, 115409 Moscow, Russia; (G.V.T.); (M.S.S.); (P.V.S.); (J.S.B.); (A.A.P.); (S.M.K.); (P.N.P.); (S.M.D.)
| | - Julia S. Babkova
- Bionanophotonics Laboratory, Institute of Engineering Physics for Biomedicine (PhysBio), National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe Shosse 31, 115409 Moscow, Russia; (G.V.T.); (M.S.S.); (P.V.S.); (J.S.B.); (A.A.P.); (S.M.K.); (P.N.P.); (S.M.D.)
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997 Moscow, Russia;
| | - Anton A. Popov
- Bionanophotonics Laboratory, Institute of Engineering Physics for Biomedicine (PhysBio), National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe Shosse 31, 115409 Moscow, Russia; (G.V.T.); (M.S.S.); (P.V.S.); (J.S.B.); (A.A.P.); (S.M.K.); (P.N.P.); (S.M.D.)
| | - Ivan V. Zelepukin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997 Moscow, Russia;
| | - Maria S. Grigoryeva
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Leninsky Prospect 53, 119991 Moscow, Russia; (A.L.P.); (D.D.K.); (M.S.G.); (A.E.S.); (V.A.R.)
| | - Alexander E. Shemyakov
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Leninsky Prospect 53, 119991 Moscow, Russia; (A.L.P.); (D.D.K.); (M.S.G.); (A.E.S.); (V.A.R.)
| | - Sergey M. Klimentov
- Bionanophotonics Laboratory, Institute of Engineering Physics for Biomedicine (PhysBio), National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe Shosse 31, 115409 Moscow, Russia; (G.V.T.); (M.S.S.); (P.V.S.); (J.S.B.); (A.A.P.); (S.M.K.); (P.N.P.); (S.M.D.)
| | - Vladimir A. Ryabov
- P. N. Lebedev Physical Institute of the Russian Academy of Sciences, Leninsky Prospect 53, 119991 Moscow, Russia; (A.L.P.); (D.D.K.); (M.S.G.); (A.E.S.); (V.A.R.)
| | - Paras N. Prasad
- Bionanophotonics Laboratory, Institute of Engineering Physics for Biomedicine (PhysBio), National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe Shosse 31, 115409 Moscow, Russia; (G.V.T.); (M.S.S.); (P.V.S.); (J.S.B.); (A.A.P.); (S.M.K.); (P.N.P.); (S.M.D.)
- Department of Chemistry, Institute for Lasers, Photonics, and Biophotonics, The State University of New York at Buffalo, Buffalo, NY 14260, USA
| | - Sergey M. Deyev
- Bionanophotonics Laboratory, Institute of Engineering Physics for Biomedicine (PhysBio), National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Kashirskoe Shosse 31, 115409 Moscow, Russia; (G.V.T.); (M.S.S.); (P.V.S.); (J.S.B.); (A.A.P.); (S.M.K.); (P.N.P.); (S.M.D.)
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117997 Moscow, Russia;
- “Biomarker” Research Laboratory, Institute of Fundamental Medicine and Biology, Kazan Federal University, 18 Kremlyovskaya St., 420008 Kazan, Russia
- Institute of Molecular Theranostics, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
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Graeff C, Volz L, Durante M. Emerging technologies for cancer therapy using accelerated particles. PROGRESS IN PARTICLE AND NUCLEAR PHYSICS 2023; 131:104046. [PMID: 37207092 PMCID: PMC7614547 DOI: 10.1016/j.ppnp.2023.104046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Cancer therapy with accelerated charged particles is one of the most valuable biomedical applications of nuclear physics. The technology has vastly evolved in the past 50 years, the number of clinical centers is exponentially growing, and recent clinical results support the physics and radiobiology rationale that particles should be less toxic and more effective than conventional X-rays for many cancer patients. Charged particles are also the most mature technology for clinical translation of ultra-high dose rate (FLASH) radiotherapy. However, the fraction of patients treated with accelerated particles is still very small and the therapy is only applied to a few solid cancer indications. The growth of particle therapy strongly depends on technological innovations aiming to make the therapy cheaper, more conformal and faster. The most promising solutions to reach these goals are superconductive magnets to build compact accelerators; gantryless beam delivery; online image-guidance and adaptive therapy with the support of machine learning algorithms; and high-intensity accelerators coupled to online imaging. Large international collaborations are needed to hasten the clinical translation of the research results.
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Affiliation(s)
- Christian Graeff
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Planckstraße 1, 64291 Darmstadt, Germany
- Technische Universität Darmstadt, Darmstadt, Germany
| | - Lennart Volz
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Planckstraße 1, 64291 Darmstadt, Germany
| | - Marco Durante
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Planckstraße 1, 64291 Darmstadt, Germany
- Technische Universität Darmstadt, Darmstadt, Germany
- Dipartimento di Fisica “Ettore Pancini”, University Federico II, Naples, Italy
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27
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Hariharan A, Tran SD. Localized Drug Delivery Systems: An Update on Treatment Options for Head and Neck Squamous Cell Carcinomas. Pharmaceutics 2023; 15:1844. [PMID: 37514031 PMCID: PMC10385385 DOI: 10.3390/pharmaceutics15071844] [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: 04/13/2023] [Revised: 06/12/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers in the world, with surgery, radiotherapy, chemotherapy, and immunotherapy being the primary treatment modalities. The treatment for HNSCC has evolved over time, due to which the prognosis has improved drastically. Despite the varied treatment options, major challenges persist. HNSCC chemotherapeutic and immunotherapeutic drugs are usually administered systemically, which could affect the patient's quality of life due to the associated side effects. Moreover, the systemic administration of salivary stimulating agents for the treatment of radiation-induced xerostomia is associated with toxicities. Localized drug delivery systems (LDDS) are gaining importance, as they have the potential to provide non-invasive, patient-friendly alternatives to cancer therapy with reduced dose-limiting toxicities. LDDSs involve directly delivering a drug to the tissue or organ affected by the disease. Some of the common localized routes of administration include the transdermal and transmucosal drug delivery system (DDSs). This review will attempt to explore the different treatment options using LDDSs for the treatment of HNSCC and radiotherapy-induced damage and their potential to provide a better experience for patients, as well as the obstacles that need to be addressed to render them successful.
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Affiliation(s)
- Arvind Hariharan
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dental Medicine and Oral Health Sciences, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
| | - Simon D Tran
- McGill Craniofacial Tissue Engineering and Stem Cells Laboratory, Faculty of Dental Medicine and Oral Health Sciences, McGill University, 3640 University Street, Montreal, QC H3A 0C7, Canada
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28
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Tran NH, Shtam T, Marchenko YY, Konevega AL, Lebedev D. Current State and Prospectives for Proton Boron Capture Therapy. Biomedicines 2023; 11:1727. [PMID: 37371822 DOI: 10.3390/biomedicines11061727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 05/19/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
The development of new methods increasing the biological effectiveness of proton therapy (PT) is of high interest in radiation oncology. The use of binary technologies, in which the damaging effect of proton radiation is further enhanced by the selective accumulation of the radiosensitizer in the target tissue, can significantly increase the effectiveness of radiation therapy. To increase the absorbed dose in a tumor target, proton boron capture therapy (PBCT) was proposed based on the reaction of proton capture on the 11B isotope with the formation of three α-particles. This review summarizes data on theoretical and experimental studies on the effectiveness and prospects of proton boron capture therapy.
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Affiliation(s)
- Nhan Hau Tran
- Petersburg Nuclear Physics Institute Named by B.P. Konstantinov of National Research Centre «Kurchatov Institute», Orlova roscha 1, Gatchina 188300, Russia
- Institute of Biomedical Systems and Biotechnology, Peter the Great St. Petersburg Polytechnic University, Politehnicheskaya 29, St. Petersburg 195251, Russia
| | - Tatiana Shtam
- Petersburg Nuclear Physics Institute Named by B.P. Konstantinov of National Research Centre «Kurchatov Institute», Orlova roscha 1, Gatchina 188300, Russia
- National Research Center "Kurchatov Institute", Akademika Kurchatova pl. 1, Moscow 123182, Russia
| | - Yaroslav Yu Marchenko
- Petersburg Nuclear Physics Institute Named by B.P. Konstantinov of National Research Centre «Kurchatov Institute», Orlova roscha 1, Gatchina 188300, Russia
| | - Andrey L Konevega
- Petersburg Nuclear Physics Institute Named by B.P. Konstantinov of National Research Centre «Kurchatov Institute», Orlova roscha 1, Gatchina 188300, Russia
- Institute of Biomedical Systems and Biotechnology, Peter the Great St. Petersburg Polytechnic University, Politehnicheskaya 29, St. Petersburg 195251, Russia
- National Research Center "Kurchatov Institute", Akademika Kurchatova pl. 1, Moscow 123182, Russia
| | - Dmitry Lebedev
- Petersburg Nuclear Physics Institute Named by B.P. Konstantinov of National Research Centre «Kurchatov Institute», Orlova roscha 1, Gatchina 188300, Russia
- National Research Center "Kurchatov Institute", Akademika Kurchatova pl. 1, Moscow 123182, Russia
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29
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Hussain RN, Chiu A, Pittam B, Taktak A, Damato BE, Kacperek A, Errington D, Cauchi P, Chadha V, Connolly J, Salvi S, Rundle P, Cohen V, Arora A, Sagoo M, Bekir O, Kopsidas K, Heimann H. Proton beam radiotherapy for choroidal and ciliary body melanoma in the UK-national audit of referral patterns of 1084 cases. Eye (Lond) 2023; 37:1033-1036. [PMID: 35840716 PMCID: PMC10050435 DOI: 10.1038/s41433-022-02178-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/03/2022] [Accepted: 07/07/2022] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Proton beam therapy has been utilised for the treatment of uveal melanoma in the UK for over 30 years, undertaken under a single centre. In the UK, all ocular tumours are treated at one of four centres. We aimed to understand the variation in referral patterns to the UK proton service, capturing all uveal melanoma patients treated with this modality. METHODS Retrospective analysis of data regarding all patients treated at the Clatterbridge Proton service between January 2004 and December 2014. RESULTS A total of 1084 patients with uveal melanoma were treated. The mean age was 57 years (range 9-90 years), basal diameter of 11.5 mm (range 2.0-23.4 mm) and tumour thickness of 3.9 mm (range 0.1-15.4 mm). The majority were TNM stage I (39%) or II (36%). The distance to the optic nerve varied from 0 to 24.5 mm with 148 (14%) of patients having ciliary body involvement. There were variations in the phenotypic characteristic of the tumours treated with protons from different centres, with London referring predominantly small tumours at the posterior pole, Glasgow referring large tumours often at the ciliary body and Liverpool sending a mix of these groups. DISCUSSION In the UK, common indications for the use of proton treatment in uveal melanoma include small tumours in the posterior pole poorly accessible for plaque treatment (adjacent to the disc), tumours at the posterior pole affecting the fovea and large anterior tumours traditionally too large for brachytherapy. This is the first UK-wide audit enabling the capture of all patients treated at the single proton centre.
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Affiliation(s)
- R N Hussain
- Liverpool Ocular Oncology Centre, Royal Liverpool Hospital, Liverpool, L7 8XP, UK.
| | - A Chiu
- Liverpool Ocular Oncology Centre, Royal Liverpool Hospital, Liverpool, L7 8XP, UK
| | - B Pittam
- Liverpool Ocular Oncology Centre, Royal Liverpool Hospital, Liverpool, L7 8XP, UK
| | - A Taktak
- Department of Eye and Vision Science and Department of Biostatistics, University of Liverpool, Liverpool, L69 3GL, UK
| | - B E Damato
- Ocular Oncology Service, Moorfields Eye Hospital, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, EC1V 2PD, UK
| | - A Kacperek
- University College London, London, WC1E 6BT, UK
| | - D Errington
- Clatterbridge Cancer Centre, Clatterbridge Road, Bebington, Wirral, CH63 4JY, UK
| | - P Cauchi
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
| | - V Chadha
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
| | - J Connolly
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
| | - S Salvi
- The National Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, S10 2JF, Sheffield, UK
| | - P Rundle
- The National Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, S10 2JF, Sheffield, UK
| | - V Cohen
- Ocular Oncology Service, Moorfields Eye Hospital, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, EC1V 2PD, UK
| | - A Arora
- Ocular Oncology Service, Moorfields Eye Hospital, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, EC1V 2PD, UK
| | - M Sagoo
- Ocular Oncology Service, Moorfields Eye Hospital, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, EC1V 2PD, UK
| | - O Bekir
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
| | - K Kopsidas
- The National Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, S10 2JF, Sheffield, UK
| | - H Heimann
- Liverpool Ocular Oncology Centre, Royal Liverpool Hospital, Liverpool, L7 8XP, UK
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30
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Heggebø LC, Borgen IMH, Rylander H, Kiserud C, Nordenmark TH, Hellebust TP, Evensen ME, Gustavsson M, Ramberg C, Sprauten M, Magelssen H, Blakstad H, Moorthy J, Andersson K, Raunert I, Henry T, Moe C, Granlund C, Goplen D, Brekke J, Johannessen TCA, Solheim TS, Marienhagen K, Humberset Ø, Bergström P, Agrup M, Dahl L, Gubanski M, Gojon H, Brahme CJ, Rydén I, Jakola AS, Vik-Mo EO, Lie HC, Asphaug L, Hervani M, Kristensen I, Rueegg CS, Olsen IC, Ledal RJ, Degsell E, Werlenius K, Blomstrand M, Brandal P. Investigating survival, quality of life and cognition in PROton versus photon therapy for IDH-mutated diffuse grade 2 and 3 GLIOmas (PRO-GLIO): a randomised controlled trial in Norway and Sweden. BMJ Open 2023; 13:e070071. [PMID: 36940951 PMCID: PMC10030923 DOI: 10.1136/bmjopen-2022-070071] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
INTRODUCTION The use of proton therapy increases globally despite a lack of randomised controlled trials demonstrating its efficacy and safety. Proton therapy enables sparing of non-neoplastic tissue from radiation. This is principally beneficial and holds promise of reduced long-term side effects. However, the sparing of seemingly non-cancerous tissue is not necessarily positive for isocitrate dehydrogenase (IDH)-mutated diffuse gliomas grade 2-3, which have a diffuse growth pattern. With their relatively good prognosis, yet incurable nature, therapy needs to be delicately balanced to achieve a maximal survival benefit combined with an optimised quality of life. METHODS AND ANALYSIS PRO-GLIO (PROton versus photon therapy in IDH-mutated diffuse grade 2 and 3 GLIOmas) is an open-label, multicentre, randomised phase III non-inferiority study. 224 patients aged 18-65 years with IDH-mutated diffuse gliomas grade 2-3 from Norway and Sweden will be randomised 1:1 to radiotherapy delivered with protons (experimental arm) or photons (standard arm). First intervention-free survival at 2 years is the primary endpoint. Key secondary endpoints are fatigue and cognitive impairment, both at 2 years. Additional secondary outcomes include several survival measures, health-related quality of life parameters and health economy endpoints. ETHICS AND DISSEMINATION To implement proton therapy as part of standard of care for patients with IDH-mutated diffuse gliomas grade 2-3, it should be deemed safe. With its randomised controlled design testing proton versus photon therapy, PRO-GLIO will provide important information for this patient population concerning safety, cognition, fatigue and other quality of life parameters. As proton therapy is considerably more costly than its photon counterpart, cost-effectiveness will also be evaluated. PRO-GLIO is approved by ethical committees in Norway (Regional Committee for Medical & Health Research Ethics) and Sweden (The Swedish Ethical Review Authority) and patient inclusion has commenced. Trial results will be published in international peer-reviewed journals, relevant conferences, national and international meetings and expert forums. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT05190172).
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Affiliation(s)
- Liv Cathrine Heggebø
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ida Maria Henriksen Borgen
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | | | - Cecilie Kiserud
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Tonje Haug Nordenmark
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Taran Paulsen Hellebust
- Department of Medical Physics, Oslo University Hospital, Oslo, Norway
- Department of Physics, University of Oslo, Oslo, Norway
| | - Morten Egeberg Evensen
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Section of Oncology, Drammen Hospital, Drammen, Norway
| | - Magnus Gustavsson
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Medical Radiation Science, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
| | - Christina Ramberg
- Department of Medical Physics, Oslo University Hospital, Oslo, Norway
| | - Mette Sprauten
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | - Hanne Blakstad
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Janani Moorthy
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | - Ingela Raunert
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Thomas Henry
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Medical Radiation Science, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
| | - Cecilie Moe
- Department of Research Support for Clinical Trials, Oslo University Hospital, Oslo, Norway
| | - Carin Granlund
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Dorota Goplen
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - Jorunn Brekke
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | | | - Tora Skeidsvoll Solheim
- Cancer Clinic, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Øyvind Humberset
- Department of Oncology, University Hospital of North Norway, Tromso, Norway
| | - Per Bergström
- Department of Oncology, University Hospital of Umeå, Umeå, Sweden
| | - Måns Agrup
- Department of Oncology, Linköping University Hospital, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Ludvig Dahl
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Michael Gubanski
- Department of Radiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Helene Gojon
- Department of Radiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | | | - Isabelle Rydén
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Asgeir S Jakola
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Einar O Vik-Mo
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Hanne C Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lars Asphaug
- Department of Research Support for Clinical Trials, Oslo University Hospital, Oslo, Norway
| | - Maziar Hervani
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Ingrid Kristensen
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Corina Silvia Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Inge C Olsen
- Department of Research Support for Clinical Trials, Oslo University Hospital, Oslo, Norway
| | | | | | - Katja Werlenius
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Oncology, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Malin Blomstrand
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Oncology, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Petter Brandal
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Institute for Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway
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Thompson SJ, Prise KM, McMahon SJ. Investigating the potential contribution of inter-track interactions within ultra-high dose-rate proton therapy. Phys Med Biol 2023; 68. [PMID: 36731135 DOI: 10.1088/1361-6560/acb88a] [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: 09/15/2022] [Accepted: 02/01/2023] [Indexed: 02/04/2023]
Abstract
Objective. Laser-accelerated protons offer an alternative delivery mechanism for proton therapy. This technique delivers dose-rates of ≥109Gy s-1, many orders of magnitude greater than used clinically. Such ultra-high dose-rates reduce delivery time to nanoseconds, equivalent to the lifetime of reactive chemical species within a biological medium. This leads to the possibility of inter-track interactions between successive protons within a pulse, potentially altering the yields of damaging radicals if they are in sufficient spatial proximity. This work investigates the temporal evolution of chemical species for a range of proton energies and doses to quantify the circumstances required for inter-track interactions, and determine any relevance within ultra-high dose-rate proton therapy.Approach. The TOPAS-nBio Monte Carlo toolkit was used to investigate possible inter-track interactions. Firstly, protons between 0.5 and 100 MeV were simulated to record the radial track dimensions throughout the chemical stage from 1 ps to 1μs. Using the track areas, the geometric probability of track overlap was calculated for various exposures and timescales. A sample of irradiations were then simulated in detail to compare any change in chemical yields for independently and instantaneously delivered tracks, and validate the analytic model.Main results. Track overlap for a clinical 2 Gy dose was negligible for biologically relevant timepoints for all energies. Overlap probability increased with time after irradiation, proton energy and dose, with a minimum 23 Gy dose required before significant track overlap occurred. Simulating chemical interactions confirmed these results with no change in radical yields seen up to 8 Gy for independently and instantaneously delivered tracks.Significance. These observations suggest that the spatial separation between incident protons is too large for physico-chemical inter-track interactions, regardless of the delivery time, indicating such interactions would not play a role in any potential changes in biological response between laser-accelerated and conventional proton therapy.
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Affiliation(s)
- Shannon J Thompson
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom
| | - Kevin M Prise
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom
| | - Stephen J McMahon
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom
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Parrella G, Vai A, Nakas A, Garau N, Meschini G, Camagni F, Molinelli S, Barcellini A, Pella A, Ciocca M, Vitolo V, Orlandi E, Paganelli C, Baroni G. Synthetic CT in Carbon Ion Radiotherapy of the Abdominal Site. Bioengineering (Basel) 2023; 10:bioengineering10020250. [PMID: 36829745 PMCID: PMC9951997 DOI: 10.3390/bioengineering10020250] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
The generation of synthetic CT for carbon ion radiotherapy (CIRT) applications is challenging, since high accuracy is required in treatment planning and delivery, especially in an anatomical site as complex as the abdomen. Thirty-nine abdominal MRI-CT volume pairs were collected and a three-channel cGAN (accounting for air, bones, soft tissues) was used to generate sCTs. The network was tested on five held-out MRI volumes for two scenarios: (i) a CT-based segmentation of the MRI channels, to assess the quality of sCTs and (ii) an MRI manual segmentation, to simulate an MRI-only treatment scenario. The sCTs were evaluated by means of similarity metrics (e.g., mean absolute error, MAE) and geometrical criteria (e.g., dice coefficient). Recalculated CIRT plans were evaluated through dose volume histogram, gamma analysis and range shift analysis. The CT-based test set presented optimal MAE on bones (86.03 ± 10.76 HU), soft tissues (55.39 ± 3.41 HU) and air (54.42 ± 11.48 HU). Higher values were obtained from the MRI-only test set (MAEBONE = 154.87 ± 22.90 HU). The global gamma pass rate reached 94.88 ± 4.9% with 3%/3 mm, while the range shift reached a median (IQR) of 0.98 (3.64) mm. The three-channel cGAN can generate acceptable abdominal sCTs and allow for CIRT dose recalculations comparable to the clinical plans.
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Affiliation(s)
- Giovanni Parrella
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
- Correspondence: ; Tel.: +39-02-2399-18-9022
| | - Alessandro Vai
- Medical Physics Unit, National Center of Oncological Hadrontherapy (CNAO), Strada Campeggi, 53, 27100 Pavia, Italy
| | - Anestis Nakas
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Noemi Garau
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Giorgia Meschini
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Francesca Camagni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Silvia Molinelli
- Medical Physics Unit, National Center of Oncological Hadrontherapy (CNAO), Strada Campeggi, 53, 27100 Pavia, Italy
| | - Amelia Barcellini
- Radiotherapy Unit, National Center of Oncological Hadrontherapy (CNAO), Strada Campeggi, 53, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
| | - Andrea Pella
- Bioengineering Unit, National Center of Oncological Hadrontherapy (CNAO), Strada Campeggi, 53, 27100 Pavia, Italy
| | - Mario Ciocca
- Medical Physics Unit, National Center of Oncological Hadrontherapy (CNAO), Strada Campeggi, 53, 27100 Pavia, Italy
| | - Viviana Vitolo
- Radiotherapy Unit, National Center of Oncological Hadrontherapy (CNAO), Strada Campeggi, 53, 27100 Pavia, Italy
| | - Ester Orlandi
- Clinical Unit, National Center of Oncological Hadrontherapy (CNAO), Strada Campeggi, 53, 27100 Pavia, Italy
| | - Chiara Paganelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Guido Baroni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
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Cunningham C, Bolcaen J, Bisio A, Genis A, Strijdom H, Vandevoorde C. Recombinant Endostatin as a Potential Radiosensitizer in the Treatment of Non-Small Cell Lung Cancer. Pharmaceuticals (Basel) 2023; 16:219. [PMID: 37259367 PMCID: PMC9961924 DOI: 10.3390/ph16020219] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 11/03/2023] Open
Abstract
Non-small cell lung cancer (NSCLC) is the most prevalent type of lung cancer, which is the leading cause of cancer-related deaths worldwide. Over the past decades, tumour angiogenesis has been intensely studied in the treatment of NSCLC due to its fundamental role in cancer progression. Several anti-angiogenic drugs, such as recombinant endostatin (RE), have been evaluated in several preclinical and clinical trials, with mixed and often disappointing results. However, there is currently an emerging interest in RE due to its ability to create a vascular normalization window, which could further improve treatment efficacy of the standard NSCLC treatment. This review provides an overview of preclinical and clinical studies that combined RE and radiotherapy for NSCLC treatment. Furthermore, it highlights the ongoing challenges that have to be overcome in order to maximize the benefit; as well as the potential advantage of combinations with particle therapy and immunotherapy, which are rapidly gaining momentum in the treatment landscape of NSCLC. Different angiogenic and immunosuppressive effects are observed between particle therapy and conventional X-ray radiotherapy. The combination of RE, particle therapy and immunotherapy presents a promising future therapeutic triad for NSCLC.
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Affiliation(s)
- Charnay Cunningham
- Centre for Cardio-Metabolic Research in Africa (CARMA), Division of Medical Physiology, Stellenbosch University, Cape Town 7602, South Africa
- Radiation Biophysics Division, SSC Laboratory, NRF Ithemba LABS, Cape Town 7131, South Africa
| | - Julie Bolcaen
- Radiation Biophysics Division, SSC Laboratory, NRF Ithemba LABS, Cape Town 7131, South Africa
| | - Alessandra Bisio
- Department of Cellular, Computational and Integrative Biology—CIBIO, University of Trento, 38123 Trento, Italy
| | - Amanda Genis
- Centre for Cardio-Metabolic Research in Africa (CARMA), Division of Medical Physiology, Stellenbosch University, Cape Town 7602, South Africa
| | - Hans Strijdom
- Centre for Cardio-Metabolic Research in Africa (CARMA), Division of Medical Physiology, Stellenbosch University, Cape Town 7602, South Africa
| | - Charlot Vandevoorde
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, Planckstr. 1, 64291 Darmstadt, Germany
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Morelli L, Palombo M, Buizza G, Riva G, Pella A, Fontana G, Imparato S, Iannalfi A, Orlandi E, Paganelli C, Baroni G. Microstructural parameters from DW-MRI for tumour characterization and local recurrence prediction in particle therapy of skull-base chordoma. Med Phys 2023; 50:2900-2913. [PMID: 36602230 DOI: 10.1002/mp.16202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/21/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Quantitative imaging such as Diffusion-Weighted MRI (DW-MRI) can be exploited to non-invasively derive patient-specific tumor microstructure information for tumor characterization and local recurrence risk prediction in radiotherapy. PURPOSE To characterize tumor microstructure according to proliferative capacity and predict local recurrence through microstructural markers derived from pre-treatment conventional DW-MRI, in skull-base chordoma (SBC) patients treated with proton (PT) and carbon ion (CIRT) radiotherapy. METHODS Forty-eight patients affected by SBC, who underwent conventional DW-MRI before treatment and were enrolled for CIRT (n = 25) or PT (n = 23), were retrospectively selected. Clinically verified local recurrence information (LR) and histological information (Ki-67, proliferation index) were collected. Apparent diffusion coefficient (ADC) maps were calculated from pre-treatment DW-MRI and, from these, a set of microstructural parameters (cellular radius R, volume fraction vf, diffusion D) were derived by applying a fine-tuning procedure to a framework employing Monte Carlo simulations on synthetic cell substrates. In addition, apparent cellularity (ρapp ) was estimated from vf and R for an easier clinical interpretation. Histogram-based metrics (mean, median, variance, entropy) from estimated parameters were considered to investigate differences (Mann-Whitney U-test, α = 0.05) in estimated tumor microstructure in SBCs characterized by low or high cell proliferation (Ki-67). Recurrence-free survival analyses were also performed to assess the ability of the microstructural parameters to stratify patients according to the risk of local recurrence (Kaplan-Meier curves, log-rank test α = 0.05). RESULTS Refined microstructural markers revealed optimal capabilities in discriminating patients according to cell proliferation, achieving best results with mean values (p-values were 0.0383, 0.0284, 0.0284, 0.0468, and 0.0088 for ADC, R, vf, D, and ρapp, respectively). Recurrence-free survival analyses showed significant differences between populations at high and low risk of local recurrence as stratified by entropy values of estimated microstructural parameters (p = 0.0110). CONCLUSION Patient-specific microstructural information was non-invasively derived providing potentially useful tools for SBC treatment personalization and optimization in particle therapy.
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Affiliation(s)
- Letizia Morelli
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
| | - Marco Palombo
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
- School of Computer Science and Informatics, Cardiff University, Cardiff, UK
| | - Giulia Buizza
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
| | - Giulia Riva
- National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Andrea Pella
- National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Giulia Fontana
- National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Sara Imparato
- National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Alberto Iannalfi
- National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Ester Orlandi
- National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Chiara Paganelli
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
| | - Guido Baroni
- Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
- National Center of Oncological Hadrontherapy (CNAO), Pavia, Italy
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Vashishta M, Kumar V, Guha C, Wu X, Dwarakanath BS. Enhanced Glycolysis Confers Resistance Against Photon but Not Carbon Ion Irradiation in Human Glioma Cell Lines. Cancer Manag Res 2023; 15:1-16. [PMID: 36628255 PMCID: PMC9826608 DOI: 10.2147/cmar.s385968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/17/2022] [Indexed: 01/05/2023] Open
Abstract
Purpose Metabolic reprogramming is a key hallmark in various malignancies and poses a challenge in achieving success with various therapies. Enhanced glycolysis is known to confer resistance against photon irradiation while the tumor response to carbon ion irradiation (CII) has not been investigated. This study aimed to investigate the effects of enhanced glycolysis on the response of human glioma cell lines to CII compared to the response to X-rays. Material and Methods Glycolysis was stimulated using Dinitrophenol (DNP), a mild OXPHOS inhibitor, in three human glioma cell lines (U251, U87, and LN229) and assessed by monitoring glucose uptake and utilization as well as expression of regulators of glycolysis (glucose transporter protein type 1(Glut1), hexokinase-II (HKII), and Pyruvate Kinase-2 (PKM2). Radiation (X-rays and CII) induced loss of clonogenic survival growth inhibition and perturbations in cell cycle progression (G2+M block), cytogenetic damage (micronuclei formation), apoptosis, necrosis (reflecting interphase death), and cell migration (Scratch assay) were investigated as parameters of radiation response. Results DNP (1 mM) enhanced the expression levels of GLUT1, HKII, and PKM2 by 30-60% and glucose uptake as well as usage by nearly 3 folds in U251 cells suggesting the stimulation of glycolysis. Enhanced glycolysis attenuated the loss of clonogenic survival with D10 doses increasing by 20% to 65% in these cell lines, while no significant changes were noted following CII. Concomitantly, dose-dependent growth inhibition, and cytogenetic damage as well as apoptosis and necrosis induced by X-rays were also reduced by elevated glycolysis in U251 and LN229 cells by 20-50%. However, stimulation of glycolysis enhanced the X-ray-induced cell migration, while it had negligible effect on migration following CII. Conclusion Our results suggest that enhanced glycolysis confers resistance against X-ray-induced cell death and migration, while it may not significantly alter the cellular responses to carbon ion irradiation.
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Affiliation(s)
- Mohit Vashishta
- R&D Department, Shanghai Proton and Heavy Ion Center (SPHIC), Shanghai, People’s Republic of China,Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People’s Republic of China,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People’s Republic of China,Rangel College of Pharmacy, Texas A&M University, College Station, TX, USA
| | - Vivek Kumar
- R&D Department, Shanghai Proton and Heavy Ion Center (SPHIC), Shanghai, People’s Republic of China,Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People’s Republic of China,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People’s Republic of China
| | - Chandan Guha
- Albert Einstein College of Medicine, The Bronx, NY, USA
| | - Xiaodong Wu
- R&D Department, Shanghai Proton and Heavy Ion Center (SPHIC), Shanghai, People’s Republic of China,Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People’s Republic of China,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People’s Republic of China
| | - Bilikere S Dwarakanath
- R&D Department, Shanghai Proton and Heavy Ion Center (SPHIC), Shanghai, People’s Republic of China,Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, People’s Republic of China,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, People’s Republic of China,Central Research Facility, Sri Ramachandra Institute of Higher Education and Research, Porur, ChennaiIndia,Indian Academy Degree College Autonomous (IADC-A), Bengaluru, Karnataka, India,Correspondence: Bilikere S Dwarakanath, Indian Academy Degree College Autonomous (IADC-A), 230, Hennur Main Rd, Meganahalli, Kalyan Nagar, Bengaluru, Karnataka, 560043, India, Tel +91 9952081077, Email
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Yoshiyama KO, Okamoto NL, Hidema J, Higashitani A. 222 nm far-UVC efficiently introduces nerve damage in Caenorhabditis elegans. PLoS One 2023; 18:e0281162. [PMID: 36719882 PMCID: PMC9888708 DOI: 10.1371/journal.pone.0281162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023] Open
Abstract
Far-ultraviolet radiation C light (far-UVC; 222 nm wavelength) has received attention as a safer light for killing pathogenic bacteria and viruses, as no or little DNA damage is observed after irradiation in mammalian skin models. Far-UVC does not penetrate deeply into tissues; therefore, it cannot reach the underlying critical basal cells. However, it was unclear whether far-UVC (222-UVC) irradiation could cause more biological damage at shallower depths than the 254 nm UVC irradiation (254-UVC), which penetrates more deeply. This study investigated the biological effects of 222- and 254-UVC on the small and transparent model organism Caenorhabditis elegans. At the same energy level of irradiation, 222-UVC introduced slightly less cyclobutane pyrimidine dimer damage to naked DNA in solution than 254-UVC. The survival of eggs laid during 0-4 h after irradiation showed a marked decrease with 254-UVC but not 222-UVC. In addition, defect of chromosomal condensation was observed in a full-grown oocyte by 254-UVC irradiation. In contrast, 222-UVC had a significant effect on the loss of motility of C. elegans. The sensory nervous system, which includes dopamine CEP and PVD neurons on the body surface, was severely damaged by 222-UVC, but not by the same dose of 254-UVC. Interestingly, increasing 254-UVC irradiation by about 10-fold causes similar damage to CEP neurons. These results suggest that 222-UVC is less penetrating, so energy transfer occurs more effectively in tissues near the surface, causing more severe damage than 254-UVC.
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Affiliation(s)
| | | | - Jun Hidema
- Graduate School of Life Sciences, Tohoku University, Sendai, Japan
- Division for the Establishment of Frontier Sciences of the Organization for Advanced Studies, Tohoku University, Sendai, Japan
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Nie S, He X, Sun Z, Zhang Y, Liu T, Chen T, Zhao J. Selenium speciation-dependent cancer radiosensitization by induction of G2/M cell cycle arrest and apoptosis. Front Bioeng Biotechnol 2023; 11:1168827. [PMID: 37034255 PMCID: PMC10073679 DOI: 10.3389/fbioe.2023.1168827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction: Radiation therapy has Q6long been a routine and effective treatment for non-small cell lung cancer (NSCLC), but the radioresistance and side effects have limited its application. In recent years, the superiority showed by trace element selenium in tumor radiotherapy sensitization has received wide attention. However, different forms of selenium compounds exhibit different chemical properties and their mechanisms of action on tumors may be different. Methods: Human non-small cell lung cancer SPC-A1 cells were studied. Drug toxicity was detected by MTT assay. The selenium content absorbed in vitro at different time points was detected by ICP-MS. Colony formation were conducted to observe the radiosensitization effect of different selenium compounds on SPC-A1 cells, and to compare the proliferation ability of SPC-A1 cells treated by radiation alone and radiation combined with different selenium compounds. Cell migration was detected by cell scratch assay. The changes of cell cycle and apoptosis were detected by flow cytometry. DCFH-DA fluorescent probe was used to detect the effects of different selenium compounds combined with X-ray on ROS production. Results: In this study, these four representative selenium compounds all have a certain ability to enhance the ability of radiotherapy to inhibit tumor cell proliferation and migration, and the mechanism may be related to blocking cell cycle in G2/M phase, activating the caspase cascade and reducing intracellular ROS levels to induce tumor cell apoptosis. Among them, -2-valent organic selenium has the most obvious effect, mainly inhibits cell migration, and induces early apoptosis by activating a large number of caspase-3, and arrest the cell cycle in S phase and G2/M phase. 0-valent selenium nanoparticles mainly arrest the cell cycle in G2/M phase. +4-valent inorganic selenium exerts its antitumor effects primarily by inhibiting tumor cell migration and inducing early apoptosis of tumor cells. Discussion: In this paper, the antitumor effects of four different forms of selenium compounds combined with X-rays on SPC-A1 cells were investigated, and their inhibitory effects on the proliferation and migration of cancer cells and their mechanisms were examined. We found that the radiosensitizing effect of selenium on NSCLC was closely related to its selenium form through the study of the sensitizing effect of different kinds of selenium compounds on radiotherapy.
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Affiliation(s)
| | | | | | | | | | | | - Jianfu Zhao
- *Correspondence: Tianfeng Chen, ; Jianfu Zhao,
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Helm A, Totis C, Durante M, Fournier C. Are charged particles a good match for combination with immunotherapy? Current knowledge and perspectives. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2023; 376:1-36. [PMID: 36997266 DOI: 10.1016/bs.ircmb.2023.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Charged particle radiotherapy, mainly using protons and carbon ions, provides physical characteristics allowing for a volume conformal irradiation and a reduction of the integral dose to normal tissue. Carbon ion therapy additionally features an increased biological effectiveness resulting in peculiar molecular effects. Immunotherapy, mostly performed with immune checkpoint inhibitors, is nowadays considered a pillar in cancer therapy. Based on the advantageous features of charged particle radiotherapy, we review pre-clinical evidence revealing a strong potential of its combination with immunotherapy. We argue that the combination therapy deserves further investigation with the aim of translation in clinics, where a few studies have been set up already.
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Affiliation(s)
- A Helm
- Biophysics Department, GSI, Darmstadt, Germany
| | - C Totis
- Biophysics Department, GSI, Darmstadt, Germany
| | - M Durante
- Biophysics Department, GSI, Darmstadt, Germany.
| | - C Fournier
- Biophysics Department, GSI, Darmstadt, Germany
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Potential benefits of using radioactive ion beams for range margin reduction in carbon ion therapy. Sci Rep 2022; 12:21792. [PMID: 36526710 PMCID: PMC9758201 DOI: 10.1038/s41598-022-26290-z] [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: 11/10/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Sharp dose gradients and high biological effectiveness make ions such as 12C an ideal tool to treat deep-seated tumors, however, at the same time, sensitive to errors in the range prediction. Tumor safety margins mitigate these uncertainties, but during the irradiation they lead to unavoidable damage to the surrounding healthy tissue. To fully exploit the Bragg peak benefits, a large effort is put into establishing precise range verification methods. Despite positron emission tomography being widely in use for this purpose in 12C therapy, the low count rates, biological washout, and broad activity distribution still limit its precision. Instead, radioactive beams used directly for treatment would yield an improved signal and a closer match with the dose fall-off, potentially enabling precise in vivo beam range monitoring. We have performed a treatment planning study to estimate the possible impact of the reduced range uncertainties, enabled by radioactive 11C ions treatments, on sparing critical organs in tumor proximity. Compared to 12C treatments, (i) annihilation maps for 11C ions can reflect sub- millimeter shifts in dose distributions in the patient, (ii) outcomes of treatment planning with 11C significantly improve and (iii) less severe toxicities for serial and parallel critical organs can be expected.
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Kiseleva V, Gordon K, Vishnyakova P, Gantsova E, Elchaninov A, Fatkhudinov T. Particle Therapy: Clinical Applications and Biological Effects. Life (Basel) 2022; 12:2071. [PMID: 36556436 PMCID: PMC9785772 DOI: 10.3390/life12122071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Particle therapy is a developing area of radiotherapy, mostly involving the use of protons, neutrons and carbon ions for cancer treatment. The reduction of side effects on healthy tissues in the peritumoral area is an important advantage of particle therapy. In this review, we analyze state-of-the-art particle therapy, as compared to conventional photon therapy, to identify clinical benefits and specify the mechanisms of action on tumor cells. Systematization of published data on particle therapy confirms its successful application in a wide range of cancers and reveals a variety of biological effects which manifest at the molecular level and produce the particle therapy-specific molecular signatures. Given the rapid progress in the field, the use of particle therapy holds great promise for the near future.
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Affiliation(s)
- Viktoriia Kiseleva
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of Ministry of Healthcare of Russian Federation, 117198 Moscow, Russia
| | - Konstantin Gordon
- Research Institute of Molecular and Cellular Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- A. Tsyb Medical Radiological Research Center, 249031 Obninsk, Russia
| | - Polina Vishnyakova
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of Ministry of Healthcare of Russian Federation, 117198 Moscow, Russia
- Research Institute of Molecular and Cellular Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Elena Gantsova
- Research Institute of Molecular and Cellular Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Andrey Elchaninov
- National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of Ministry of Healthcare of Russian Federation, 117198 Moscow, Russia
- Research Institute of Molecular and Cellular Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- A.P. Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution “Petrovsky National Research Centre of Surgery”, 117418 Moscow, Russia
| | - Timur Fatkhudinov
- Research Institute of Molecular and Cellular Medicine, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- A.P. Avtsyn Research Institute of Human Morphology of Federal State Budgetary Scientific Institution “Petrovsky National Research Centre of Surgery”, 117418 Moscow, Russia
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Towards high sensitivity and high-resolution PET scanners: imaging-guided proton therapy and total body imaging. BIO-ALGORITHMS AND MED-SYSTEMS 2022. [DOI: 10.2478/bioal-2022-0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
Quantitative imaging (i.e., providing not just an image but also the related data) guidance in proton radiation therapy to achieve and monitor the precision of planned radiation energy deposition field in-vivo (a.k.a. proton range verification) is one of the most under-invested aspects of radiation cancer treatment despite that it may dramatically enhance the treatment accuracy and lower the exposure related toxicity improving the entire outcome of cancer therapy. In this article, we briefly describe the effort of the TPPT Consortium (a collaborative effort of groups from the University of Texas and Portugal) on building a time-of-flight positron-emission-tomography (PET) scanner to be used in pre-clinical studies for proton therapy at MD Anderson Proton Center in Houston. We also discuss some related ideas towards improving and expanding the use of PET detectors, including the total body imaging.
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Deng ZY, Hu Z, Feng HJ. Dynamic interplay between thionine and DNA under carbon ion irradiation: a real-time first-principles study. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2022; 51:025101. [PMID: 36327460 DOI: 10.1088/1361-648x/ac9fff] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Understanding the interactions between deoxyribonucleic acid (DNA) and photosensitizer under ion irradiation benefits the development of aptasensors, DNA biosensors and cancer diagnosis. Using real-time time-depended density functional theory, by simulating high-energy C ion passing through DNA with poly(dG)·poly(dC) sequence and that with embedded thionine (3,7-diamino-5-phenothiazinium, TH), we compared the electronic stopping power (ESP), evolution of the structure and charge, and absorption spectrum. TH inserting leads the increase in space charge density, a larger electron de-excitation and a larger ESP, but the speed corresponding to the maximum ESP is almost same. When C ion passes through TH-DNA, the structure of TH slightly changes and there still exists noncovalent interaction between TH and DNA, but the absorption coefficient depends on the electron occupied state of TH when the ion passes through. These results indicate that at low radiation doses, TH still can be a DNA detector, although its response wavelength and intensity have been slightly changed, and provide a theoretical reference to improve the possible application of phenothiazine dye in DNA biosensor under ion irradiation.
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Affiliation(s)
- Zun-Yi Deng
- School of Physics, Northwest University, Xi'an 710127, People's Republic of China
| | - Zhihua Hu
- School of Physics, Northwest University, Xi'an 710127, People's Republic of China
| | - Hong-Jian Feng
- School of Physics, Northwest University, Xi'an 710127, People's Republic of China
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Molinelli S, Vai A, Russo S, Loap P, Meschini G, Paganelli C, Barcellini A, Vitolo V, Orlandi E, Ciocca M. The role of multiple anatomical scenarios in plan optimization for carbon ion radiotherapy of pancreatic cancer. Radiother Oncol 2022; 176:1-8. [PMID: 36113776 DOI: 10.1016/j.radonc.2022.09.005] [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: 03/28/2022] [Revised: 08/17/2022] [Accepted: 09/07/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE /OBJECTIVE To quantify benefits of robust optimization on multiple 4DCT acquisitions combined with off-line treatment adaptation for neoadjuvant carbon ion therapy (CIRT) of pancreatic cancer. MATERIAL/METHODS For 10 previously treated patients, 4DCTs were acquired around -15 (CTPlan), -5 (RE1), -1 (RE2) and +6 (RE3) days from RT start. Treatment plans were newly optimized to a dose prescription of 38.4 Gy(RBE) (8 fractions) with a constraint of 38 Gy(RBE) to 1% of the gastrointestinal organs at risk volume (D1%). Three strategies were tested: (A) robust optimization on CTPlan maximum exhale (0Ex) with 3 mm set-up, 3% range uncertainty, including 30%-inhale; (B) addition of the RE1-0Ex scenario; (C) plan recalculation at each REi and adaptation (RPi) according to deviation thresholds from clinical goals. The cumulative variation of target coverage and GI-OARs doses was evaluated. Duodenum contours of all 4DCTs of each patient were registered on CTPlan-0Ex. The capacity of pre-RT acquisitions to predict duodenum position was investigated by computing the intersection of contours at CTplan, RE1, or their union, with respect to subsequent 4DCTs and the CTV, coupled with increasing margin. RESULTS (A) No recalculation exceeded the D1% constraint. (B) The inclusion of RE1-0Ex in the optimization problem improved inter-fraction robustness on a patient-specific basis, but was non-significant on average. (C) Half of the plans would be re-optimized to recover target coverage and/or minimize duodenum dose, at least once. A significant difference was observed between pre-RT duodenum contours when intersecting subsequent contours, either with a margin expansion. CONCLUSION Anatomical variations highlighted at multiple REi proved that a fast and efficient online adaptation is essential to optimize treatment quality of CIRT for pancreatic cancer.
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Affiliation(s)
| | | | | | - Pierre Loap
- Institut Curie, Department of Radiation Oncology, Paris, France
| | - Giorgia Meschini
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
| | - Chiara Paganelli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
| | | | | | | | - Mario Ciocca
- Dipartimento Clinico, Fondazione CNAO, Pavia, Italy
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Vozenin MC, Bourhis J, Durante M. Towards clinical translation of FLASH radiotherapy. Nat Rev Clin Oncol 2022; 19:791-803. [DOI: 10.1038/s41571-022-00697-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/09/2022]
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Mladenova V, Mladenov E, Chaudhary S, Stuschke M, Iliakis G. The high toxicity of DSB-clusters modelling high-LET-DNA damage derives from inhibition of c-NHEJ and promotion of alt-EJ and SSA despite increases in HR. Front Cell Dev Biol 2022; 10:1016951. [PMID: 36263011 PMCID: PMC9574094 DOI: 10.3389/fcell.2022.1016951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
Heavy-ion radiotherapy utilizing high linear energy transfer (high-LET) ionizing radiation (IR) is a promising cancer treatment modality owing to advantageous physical properties of energy deposition and associated toxicity over X-rays. Therapies utilizing high-LET radiation will benefit from a better understanding of the molecular mechanisms underpinning their increased biological efficacy. Towards this goal, we investigate here the biological consequences of well-defined clusters of DNA double-strand breaks (DSBs), a form of DNA damage, which on theoretical counts, has often been considered central to the enhanced toxicity of high-LET IR. We test clonal cell lines harboring in their genomes constructs with appropriately engineered I-SceI recognition sites that convert upon I-SceI expression to individual DSBs, or DSB-clusters comprising known numbers of DSBs with defined DNA-ends. We find that, similarly to high-LET IR, DSB-clusters of increasing complexity, i.e. increasing numbers of DSBs, with compatible or incompatible ends, compromise classical non-homologous end-joining, favor DNA end-resection and promote resection-dependent DSB-processing. Analysis of RAD51 foci shows increased engagement of error-free homologous recombination on DSB-clusters. Multicolor fluorescence in situ hybridization analysis shows that complex DSB-clusters markedly increase the incidence of structural chromosomal abnormalities (SCAs). Since RAD51-knockdown further increases SCAs-incidence, we conclude that homologous recombination suppresses SCAs-formation. Strikingly, CtIP-depletion inhibits SCAs-formation, suggesting that it relies on alternative end-joining or single-strand annealing. Indeed, ablation of RAD52 causes a marked reduction in SCAs, as does also inhibition of PARP1. We conclude that increased DSB-cluster formation that accompanies LET-increases, enhances IR-effectiveness by promoting DNA end-resection, which suppresses c-NHEJ and enhances utilization of alt-EJ or SSA. Although increased resection also favors HR, on balance, error-prone processing dominates, causing the generally observed increased toxicity of high-LET radiation. These findings offer new mechanistic insights into high-LET IR-toxicity and have translational potential in the clinical setting that may be harnessed by combining high-LET IR with inhibitors of PARP1 or RAD52.
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Affiliation(s)
- Veronika Mladenova
- Department of Radiation Therapy, Division of Experimental Radiation Biology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute of Medical Radiation Biology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Emil Mladenov
- Department of Radiation Therapy, Division of Experimental Radiation Biology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute of Medical Radiation Biology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Shipra Chaudhary
- Institute of Medical Radiation Biology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute for Advanced Biosciences, Inserm U 1209 / CNRS UMR 5309 Joint Research Center, Grenoble Alpes University, Grenoble, France
| | - Martin Stuschke
- Department of Radiation Therapy, Division of Experimental Radiation Biology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - George Iliakis
- Department of Radiation Therapy, Division of Experimental Radiation Biology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Institute of Medical Radiation Biology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- *Correspondence: George Iliakis,
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Unraveling Mitochondrial Determinants of Tumor Response to Radiation Therapy. Int J Mol Sci 2022; 23:ijms231911343. [PMID: 36232638 PMCID: PMC9569617 DOI: 10.3390/ijms231911343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/18/2022] Open
Abstract
Radiotherapy represents a highly targeted and efficient treatment choice in many cancer types, both with curative and palliative intents. Nevertheless, radioresistance, consisting in the adaptive response of the tumor to radiation-induced damage, represents a major clinical problem. A growing body of the literature suggests that mechanisms related to mitochondrial changes and metabolic remodeling might play a major role in radioresistance development. In this work, the main contributors to the acquired cellular radioresistance and their relation with mitochondrial changes in terms of reactive oxygen species, hypoxia, and epigenetic alterations have been discussed. We focused on recent findings pointing to a major role of mitochondria in response to radiotherapy, along with their implication in the mechanisms underlying radioresistance and radiosensitivity, and briefly summarized some of the recently proposed mitochondria-targeting strategies to overcome the radioresistant phenotype in cancer.
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Volpe S, Piperno G, Colombo F, Biffi A, Comi S, Mastroleo F, Maria Camarda A, Casbarra A, Cattani F, Corrao G, de Marinis F, Spaggiari L, Guckenberger M, Orecchia R, Alterio D, Alicja Jereczek-Fossa B. Hypofractionated proton therapy for non-small cell lung cancer: Ready for prime time? A systematic review and meta-analysis. Cancer Treat Rev 2022; 110:102464. [DOI: 10.1016/j.ctrv.2022.102464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 11/02/2022]
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Physical aspects of Bragg curve of therapeutic oxygen-ion beam: Monte Carlo simulation. POLISH JOURNAL OF MEDICAL PHYSICS AND ENGINEERING 2022. [DOI: 10.2478/pjmpe-2022-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Introduction: Oxygen (16O) ion beams have been recommended for cancer treatment due to its physical Bragg curve feature and biological property. The goal of this research is to use Monte Carlo simulation to analyze the physical features of the 16O Bragg curve in water and tissue.
Material and methods: In order to determine the benefits and drawbacks of ion beam therapy, Monte Carlo simulation (PHITS code) was used to investigate the interaction and dose deposition properties of oxygen ions beam in water and human tissue medium. A benchmark study for the depth–dose distribution of a 16O ion beam in a water phantom was established using the PHITS code. Bragg’s peak location of 16O ions in water was simulated using the effect of water’s mean ionization potential. The contribution of secondary particles produced by nuclear fragmentation to the total dose has been calculated. The depth and radial dose profiles of 16O, 12C, 4He, and 1H beams were compared.
Results: It was shown that PHITS accurately reproduces the measured Bragg curves. The mean ionization potential of water was estimated. It has been found that secondary particles contribute 10% behind the Bragg peak for 16O energy of 300 MeV/u. The comparison of the depth and radial dose profiles of 16O, 12C, 4He, and 1H beams, shows clearly, that the oxygen beam has the greater deposited dose at Bragg peak and the minor lateral deflection.
Conclusions: The combination of these physical characteristics with radio-biological ones in the case of resistant organs located behind the tumor volume, leads to the conclusion that the 16O ion beams can be used to treat deep-seated hypoxic tumors.
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Mairani A, Mein S, Blakely E, Debus J, Durante M, Ferrari A, Fuchs H, Georg D, Grosshans DR, Guan F, Haberer T, Harrabi S, Horst F, Inaniwa T, Karger CP, Mohan R, Paganetti H, Parodi K, Sala P, Schuy C, Tessonnier T, Titt U, Weber U. Roadmap: helium ion therapy. Phys Med Biol 2022; 67. [PMID: 35395649 DOI: 10.1088/1361-6560/ac65d3] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 04/08/2022] [Indexed: 12/16/2022]
Abstract
Helium ion beam therapy for the treatment of cancer was one of several developed and studied particle treatments in the 1950s, leading to clinical trials beginning in 1975 at the Lawrence Berkeley National Laboratory. The trial shutdown was followed by decades of research and clinical silence on the topic while proton and carbon ion therapy made debuts at research facilities and academic hospitals worldwide. The lack of progression in understanding the principle facets of helium ion beam therapy in terms of physics, biological and clinical findings persists today, mainly attributable to its highly limited availability. Despite this major setback, there is an increasing focus on evaluating and establishing clinical and research programs using helium ion beams, with both therapy and imaging initiatives to supplement the clinical palette of radiotherapy in the treatment of aggressive disease and sensitive clinical cases. Moreover, due its intermediate physical and radio-biological properties between proton and carbon ion beams, helium ions may provide a streamlined economic steppingstone towards an era of widespread use of different particle species in light and heavy ion therapy. With respect to the clinical proton beams, helium ions exhibit superior physical properties such as reduced lateral scattering and range straggling with higher relative biological effectiveness (RBE) and dose-weighted linear energy transfer (LETd) ranging from ∼4 keVμm-1to ∼40 keVμm-1. In the frame of heavy ion therapy using carbon, oxygen or neon ions, where LETdincreases beyond 100 keVμm-1, helium ions exhibit similar physical attributes such as a sharp lateral penumbra, however, with reduced radio-biological uncertainties and without potentially spoiling dose distributions due to excess fragmentation of heavier ion beams, particularly for higher penetration depths. This roadmap presents an overview of the current state-of-the-art and future directions of helium ion therapy: understanding physics and improving modeling, understanding biology and improving modeling, imaging techniques using helium ions and refining and establishing clinical approaches and aims from learned experience with protons. These topics are organized and presented into three main sections, outlining current and future tasks in establishing clinical and research programs using helium ion beams-A. Physics B. Biological and C. Clinical Perspectives.
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Affiliation(s)
- Andrea Mairani
- Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,National Centre of Oncological Hadrontherapy (CNAO), Medical Physics, Pavia, Italy.,Division of Molecular and Translational Radiation Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany
| | - Stewart Mein
- Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Division of Molecular and Translational Radiation Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,German Cancer Consortium (DKTK) Core-Center Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eleanor Blakely
- Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, CA, United States of America
| | - Jürgen Debus
- Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Division of Molecular and Translational Radiation Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,German Cancer Consortium (DKTK) Core-Center Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Oncology (NCRO), Heidelberg University and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marco Durante
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany.,Technische Universität Darmstadt, Institut für Physik Kondensierter Materie, Darmstadt, Germany
| | - Alfredo Ferrari
- Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Hermann Fuchs
- Division of Medical Physics, Department of Radiation Oncology, Medical University of Vienna, Austria.,MedAustron Ion Therapy Center, Wiener Neustadt, Austria
| | - Dietmar Georg
- Division of Medical Physics, Department of Radiation Oncology, Medical University of Vienna, Austria.,MedAustron Ion Therapy Center, Wiener Neustadt, Austria
| | - David R Grosshans
- The University of Texas MD Anderson cancer Center, Houston, Texas, United States of America
| | - Fada Guan
- The University of Texas MD Anderson cancer Center, Houston, Texas, United States of America.,Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, 06510, United States of America
| | - Thomas Haberer
- Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Semi Harrabi
- Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,German Cancer Consortium (DKTK) Core-Center Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Oncology (NCRO), Heidelberg University and German Cancer Research Center (DKFZ), Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Felix Horst
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - Taku Inaniwa
- Department of Accelerator and Medical Physics, Institute for Quantum Medical Science, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.,Medical Physics Laboratory, Division of Health Science, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Christian P Karger
- National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany.,Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Radhe Mohan
- The University of Texas MD Anderson cancer Center, Houston, Texas, United States of America
| | - Harald Paganetti
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, United States of America.,Harvard Medical School, Boston, United States of America
| | - Katia Parodi
- Ludwig-Maximilians-Universität München, Department of Experimental Physics-Medical Physics, Munich, Germany
| | - Paola Sala
- Ludwig-Maximilians-Universität München, Department of Experimental Physics-Medical Physics, Munich, Germany
| | - Christoph Schuy
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
| | - Thomas Tessonnier
- Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Uwe Titt
- The University of Texas MD Anderson cancer Center, Houston, Texas, United States of America
| | - Ulrich Weber
- GSI Helmholtzzentrum für Schwerionenforschung, D-64291 Darmstadt, Germany
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The role of medical physicists in clinical trials across Europe. Phys Med 2022; 100:31-38. [PMID: 35717777 DOI: 10.1016/j.ejmp.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/11/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The roles and responsibilities of medical physicists (MPs) are growing together with the evolving science and technology. The complexity of today's clinical trials requires the skills and knowledge of MPs for their safe and efficient implementation. However, it is unclear to what extent the skillsets offered by MPs are being exploited in clinical trials across Europe. METHODS The EFOMP Working Group on the role of Medical Physics Experts in Clinical Trials has designed a survey that targeted all 36 current National Member Organisations, receiving a response from 31 countries. The survey included both quantitative and qualitative queries regarding the involvement of MPs in trial design, setup, and coordination, either as trial team members or principal investigators. RESULTS The extent of MPs involvement in clinical trials greatly varies across European countries. The results showed disparities between the roles played by MPs in trial design, conduct or data processing. Similarly, differences among the 31 European countries that responded to the survey were found regarding the existence of national bodies responsible for trials or the available training offered to MPs. The role of principal investigator or co-investigator was reported by 12 countries (39%), a sign of efficient collaboration with medical doctors in designing and implementing clinical studies. CONCLUSION Organisation of specific training courses and guideline development for clinical trial design and conduct would encourage the involvement of a larger number of MPs in all stages of trials across Europe, leading to a better standardisation of clinical practice.
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