1
|
Borghini A, Labate L, Piccinini S, Panaino CMV, Andreassi MG, Gizzi LA. FLASH Radiotherapy: Expectations, Challenges, and Current Knowledge. Int J Mol Sci 2024; 25:2546. [PMID: 38473799 DOI: 10.3390/ijms25052546] [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: 11/18/2023] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
Major strides have been made in the development of FLASH radiotherapy (FLASH RT) in the last ten years, but there are still many obstacles to overcome for transfer to the clinic to become a reality. Although preclinical and first-in-human clinical evidence suggests that ultra-high dose rates (UHDRs) induce a sparing effect in normal tissue without modifying the therapeutic effect on the tumor, successful clinical translation of FLASH-RT depends on a better understanding of the biological mechanisms underpinning the sparing effect. Suitable in vitro studies are required to fully understand the radiobiological mechanisms associated with UHDRs. From a technical point of view, it is also crucial to develop optimal technologies in terms of beam irradiation parameters for producing FLASH conditions. This review provides an overview of the research progress of FLASH RT and discusses the potential challenges to be faced before its clinical application. We critically summarize the preclinical evidence and in vitro studies on DNA damage following UHDR irradiation. We also highlight the ongoing developments of technologies for delivering FLASH-compliant beams, with a focus on laser-driven plasma accelerators suitable for performing basic radiobiological research on the UHDR effects.
Collapse
Affiliation(s)
| | - Luca Labate
- Intense Laser Irradiation Laboratory (ILIL), CNR Istituto Nazionale di Ottica, 56124 Pisa, Italy
| | - Simona Piccinini
- Intense Laser Irradiation Laboratory (ILIL), CNR Istituto Nazionale di Ottica, 56124 Pisa, Italy
| | | | | | - Leonida Antonio Gizzi
- Intense Laser Irradiation Laboratory (ILIL), CNR Istituto Nazionale di Ottica, 56124 Pisa, Italy
| |
Collapse
|
2
|
Clausen M, Ruangchan S, Sotoudegan A, Resch AF, Knäusl B, Palmans H, Georg D. Small field proton irradiation for in vivo studies: Potential and limitations when adapting clinical infrastructure. Z Med Phys 2023; 33:542-551. [PMID: 36357294 PMCID: PMC10751703 DOI: 10.1016/j.zemedi.2022.10.002] [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: 05/12/2022] [Revised: 09/22/2022] [Accepted: 10/04/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE To evaluate the dosimetric accuracy for small field proton irradiation relevant for pre-clinical in vivo studies using clinical infrastructure and technology. In this context additional beam collimation and range reduction was implemented. METHODS AND MATERIALS The clinical proton beam line employing pencil beam scanning (PBS) was adapted for the irradiation of small fields at shallow depths. Cylindrical collimators with apertures of 15, 12, 7 and 5mm as well as two different range shifter types, placed at different distances relative to the target, were tested: a bolus range shifter (BRS) attached to the collimator and a clinical nozzle mounted range shifter (CRS) placed at a distance of 72cm from the collimator. The Monte Carlo (MC) based dose calculation engine implemented in the clinical treatment planning system (TPS) was commissioned for these two additional hardware components. The study was conducted with a phantom and cylindrical target sizes between 2 and 25mm in diameter following a dosimetric end-to-end test concept. RESULTS The setup with the CRS provided a uniform dose distribution across the target. An agreement of better than5% between the planned dose and the measurements was obtained for a target with 3mm diameter (collimator 5mm). A 2mm difference between the collimator and the target diameter (target being 2 mm smaller than the collimator) sufficed to cover the whole target with the planned dose in the setup with CRS. Using the BRS setup (target 8mm, collimator 12mm) resulted in non-homogeneous dose distributions, with a dose discrepancy of up to 10% between the planned and measured doses. CONCLUSION The clinical proton infrastructure with adequate beam line adaptations and a state-of-the-art TPS based on MC dose calculations enables small animal irradiations with a high dosimetric precision and accuracy for target sizes down to 3mm.
Collapse
Affiliation(s)
- Monika Clausen
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria.
| | - Sirinya Ruangchan
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria; Division of Therapeutic Radiation and Oncology, Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Arame Sotoudegan
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria
| | - Andreas F Resch
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria
| | - Barbara Knäusl
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria
| | - Hugo Palmans
- Division of Medical Physics, MedAustron Ion Therapy Center, Wiener Neustadt, Austria; National Physical Laboratory, Teddington, United Kingdom
| | - Dietmar Georg
- Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, Austria; Division of Medical Physics, MedAustron Ion Therapy Center, Wiener Neustadt, Austria
| |
Collapse
|
3
|
Reimold M, Assenbaum S, Bernert C, Beyreuther E, Brack FE, Karsch L, Kraft SD, Kroll F, Nossula A, Pawelke J, Rehwald M, Schlenvoigt HP, Schramm U, Umlandt MEP, Zeil K, Ziegler T, Metzkes-Ng J. Dosimetry for radiobiological in vivoexperiments at laser plasma-based proton accelerators. Phys Med Biol 2023; 68:185009. [PMID: 37579761 DOI: 10.1088/1361-6560/acf025] [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: 01/04/2023] [Accepted: 08/14/2023] [Indexed: 08/16/2023]
Abstract
Objective.Laser plasma-based accelerators (LPAs) of protons can contribute to research of ultra-high dose rate radiobiology as they provide pulse dose rates unprecedented at medical proton sources. Yet, LPAs pose challenges regarding precise and accurate dosimetry due to the high pulse dose rates, but also due to the sources' lower spectral stability and pulsed operation mode. Forin vivomodels, further challenges arise from the necessary small field dosimetry for volumetric dose distributions. For these novel source parameters and intended applications, a dosimetric standard needs to be established.Approach.In this work, we present a dosimetry and beam monitoring framework forin vivoirradiations of small target volumes with LPA protons, solving aforementioned challenges. The volumetric dose distribution in a sample (mean dose value and lateral/depth dose inhomogeneity) is provided by combining two independent dose measurements using radiochromic films (dose rate-independent) and ionization chambers (dose rate-dependent), respectively. The unique feature of the dosimetric setup is beam monitoring with a transmission time-of-flight spectrometer to quantify spectral fluctuations of the irradiating proton pulses. The resulting changes in the depth dose profile during irradiation of anin vivosample are hence accessible and enable pulse-resolved depth dose correction for each dose measurement.Main results.A first successful small animal pilot study using an LPA proton source serves as a testcase for the presented dosimetry approach and proves its performance in a realistic setting.Significance.With several facilities worldwide either setting up or already using LPA infrastructure for radiobiological studies with protons, the importance of LPA-adapted dosimetric frameworks as presented in this work is clearly underlined.
Collapse
Affiliation(s)
- Marvin Reimold
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
- Technische Universität Dresden, D-01062 Dresden, Germany
| | - Stefan Assenbaum
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
- Technische Universität Dresden, D-01062 Dresden, Germany
| | - Constantin Bernert
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
- Technische Universität Dresden, D-01062 Dresden, Germany
| | - Elke Beyreuther
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
- OncoRay-National Center for Radiation Research in Oncology, D-01309 Dresden, Germany
| | | | - Leonhard Karsch
- OncoRay-National Center for Radiation Research in Oncology, D-01309 Dresden, Germany
| | - Stephan D Kraft
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
| | - Florian Kroll
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
| | - Alexej Nossula
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
- Martin-Luther-Universität Halle-Wittenberg, D-06120 Halle, Germany
| | - Jörg Pawelke
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
- OncoRay-National Center for Radiation Research in Oncology, D-01309 Dresden, Germany
| | - Martin Rehwald
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
| | | | - Ulrich Schramm
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
- Technische Universität Dresden, D-01062 Dresden, Germany
| | - Marvin E P Umlandt
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
- Technische Universität Dresden, D-01062 Dresden, Germany
| | - Karl Zeil
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
| | - Tim Ziegler
- Helmholtz-Zentrum Dresden-Rossendorf, D-01328 Dresden, Germany
- Technische Universität Dresden, D-01062 Dresden, Germany
| | | |
Collapse
|
4
|
Schulte R, Johnstone C, Boucher S, Esarey E, Geddes CGR, Kravchenko M, Kutsaev S, Loo BW, Méot F, Mustapha B, Nakamura K, Nanni EA, Obst-Huebl L, Sampayan SE, Schroeder CB, Sheng K, Snijders AM, Snively E, Tantawi SG, Van Tilborg J. Transformative Technology for FLASH Radiation Therapy. APPLIED SCIENCES (BASEL, SWITZERLAND) 2023; 13:5021. [PMID: 38240007 PMCID: PMC10795821 DOI: 10.3390/app13085021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
The general concept of radiation therapy used in conventional cancer treatment is to increase the therapeutic index by creating a physical dose differential between tumors and normal tissues through precision dose targeting, image guidance, and radiation beams that deliver a radiation dose with high conformality, e.g., protons and ions. However, the treatment and cure are still limited by normal tissue radiation toxicity, with the corresponding side effects. A fundamentally different paradigm for increasing the therapeutic index of radiation therapy has emerged recently, supported by preclinical research, and based on the FLASH radiation effect. FLASH radiation therapy (FLASH-RT) is an ultra-high-dose-rate delivery of a therapeutic radiation dose within a fraction of a second. Experimental studies have shown that normal tissues seem to be universally spared at these high dose rates, whereas tumors are not. While dose delivery conditions to achieve a FLASH effect are not yet fully characterized, it is currently estimated that doses delivered in less than 200 ms produce normal-tissue-sparing effects, yet effectively kill tumor cells. Despite a great opportunity, there are many technical challenges for the accelerator community to create the required dose rates with novel compact accelerators to ensure the safe delivery of FLASH radiation beams.
Collapse
Affiliation(s)
- Reinhard Schulte
- Division of Biomedical Engineering Sciences, Loma Linda University, Loma Linda, CA 92350, USA
| | - Carol Johnstone
- Fermi National Accelerator Laboratory, Batavia, IL 60510, USA
| | - Salime Boucher
- RadiaBeam Technologies, LLC, Santa Monica, CA 90404, USA
| | - Eric Esarey
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | | | | | - Sergey Kutsaev
- RadiaBeam Technologies, LLC, Santa Monica, CA 90404, USA
| | - Billy W. Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - François Méot
- Brookhaven National Laboratory, Upton, NY 11973, USA
| | | | - Kei Nakamura
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Emilio A. Nanni
- SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | | | - Stephen E. Sampayan
- Lawrence Livermore National Laboratory, Livermore, CA 94551, USA
- Opcondys, Inc., Manteca, CA 95336, USA
| | | | - Ke Sheng
- Department of Radiation Oncology, University of California, San Francisco, CA 94115, USA
| | | | - Emma Snively
- SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | - Sami G. Tantawi
- SLAC National Accelerator Laboratory, Menlo Park, CA 94025, USA
| | | |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Reimold M, Assenbaum S, Bernert C, Beyreuther E, Brack FE, Karsch L, Kraft SD, Kroll F, Loeser M, Nossula A, Pawelke J, Püschel T, Schlenvoigt HP, Schramm U, Umlandt MEP, Zeil K, Ziegler T, Metzkes-Ng J. Time-of-flight spectroscopy for laser-driven proton beam monitoring. Sci Rep 2022; 12:21488. [PMID: 36509788 PMCID: PMC9744900 DOI: 10.1038/s41598-022-25120-6] [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: 08/18/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
Application experiments with laser plasma-based accelerators (LPA) for protons have to cope with the inherent fluctuations of the proton source. This creates a demand for non-destructive and online spectral characterization of the proton pulses, which are for application experiments mostly spectrally filtered and transported by a beamline. Here, we present a scintillator-based time-of-flight (ToF) beam monitoring system (BMS) for the recording of single-pulse proton energy spectra. The setup's capabilities are showcased by characterizing the spectral stability for the transport of LPA protons for two beamline application cases. For the two beamline settings monitored, data of 122 and 144 proton pulses collected over multiple days were evaluated, respectively. A relative energy uncertainty of 5.5% (1[Formula: see text]) is reached for the ToF BMS, allowing for a Monte-Carlo based prediction of depth dose distributions, also used for the calibration of the device. Finally, online spectral monitoring combined with the prediction of the corresponding depth dose distribution in the irradiated samples is demonstrated to enhance applicability of plasma sources in dose-critical scenarios.
Collapse
Affiliation(s)
- Marvin Reimold
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany.
- Technische Universität Dresden, 01062, Dresden, Germany.
| | - Stefan Assenbaum
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- Technische Universität Dresden, 01062, Dresden, Germany
| | - Constantin Bernert
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- Technische Universität Dresden, 01062, Dresden, Germany
| | - Elke Beyreuther
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- OncoRay - National Center for Radiation Research in Oncology, 01309, Dresden, Germany
| | - Florian-Emanuel Brack
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- Technische Universität Dresden, 01062, Dresden, Germany
| | - Leonhard Karsch
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- OncoRay - National Center for Radiation Research in Oncology, 01309, Dresden, Germany
| | - Stephan D Kraft
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
| | - Florian Kroll
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
| | - Markus Loeser
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
| | - Alexej Nossula
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- Martin-Luther-Universität Halle-Wittenberg, 06120, Halle, Germany
| | - Jörg Pawelke
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- OncoRay - National Center for Radiation Research in Oncology, 01309, Dresden, Germany
| | - Thomas Püschel
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
| | | | - Ulrich Schramm
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- Technische Universität Dresden, 01062, Dresden, Germany
| | - Marvin E P Umlandt
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- Technische Universität Dresden, 01062, Dresden, Germany
| | - Karl Zeil
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
| | - Tim Ziegler
- Helmholtz-Zentrum Dresden, Rossendorf, 01328, Dresden, Germany
- Technische Universität Dresden, 01062, Dresden, Germany
| | | |
Collapse
|
7
|
Friedl AA, Prise KM, Butterworth KT, Montay-Gruel P, Favaudon V. Radiobiology of the FLASH effect. Med Phys 2022; 49:1993-2013. [PMID: 34426981 DOI: 10.1002/mp.15184] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 12/17/2022] Open
Abstract
Radiation exposures at ultrahigh dose rates (UHDRs) at several orders of magnitude greater than in current clinical radiotherapy (RT) have been shown to manifest differential radiobiological responses compared to conventional (CONV) dose rates. This has led to studies investigating the application of UHDR for therapeutic advantage (FLASH-RT) that have gained significant interest since the initial discovery in 2014 that demonstrated reduced lung toxicity with equivalent levels of tumor control compared with conventional dose-rate RT. Many subsequent studies have demonstrated the potential protective role of FLASH-RT in normal tissues, yet the underlying molecular and cellular mechanisms of the FLASH effect remain to be fully elucidated. Here, we summarize the current evidence of the FLASH effect and review FLASH-RT studies performed in preclinical models of normal tissue response. To critically examine the underlying biological mechanisms of responses to UHDR radiation exposures, we evaluate in vitro studies performed with normal and tumor cells. Differential responses to UHDR versus CONV irradiation recurrently involve reduced inflammatory processes and differential expression of pro- and anti-inflammatory genes. In addition, frequently reduced levels of DNA damage or misrepair products are seen after UHDR irradiation. So far, it is not clear what signal elicits these differential responses, but there are indications for involvement of reactive species. Different susceptibility to FLASH effects observed between normal and tumor cells may result from altered metabolic and detoxification pathways and/or repair pathways used by tumor cells. We summarize the current theories that may explain the FLASH effect and highlight important research questions that are key to a better mechanistic understanding and, thus, the future implementation of FLASH-RT in the clinic.
Collapse
Affiliation(s)
- Anna A Friedl
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Kevin M Prise
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - Karl T Butterworth
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - Pierre Montay-Gruel
- Department of Radiation Oncology, University of California at Irvine, Irvine, California, USA
| | - Vincent Favaudon
- Institut Curie, Inserm U 1021-CNRS UMR 3347, Université Paris-Saclay, PSL Research University, Centre Universitaire, Orsay, France
| |
Collapse
|
8
|
Abstract
FLASH radiotherapy is a novel technique that has been shown in numerous preclinical in vivo studies to have the potential to be the next important improvement in cancer treatment. However, the biological mechanisms responsible for the selective FLASH sparing effect of normal tissues are not yet known. An optimal translation of FLASH radiotherapy into the clinic would require a good understanding of the specific beam parameters that induces a FLASH effect, environmental conditions affecting the response, and the radiobiological mechanisms involved. Even though the FLASH effect has generally been considered as an in vivo effect, studies finding these answers would be difficult and ethically challenging to carry out solely in animals. Hence, suitable in vitro studies aimed towards finding these answers are needed. In this review, we describe and summarise several in vitro assays that have been used or could be used to finally elucidate the mechanisms behind the FLASH effect.
Collapse
|
9
|
Experimental Setup for Irradiation of Cell Cultures at L2A2. QUANTUM BEAM SCIENCE 2022. [DOI: 10.3390/qubs6010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Laser–plasma proton sources and their applications to preclinical research has become a very active field of research in recent years. In addition to their small dimensions as compared to classical ion accelerators, they offer the possibility to study the biological effects of ultra-short particle bunches and the correspondingly high dose rates. We report on the design of an experimental setup for the irradiation of cell cultures at the L2A2 laboratory at the University of Santiago de Compostela, making use of a 1.2 J Ti: Sapphire laser with a 10 Hz repetition rate. Our setup comprises a proton energy separator consisting of two antiparallel magnetic fields realized by a set of permanent magnets. It allows for selecting a narrow energy window around an adaptable design value of 5 MeV out of the initially broad spectrum typical for Target Normal Sheath Acceleration (TNSA). At the same time, unwanted electrons and X-rays are segregated from the protons. This part of the setup is located inside the target vessel of the L2A2 laser. A subsequent vacuum flange sealed with a thin kapton window allows for particle passage to external sample irradiation. A combination of passive detector materials and real-time monitors is applied for measurement of the deposited radiation dose. A critical point of this interdisciplinary project is the manipulation of biological samples under well-controlled, sterile conditions. Cell cultures are prepared in sealed flasks with an ultra-thin entrance window and analysed at the nearby Fundación Pública Galega Medicina Xenómica and IDIS. The first trials will be centred at the quantification of DNA double-strand breaks as a function of radiation dose.
Collapse
|
10
|
A new platform for ultra-high dose rate radiobiological research using the BELLA PW laser proton beamline. Sci Rep 2022; 12:1484. [PMID: 35087083 PMCID: PMC8795353 DOI: 10.1038/s41598-022-05181-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 01/04/2022] [Indexed: 12/15/2022] Open
Abstract
Radiotherapy is the current standard of care for more than 50% of all cancer patients. Improvements in radiotherapy (RT) technology have increased tumor targeting and normal tissue sparing. Radiations at ultra-high dose rates required for FLASH-RT effects have sparked interest in potentially providing additional differential therapeutic benefits. We present a new experimental platform that is the first one to deliver petawatt laser-driven proton pulses of 2 MeV energy at 0.2 Hz repetition rate by means of a compact, tunable active plasma lens beamline to biological samples. Cell monolayers grown over a 10 mm diameter field were exposed to clinically relevant proton doses ranging from 7 to 35 Gy at ultra-high instantaneous dose rates of 107 Gy/s. Dose-dependent cell survival measurements of human normal and tumor cells exposed to LD protons showed significantly higher cell survival of normal-cells compared to tumor-cells for total doses of 7 Gy and higher, which was not observed to the same extent for X-ray reference irradiations at clinical dose rates. These findings provide preliminary evidence that compact LD proton sources enable a new and promising platform for investigating the physical, chemical and biological mechanisms underlying the FLASH effect.
Collapse
|
11
|
Vorhees CV, Vatner RE, Williams MT. Review of Conventional and High Dose Rate Brain Radiation (FLASH): Neurobehavioural, Neurocognitive and Assessment Issues in Rodent Models. Clin Oncol (R Coll Radiol) 2021; 33:e482-e491. [PMID: 34548203 PMCID: PMC10114147 DOI: 10.1016/j.clon.2021.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/29/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
Ionising radiation causes secondary tumours and/or enduring cognitive deficits, especially in children. Proton radiotherapy reduces exposure of the developing brain in children but may still cause some lasting effects. Recent observations show that ultra-high dose rate radiation treatment (≥40 Gy/s), called the FLASH effect, is equally effective at tumour control but less damaging to surrounding tissue compared with conventional dose rate protons (0.03-3 Gy/s). Most studies on the FLASH effect in brain and other tissues with different radiation modalities (electron and photon radiation), show FLASH benefits in these preclinical rodent models, but the data are limited, especially for proton FLASH, including for dose, dose rate and neurochemical and neurobehavioural outcomes. Tests of neurocognitive outcomes have been limited despite clinical evidence that this is the area of greatest concern. The FLASH effect in the context of proton exposure is promising, but a more systematic and comprehensive approach to outcomes is needed.
Collapse
Affiliation(s)
- C V Vorhees
- Department of Pediatrics, University of Cincinnati College of Medicine and Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Cincinnati Children's/University of Cincinnati Proton Therapy and Research Center, Cincinnati, Ohio, USA.
| | - R E Vatner
- Cincinnati Children's/University of Cincinnati Proton Therapy and Research Center, Cincinnati, Ohio, USA; Department of Radiation Oncology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - M T Williams
- Department of Pediatrics, University of Cincinnati College of Medicine and Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; Cincinnati Children's/University of Cincinnati Proton Therapy and Research Center, Cincinnati, Ohio, USA
| |
Collapse
|
12
|
Zimmer M, Scheuren S, Ebert T, Schaumann G, Schmitz B, Hornung J, Bagnoud V, Rödel C, Roth M. Analysis of laser-proton acceleration experiments for development of empirical scaling laws. Phys Rev E 2021; 104:045210. [PMID: 34781535 DOI: 10.1103/physreve.104.045210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
Numerous experiments on laser-driven proton acceleration in the MeV range have been performed with a large variety of laser parameters since its discovery around the year 2000. Both experiments and simulations have revealed that protons are accelerated up to a maximum cut-off energy during this process. Several attempts have been made to find a universal model for laser proton acceleration in the target normal sheath acceleration regime. While these models can qualitatively explain most experimental findings, they can hardly be used as predictive models, for example, for the energy cut-off of accelerated protons, as many of the underlying parameters are often unknown. Here we analyze experiments on laser proton acceleration in which scans of laser and target parameters were performed. We derive empirical scaling laws from these parameter scans and combine them in a scaling law for the proton energy cut-off that incorporates the laser pulse energy, the laser pulse duration, the focal spot radius, and the target thickness. Using these scaling laws, we give examples for predicting the proton energy cut-off and conversion efficiency for state-of-the-art laser systems.
Collapse
Affiliation(s)
- M Zimmer
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - S Scheuren
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - T Ebert
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - G Schaumann
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - B Schmitz
- Institute for Accelerator Science and Electromagnetic Fields, Technical University of Darmstadt, Schlossgartenstr. 8, 64289 Darmstadt, Germany
| | - J Hornung
- GSI Helmholtz Centre for Heavy Ion Research, Planckstr. 1, 64291 Darmstadt, Germany
- Friedrich-Schiller-Universität Jena, Fürstengraben 1, 07743 Jena, Germany
- Helmholtz-Institut Jena, Fröbelstieg 3, 07743 Jena, Germany
| | - V Bagnoud
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
- GSI Helmholtz Centre for Heavy Ion Research, Planckstr. 1, 64291 Darmstadt, Germany
| | - C Rödel
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - M Roth
- Institute of Nuclear Physics, Technical University of Darmstadt, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| |
Collapse
|
13
|
Ronga MG, Cavallone M, Patriarca A, Leite AM, Loap P, Favaudon V, Créhange G, De Marzi L. Back to the Future: Very High-Energy Electrons (VHEEs) and Their Potential Application in Radiation Therapy. Cancers (Basel) 2021; 13:4942. [PMID: 34638424 PMCID: PMC8507836 DOI: 10.3390/cancers13194942] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/14/2022] Open
Abstract
The development of innovative approaches that would reduce the sensitivity of healthy tissues to irradiation while maintaining the efficacy of the treatment on the tumor is of crucial importance for the progress of the efficacy of radiotherapy. Recent methodological developments and innovations, such as scanned beams, ultra-high dose rates, and very high-energy electrons, which may be simultaneously available on new accelerators, would allow for possible radiobiological advantages of very short pulses of ultra-high dose rate (FLASH) therapy for radiation therapy to be considered. In particular, very high-energy electron (VHEE) radiotherapy, in the energy range of 100 to 250 MeV, first proposed in the 2000s, would be particularly interesting both from a ballistic and biological point of view for the establishment of this new type of irradiation technique. In this review, we examine and summarize the current knowledge on VHEE radiotherapy and provide a synthesis of the studies that have been published on various experimental and simulation works. We will also consider the potential for VHEE therapy to be translated into clinical contexts.
Collapse
Affiliation(s)
- Maria Grazia Ronga
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
- Thales AVS Microwave & Imaging Sub-Systems, 78141 Vélizy-Villacoublay, France
| | - Marco Cavallone
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
| | - Annalisa Patriarca
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
| | - Amelia Maia Leite
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
- INSERM LITO U1288, Campus Universitaire, Institut Curie, PSL Research University, University Paris Saclay, 91898 Orsay, France
| | - Pierre Loap
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
| | - Vincent Favaudon
- INSERM U 1021-CNRS UMR 3347, Campus Universitaire, Institut Curie, PSL Research University, University Paris Saclay, 91898 Orsay, France;
| | - Gilles Créhange
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
| | - Ludovic De Marzi
- Centre de Protonthérapie d’Orsay, Department of Radiation Oncology, Campus Universitaire, Institut Curie, PSL Research University, 91898 Orsay, France; (M.G.R.); (M.C.); (A.P.); (A.M.L.); (P.L.); (G.C.)
- INSERM LITO U1288, Campus Universitaire, Institut Curie, PSL Research University, University Paris Saclay, 91898 Orsay, France
| |
Collapse
|
14
|
Tsakanova G, Arakelova E, Ayvazyan V, Karalyan Z, Matevosyan L, Arakelyan A, Amirkhanyan Z, Davtyan H, Khachatryan V, Grigoryan B. The LD50 for Low-Energy Ultrashort-Pulsed Laser Driven Electron Beam Whole-Body Irradiation of Wistar Rats. Radiat Res 2021; 196:658-667. [PMID: 34478547 DOI: 10.1667/rade-20-00198.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/17/2021] [Indexed: 11/03/2022]
Abstract
Recently, a new technology of low-energy ultrashort-pulsed electron beam (UPEB) accelerators has been developed opening new directions for radiobiology and biomedical research. The purpose of this study was to reveal the lethal dose, LD50 (lethal dose, 50%) delivered by low-energy UPEB whole-body exposure on an organismal level. Wistar rats were exposed to low-energy UPEB whole-body irradiation with different doses and pulse repetition rates to find the LD50 and in silico computer simulations were performed to conduct numerical dose calculations. Survival rate, body weight and water consumption were monitored over the 30-day observation period postirradiation. The LD50 was observed after a 2 Gy dose and pulse repetition rate of 2 Hz. In this group, 50% of the animals survived 30 days postirradiation. The groups of animals exposed to low-energy UPEB radiation at higher doses and pulse repetition rates demonstrated higher mortality rates. We demonstrated that the LD50 dose for the low-energy UPEB whole body irradiation in Wistar rats corresponds to 2 Gy with a pulse repetition rate of 2 Hz. Moreover, we showed that the pulse repetition rate is a very important parameter in the experiments with UPEB and should be assessed in the experiments with such kind of novel irradiation sources.
Collapse
Affiliation(s)
- Gohar Tsakanova
- Institute of Molecular Biology NAS RA, Yerevan, Armenia.,CANDLE Synchrotron Research Institute, Yerevan, Armenia
| | | | | | | | | | | | | | - Hakob Davtyan
- CANDLE Synchrotron Research Institute, Yerevan, Armenia
| | | | | |
Collapse
|
15
|
Adrian G, Konradsson E, Beyer S, Wittrup A, Butterworth KT, McMahon SJ, Ghita M, Petersson K, Ceberg C. Cancer Cells Can Exhibit a Sparing FLASH Effect at Low Doses Under Normoxic In Vitro-Conditions. Front Oncol 2021; 11:686142. [PMID: 34395253 PMCID: PMC8358772 DOI: 10.3389/fonc.2021.686142] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/07/2021] [Indexed: 01/15/2023] Open
Abstract
Background Irradiation with ultra-high dose rate (FLASH) has been shown to spare normal tissue without hampering tumor control in several in vivo studies. Few cell lines have been investigated in vitro, and previous results are inconsistent. Assuming that oxygen depletion accounts for the FLASH sparing effect, no sparing should appear for cells irradiated with low doses in normoxia. Methods Seven cancer cell lines (MDA-MB-231, MCF7, WiDr, LU-HNSCC4, HeLa [early passage and subclone]) and normal lung fibroblasts (MRC-5) were irradiated with doses ranging from 0 to 12 Gy using FLASH (≥800 Gy/s) or conventional dose rates (CONV, 14 Gy/min), with a 10 MeV electron beam from a clinical linear accelerator. Surviving fraction (SF) was determined with clonogenic assays. Three cell lines were further studied for radiation-induced DNA-damage foci using a 53BP1-marker and for cell cycle synchronization after irradiation. Results A tendency of increased survival following FLASH compared with CONV was suggested for all cell lines, with significant differences for 4/7 cell lines. The magnitude of the FLASH-sparing expressed as a dose-modifying factor at SF=0.1 was around 1.1 for 6/7 cell lines and around 1.3 for the HeLasubclone. Similar cell cycle distributions and 53BP1-foci numbers were found comparing FLASH to CONV. Conclusion We have found a FLASH effect appearing at low doses under normoxic conditions for several cell lines in vitro. The magnitude of the FLASH effect differed between the cell lines, suggesting inherited biological susceptibilities for FLASH irradiation.
Collapse
Affiliation(s)
- Gabriel Adrian
- Division of Oncology and Pathology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden.,Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Elise Konradsson
- Department of Medical Radiation Physics, Clinical Sciences, Lund University, Lund, Sweden
| | - Sarah Beyer
- Division of Oncology and Pathology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Anders Wittrup
- Division of Oncology and Pathology, Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden.,Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund, Sweden
| | - Karl T Butterworth
- 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
| | - Mihaela Ghita
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom
| | - Kristoffer Petersson
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.,Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Crister Ceberg
- Department of Medical Radiation Physics, Clinical Sciences, Lund University, Lund, Sweden
| |
Collapse
|
16
|
Enhanced laser-driven proton acceleration via improved fast electron heating in a controlled pre-plasma. Sci Rep 2021; 11:13728. [PMID: 34215775 PMCID: PMC8253820 DOI: 10.1038/s41598-021-93011-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/10/2021] [Indexed: 11/11/2022] Open
Abstract
The interaction of ultraintense laser pulses with solids is largely affected by the plasma gradient at the vacuum–solid interface, which modifies the absorption and ultimately, controls the energy distribution function of heated electrons. A micrometer scale-length plasma has been predicted to yield a significant enhancement of the energy and weight of the fast electron population and to play a major role in laser-driven proton acceleration with thin foils. We report on recent experimental results on proton acceleration from laser interaction with foil targets at ultra-relativistic intensities. We show a threefold increase of the proton cut-off energy when a micrometer scale-length pre-plasma is introduced by irradiation with a low energy femtosecond pre-pulse. Our realistic numerical simulations agree with the observed gain of the proton cut-off energy and confirm the role of stochastic heating of fast electrons in the enhancement of the accelerating sheath field.
Collapse
|
17
|
Abstract
The versatility of laser accelerators in generating particle beams of various types is often promoted as a key applicative advantage. These multiple types of particles, however, are generated on vastly different irradiation setups, so that switching from one type to another involves substantial mechanical changes. In this letter, we report on a laser-based accelerator that generates beams of either multi-MeV electrons or ions from the same thin-foil irradiation setup. Switching from generation of ions to electrons is achieved by introducing an auxiliary laser pulse, which pre-explodes the foil tens of ns before irradiation by the main pulse. We present an experimental characterization of the emitted beams in terms of energy, charge, divergence, and repeatability, and conclude with several examples of prospective applications for industry and research.
Collapse
|
18
|
Pawelke J, Brand M, Hans S, Hideghéty K, Karsch L, Lessmann E, Löck S, Schürer M, Szabó ER, Beyreuther E. Electron dose rate and oxygen depletion protect zebrafish embryos from radiation damage. Radiother Oncol 2021; 158:7-12. [DOI: 10.1016/j.radonc.2021.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
|
19
|
Han J, Mei Z, Lu C, Qian J, Liang Y, Sun X, Pan Z, Kong D, Xu S, Liu Z, Gao Y, Qi G, Shou Y, Chen S, Cao Z, Zhao Y, Lin C, Zhao Y, Geng Y, Chen J, Yan X, Ma W, Yang G. Ultra-High Dose Rate FLASH Irradiation Induced Radio-Resistance of Normal Fibroblast Cells Can Be Enhanced by Hypoxia and Mitochondrial Dysfunction Resulting From Loss of Cytochrome C. Front Cell Dev Biol 2021; 9:672929. [PMID: 33996831 PMCID: PMC8121317 DOI: 10.3389/fcell.2021.672929] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/08/2021] [Indexed: 01/15/2023] Open
Abstract
Ultra-high dose rate FLASH irradiation (FLASH-IR) has got extensive attention since it may provide better protection on normal tissues while maintain tumor killing effect compared with conventional dose rate irradiation. The FLASH-IR induced protection effect on normal tissues is exhibited as radio-resistance of the irradiated normal cells, and is suggested to be related to oxygen depletion. However, the detailed cell death profile and pathways are still unclear. Presently normal mouse embryonic fibroblast cells were FLASH irradiated (∼109 Gy/s) at the dose of ∼10–40 Gy in hypoxic and normoxic condition, with ultra-fast laser-generated particles. The early apoptosis, late apoptosis and necrosis of cells were detected and analyzed at 6, 12, and 24 h post FLASH-IR. The results showed that FLASH-IR induced significant early apoptosis, late apoptosis and necrosis in normal fibroblast cells, and the apoptosis level increased with time, in either hypoxic or normoxic conditions. In addition, the proportion of early apoptosis, late apoptosis and necrosis were significantly lower in hypoxia than that of normoxia, indicating that radio-resistance of normal fibroblast cells under FLASH-IR can be enhanced by hypoxia. To further investigate the apoptosis related profile and potential pathways, mitochondria dysfunction cells resulting from loss of cytochrome c (cyt c–/–) were also irradiated. The results showed that compared with irradiated normal cells (cyt c+/+), the late apoptosis and necrosis but not early apoptosis proportions of irradiated cyt c–/– cells were significant decreased in both hypoxia and normoxia, indicating mitochondrial dysfunction increased radio-resistance of FLASH irradiated cells. Taken together, to our limited knowledge, this is the first report shedding light on the death profile and pathway of normal and cyt c–/– cells under FLASH-IR in hypoxic and normoxic circumstances, which might help us improve the understanding of the FLASH-IR induced protection effect in normal cells, and thus might potentially help to optimize the future clinical FLASH treatment.
Collapse
Affiliation(s)
- Jintao Han
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Zhusong Mei
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Chunyang Lu
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Jing Qian
- Teaching and Research Section of Nuclear Medicine, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Yulan Liang
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Xiaoyi Sun
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Zhuo Pan
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Defeng Kong
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Shirui Xu
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Zhipeng Liu
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Ying Gao
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Guijun Qi
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Yinren Shou
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Shiyou Chen
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Zhengxuan Cao
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Ye Zhao
- Teaching and Research Section of Nuclear Medicine, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Chen Lin
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Yanying Zhao
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Yixing Geng
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Jiaer Chen
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Xueqing Yan
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China.,Collaborative Innovation Center of Extreme Optics, Shanxi University, Taiyuan, China
| | - Wenjun Ma
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| | - Gen Yang
- State Key Laboratory of Nuclear Physics and Technology, School of Physics and CAPT, Peking University, Beijing, China
| |
Collapse
|
20
|
Yang G, Lu C, Mei Z, Sun X, Han J, Qian J, Liang Y, Pan Z, Kong D, Xu S, Liu Z, Gao Y, Qi G, Shou Y, Chen S, Cao Z, Zhao Y, Lin C, Zhao Y, Geng Y, Ma W, Yan X. Association of Cancer Stem Cell Radio-Resistance Under Ultra-High Dose Rate FLASH Irradiation With Lysosome-Mediated Autophagy. Front Cell Dev Biol 2021; 9:672693. [PMID: 33996830 PMCID: PMC8116574 DOI: 10.3389/fcell.2021.672693] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/06/2021] [Indexed: 12/03/2022] Open
Abstract
Cancer stem cell (CSC) is thought to be the major cause of radio-resistance and relapse post radiotherapy (RT). Recently ultra-high dose rate “FLASH-RT” evokes great interest for its decreasing normal tissue damages while maintaining tumor responses compared with conventional dose rate RT. However, the killing effect and mechanism of FLASH irradiation (FLASH-IR) on CSC and normal cancer cell are still unclear. Presently the radiation induced death profile of CSC and normal cancer cell were studied. Cells were irradiated with FLASH-IR (∼109 Gy/s) at the dose of 6–9 Gy via laser-accelerated nanosecond particles. Then the ratio of apoptosis, pyroptosis and necrosis were determined. The results showed that FLASH-IR can induce apoptosis, pyroptosis and necrosis in both CSC and normal cancer cell with different ratios. And CSC was more resistant to radiation than normal cancer cell under FLASH-IR. Further experiments tracing lysosome and autophagy showed that CSCs had higher levels of lysosome and autophagy. Taken together, our results suggested that the radio-resistance of CSC may associate with the increase of lysosome-mediated autophagy, and the decrease of apoptosis, necrosis and pyroptosis. To our limited knowledge, this is the first report shedding light on the killing effects and death pathways of CSC and normal cancer cell under FLASH-IR. By clarifying the death pathways of CSC and normal cancer cell under FLASH-IR, it may help us improve the understanding of the radio-resistance of CSC and thus help to optimize the future clinical FLASH treatment plan.
Collapse
Affiliation(s)
- Gen Yang
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Chunyang Lu
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Zhusong Mei
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Xiaoyi Sun
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Jintao Han
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Jing Qian
- Teaching and Research Section of Nuclear Medicine, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Yulan Liang
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Zhuo Pan
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Defeng Kong
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Shirui Xu
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Zhipeng Liu
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Ying Gao
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Guijun Qi
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Yinren Shou
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Shiyou Chen
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Zhengxuan Cao
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Ye Zhao
- Teaching and Research Section of Nuclear Medicine, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Chen Lin
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Yanying Zhao
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Yixing Geng
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Wenjun Ma
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China
| | - Xueqing Yan
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, CAPT, Peking University, Beijing, China.,Collaborative Innovation Center of Extreme Optics, Shanxi University, Taiyuan, China
| |
Collapse
|
21
|
Apiñaniz JI, Malko S, Fedosejevs R, Cayzac W, Vaisseau X, de Luis D, Gatti G, McGuffey C, Bailly-Grandvaux M, Bhutwala K, Ospina-Bohorquez V, Balboa J, Santos JJ, Batani D, Beg F, Roso L, Perez-Hernandez JA, Volpe L. A quasi-monoenergetic short time duration compact proton source for probing high energy density states of matter. Sci Rep 2021; 11:6881. [PMID: 33767262 PMCID: PMC7994565 DOI: 10.1038/s41598-021-86234-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/09/2021] [Indexed: 11/09/2022] Open
Abstract
We report on the development of a highly directional, narrow energy band, short time duration proton beam operating at high repetition rate. The protons are generated with an ultrashort-pulse laser interacting with a solid target and converted to a pencil-like narrow-band beam using a compact magnet-based energy selector. We experimentally demonstrate the production of a proton beam with an energy of 500 keV and energy spread well below 10[Formula: see text], and a pulse duration of 260 ps. The energy loss of this beam is measured in a 2 [Formula: see text]m thick solid Mylar target and found to be in good agreement with the theoretical predictions. The short time duration of the proton pulse makes it particularly well suited for applications involving the probing of highly transient plasma states produced in laser-matter interaction experiments. This proton source is particularly relevant for measurements of the proton stopping power in high energy density plasmas and warm dense matter.
Collapse
Affiliation(s)
- J I Apiñaniz
- Centro de Laseres Pulsados (CLPU), Parque Cientifico, 37185, Villamayor, Salamanca, Spain.
| | - S Malko
- Centro de Laseres Pulsados (CLPU), Parque Cientifico, 37185, Villamayor, Salamanca, Spain
| | - R Fedosejevs
- Department of Electrical and Computing Engineering, University of Alberta, Edmonton, AB, T6G 2V4, Canada
| | - W Cayzac
- CEA, DAM, DIF, 91297, Arpajon, France
| | | | - D de Luis
- Centro de Laseres Pulsados (CLPU), Parque Cientifico, 37185, Villamayor, Salamanca, Spain
| | - G Gatti
- Centro de Laseres Pulsados (CLPU), Parque Cientifico, 37185, Villamayor, Salamanca, Spain
| | - C McGuffey
- Center for Energy Research, University of California San Diego, La Jolla, CA, 92093, USA
| | - M Bailly-Grandvaux
- Center for Energy Research, University of California San Diego, La Jolla, CA, 92093, USA
| | - K Bhutwala
- Center for Energy Research, University of California San Diego, La Jolla, CA, 92093, USA
| | - V Ospina-Bohorquez
- University of Salamanca, Salamanca, Spain.,CEA, DAM, DIF, 91297, Arpajon, France.,CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, University of Bordeaux, 33405, Talence, France
| | - J Balboa
- University of Salamanca, Salamanca, Spain
| | - J J Santos
- CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, University of Bordeaux, 33405, Talence, France
| | - D Batani
- CNRS, CEA, CELIA (Centre Lasers Intenses et Applications), UMR 5107, University of Bordeaux, 33405, Talence, France
| | - F Beg
- Center for Energy Research, University of California San Diego, La Jolla, CA, 92093, USA
| | - L Roso
- Centro de Laseres Pulsados (CLPU), Parque Cientifico, 37185, Villamayor, Salamanca, Spain
| | - J A Perez-Hernandez
- Centro de Laseres Pulsados (CLPU), Parque Cientifico, 37185, Villamayor, Salamanca, Spain
| | - L Volpe
- Centro de Laseres Pulsados (CLPU), Parque Cientifico, 37185, Villamayor, Salamanca, Spain.,Laser-Plasma Chair at the University of Salamanca, Salamanca, Spain.,Instituto Universitario Física Fundamental y Matemáticas, 37008, Salamanca, Spain
| |
Collapse
|
22
|
Esplen N, Mendonca MS, Bazalova-Carter M. Physics and biology of ultrahigh dose-rate (FLASH) radiotherapy: a topical review. Phys Med Biol 2020; 65:23TR03. [PMID: 32721941 DOI: 10.1088/1361-6560/abaa28] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Ultrahigh dose-rate radiotherapy (RT), or 'FLASH' therapy, has gained significant momentum following various in vivo studies published since 2014 which have demonstrated a reduction in normal tissue toxicity and similar tumor control for FLASH-RT when compared with conventional dose-rate RT. Subsequent studies have sought to investigate the potential for FLASH normal tissue protection and the literature has been since been inundated with publications on FLASH therapies. Today, FLASH-RT is considered by some as having the potential to 'revolutionize radiotherapy'. FLASH-RT is considered by some as having the potential to 'revolutionize radiotherapy'. The goal of this review article is to present the current state of this intriguing RT technique and to review existing publications on FLASH-RT in terms of its physical and biological aspects. In the physics section, the current landscape of ultrahigh dose-rate radiation delivery and dosimetry is presented. Specifically, electron, photon and proton radiation sources capable of delivering ultrahigh dose-rates along with their beam delivery parameters are thoroughly discussed. Additionally, the benefits and drawbacks of radiation detectors suitable for dosimetry in FLASH-RT are presented. The biology section comprises a summary of pioneering in vitro ultrahigh dose-rate studies performed in the 1960s and early 1970s and continues with a summary of the recent literature investigating normal and tumor tissue responses in electron, photon and proton beams. The section is concluded with possible mechanistic explanations of the FLASH normal-tissue protection effect (FLASH effect). Finally, challenges associated with clinical translation of FLASH-RT and its future prospects are critically discussed; specifically, proposed treatment machines and publications on treatment planning for FLASH-RT are reviewed.
Collapse
Affiliation(s)
- Nolan Esplen
- Department of Physics and Astronomy, University of Victoria, Victoria, BC, Canada
| | | | | |
Collapse
|
23
|
Schüller A, Heinrich S, Fouillade C, Subiel A, De Marzi L, Romano F, Peier P, Trachsel M, Fleta C, Kranzer R, Caresana M, Salvador S, Busold S, Schönfeld A, McEwen M, Gomez F, Solc J, Bailat C, Linhart V, Jakubek J, Pawelke J, Borghesi M, Kapsch RP, Knyziak A, Boso A, Olsovcova V, Kottler C, Poppinga D, Ambrozova I, Schmitzer CS, Rossomme S, Vozenin MC. The European Joint Research Project UHDpulse – Metrology for advanced radiotherapy using particle beams with ultra-high pulse dose rates. Phys Med 2020; 80:134-150. [DOI: 10.1016/j.ejmp.2020.09.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/17/2020] [Accepted: 09/23/2020] [Indexed: 02/08/2023] Open
|
24
|
Zou W, Diffenderfer ES, Cengel KA, Kim MM, Avery S, Konzer J, Cai Y, Boisseu P, Ota K, Yin L, Wiersma R, Carlson DJ, Fan Y, Busch TM, Koumenis C, Lin A, Metz JM, Teo BK, Dong L. Current delivery limitations of proton PBS for FLASH. Radiother Oncol 2020; 155:212-218. [PMID: 33186682 DOI: 10.1016/j.radonc.2020.11.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 01/01/2023]
Abstract
PURPOSE Proton Pencil Beam Scanning (PBS) is an attractive solution to realize the advantageous normal tissue sparing elucidated from FLASH high dose rates. The mechanics of PBS spot delivery will impose limitations on the effective field dose rate for PBS. METHODS This study incorporates measurements from clinical and FLASH research beams on uniform single energy and the spread-out Bragg Peak PBS fields to extrapolate the PBS dose rate to high cyclotron beam currents 350, 500, and 800 nA. The impact of the effective field dose rate from cyclotron current, spot spacing, slew time and field size were studied. RESULTS When scanning magnet slew time and energy switching time are not considered, single energy effective field FLASH dose rate (≥40 Gy/s) can only be achieved with less than 4 × 4 cm2 fields when the cyclotron output current is above 500 nA. Slew time and energy switching time remain the limiting factors for achieving high effective dose rate of the field. The dose rate-time structures were obtained. The amount of the total dose delivered at the FLASH dose rate in single energy layer and volumetric field was also studied. CONCLUSION It is demonstrated that while it is difficult to achieve FLASH dose rate for a large field or in a volume, local FLASH delivery to certain percentage of the total dose is possible. With further understanding of the FLASH radiobiological mechanism, this study could provide guidance to adapt current clinical multi-field proton PBS delivery practice for FLASH proton radiotherapy.
Collapse
Affiliation(s)
- Wei Zou
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA.
| | - Eric S Diffenderfer
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Keith A Cengel
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Michele M Kim
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Steve Avery
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Joshua Konzer
- IBA PT-Inc., PT Engineer-Beam Physics, Louvain-La-Neuve, Belgium
| | - Yongliang Cai
- IBA PT-Inc., PT Engineer-Beam Physics, Louvain-La-Neuve, Belgium
| | - Paul Boisseu
- Pyramid Technical Consultants, Systems Engineering, Boston, USA
| | - Kan Ota
- Pyramid Technical Consultants, Systems Engineering, Boston, USA
| | - Lingshu Yin
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Rodney Wiersma
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - David J Carlson
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Yi Fan
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Theresa M Busch
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Costas Koumenis
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Alexander Lin
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - James M Metz
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - BoonKeng K Teo
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| | - Lei Dong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
25
|
Pedrosa-Rivera M, Praena J, Porras I, Sabariego MP, Köster U, Haertlein M, Forsyth VT, Ramírez JC, Jover C, Jimena D, Osorio JL, Álvarez P, Ruiz-Ruiz C, Ruiz-Magaña MJ. Thermal Neutron Relative Biological Effectiveness Factors for Boron Neutron Capture Therapy from In Vitro Irradiations. Cells 2020; 9:cells9102144. [PMID: 32977400 PMCID: PMC7598166 DOI: 10.3390/cells9102144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022] Open
Abstract
The experimental determination of the relative biological effectiveness of thermal neutron factors is fundamental in Boron Neutron Capture Therapy. The present values have been obtained while using mixed beams that consist of both neutrons and photons of various energies. A common weighting factor has been used for both thermal and fast neutron doses, although such an approach has been questioned. At the nuclear reactor of the Institut Laue-Langevin a pure low-energy neutron beam has been used to determine thermal neutron relative biological effectiveness factors. Different cancer cell lines, which correspond to glioblastoma, melanoma, and head and neck squamous cell carcinoma, and non-tumor cell lines (lung fibroblast and embryonic kidney), have been irradiated while using an experimental arrangement designed to minimize neutron-induced secondary gamma radiation. Additionally, the cells were irradiated with photons at a medical linear accelerator, providing reference data for comparison with that from neutron irradiation. The survival and proliferation were studied after irradiation, yielding the Relative Biological Effectiveness that corresponds to the damage of thermal neutrons for the different tissue types.
Collapse
Affiliation(s)
- María Pedrosa-Rivera
- Departamento de Física Atómica, Molecular y Nuclear, Facultad de Ciencias, Universidad de Granada, 18071 Granada, Spain; (M.P.-R.); (J.P.); (M.P.S.)
| | - Javier Praena
- Departamento de Física Atómica, Molecular y Nuclear, Facultad de Ciencias, Universidad de Granada, 18071 Granada, Spain; (M.P.-R.); (J.P.); (M.P.S.)
| | - Ignacio Porras
- Departamento de Física Atómica, Molecular y Nuclear, Facultad de Ciencias, Universidad de Granada, 18071 Granada, Spain; (M.P.-R.); (J.P.); (M.P.S.)
- Correspondence: (I.P.); (C.R.-R.)
| | - Manuel P. Sabariego
- Departamento de Física Atómica, Molecular y Nuclear, Facultad de Ciencias, Universidad de Granada, 18071 Granada, Spain; (M.P.-R.); (J.P.); (M.P.S.)
| | - Ulli Köster
- Institut Laue-Langevin, 71 Avenue des Martyrs, CEDEX 9, 38042 Grenoble, France; (U.K.); (M.H.); (V.T.F.)
| | - Michael Haertlein
- Institut Laue-Langevin, 71 Avenue des Martyrs, CEDEX 9, 38042 Grenoble, France; (U.K.); (M.H.); (V.T.F.)
- Partnership for Structural Biology (PSB), CEDEX 9, 38042 Grenoble, France
| | - V. Trevor Forsyth
- Institut Laue-Langevin, 71 Avenue des Martyrs, CEDEX 9, 38042 Grenoble, France; (U.K.); (M.H.); (V.T.F.)
- Partnership for Structural Biology (PSB), CEDEX 9, 38042 Grenoble, France
- Faculty of Natural Sciences, Keele University, Staffordshire ST5 5BG, UK
| | - José C. Ramírez
- Servicio de Radiofísica y Protección Radiológica, Hospital Universitario Virgen de las Nieves, Avda. Fuerzas Armadas 2, 18014 Granada, Spain; (J.C.R.); (C.J.); (D.J.); (J.L.O.)
| | - Clara Jover
- Servicio de Radiofísica y Protección Radiológica, Hospital Universitario Virgen de las Nieves, Avda. Fuerzas Armadas 2, 18014 Granada, Spain; (J.C.R.); (C.J.); (D.J.); (J.L.O.)
| | - Daniel Jimena
- Servicio de Radiofísica y Protección Radiológica, Hospital Universitario Virgen de las Nieves, Avda. Fuerzas Armadas 2, 18014 Granada, Spain; (J.C.R.); (C.J.); (D.J.); (J.L.O.)
| | - Juan L. Osorio
- Servicio de Radiofísica y Protección Radiológica, Hospital Universitario Virgen de las Nieves, Avda. Fuerzas Armadas 2, 18014 Granada, Spain; (J.C.R.); (C.J.); (D.J.); (J.L.O.)
| | - Patricia Álvarez
- Departamento de Bioquímica y Biología Molecular III e Inmunología, Facultad de Medicina, Universidad de Granada, 18016 Granada, Spain; (P.Á.); (M.J.R.-M.)
| | - Carmen Ruiz-Ruiz
- Departamento de Bioquímica y Biología Molecular III e Inmunología, Facultad de Medicina, Universidad de Granada, 18016 Granada, Spain; (P.Á.); (M.J.R.-M.)
- Correspondence: (I.P.); (C.R.-R.)
| | - María J. Ruiz-Magaña
- Departamento de Bioquímica y Biología Molecular III e Inmunología, Facultad de Medicina, Universidad de Granada, 18016 Granada, Spain; (P.Á.); (M.J.R.-M.)
| |
Collapse
|
26
|
[Radiation-oncology horizon 2030: From microbiota to plasma laser]. Cancer Radiother 2020; 24:744-750. [PMID: 32861611 DOI: 10.1016/j.canrad.2020.06.023] [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: 06/08/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 11/20/2022]
Abstract
Advances in physical, technological and biological fields have made radiation oncology a discipline in continual evolution. New current research areas could be implemented in the clinic in the near future. In this review in the form of several interviews, various promising themes for our specialty are described such as the gut microbiota, tumor organoids (or avatar), artificial intelligence, connected therapies, nanotechnologies and plasma laser. The individual prediction of the best therapeutic index combined with the integration of new technologies will ideally allow highly personalized treatment of patients receiving radiation therapy.
Collapse
|
27
|
De Marzi L, Patriarca A, Scher N, Thariat J, Vidal M. Exploiting the full potential of proton therapy: An update on the specifics and innovations towards spatial or temporal optimisation of dose delivery. Cancer Radiother 2020; 24:691-698. [PMID: 32753235 DOI: 10.1016/j.canrad.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 02/07/2023]
Abstract
Prescription and delivery of protons are somewhat different compared to photons and may influence outcomes (tumour control and toxicity). These differences should be taken into account to fully exploit the clinical potential of proton therapy. Innovations in proton therapy treatment are also required to widen the therapeutic window and determine appropriate populations of patients that would benefit from new treatments. Therefore, strategies are now being developed to reduce side effects to critical normal tissues using alternative treatment configurations and new spatial or temporal-driven optimisation approaches. Indeed, spatiotemporal optimisation (based on flash, proton minibeam radiation therapy or hypofractionated delivery methods) has been gaining some attention in proton therapy as a mean of improving (biological and physical) dose distribution. In this short review, the main differences in planning and delivery between protons and photons, as well as some of the latest developments and methodological issues (in silico modelling) related to providing scientific evidence for these new techniques will be discussed.
Collapse
Affiliation(s)
- L De Marzi
- Institut Curie, centre de protonthérapie d'Orsay, campus universitaire, bâtiment 101, 91898 Orsay, France; Université PSL (Paris Sciences & Lettres), 60, rue Mazarine, 75006 Paris, France; Université Paris-Saclay, route de l'Orme-aux-Merisiers, RD 128, 91190 Saint-Aubin, France; Inserm U1021, centre universitaire, bâtiment 110, rue Henri-Becquerel, 91405 Orsay cedex, France; CNRS, UMR 3347, centre universitaire, bâtiment 110, rue Henri-Becquerel, 91405 Orsay cedex, France.
| | - A Patriarca
- Institut Curie, centre de protonthérapie d'Orsay, campus universitaire, bâtiment 101, 91898 Orsay, France; Université PSL (Paris Sciences & Lettres), 60, rue Mazarine, 75006 Paris, France
| | - N Scher
- Institut Curie, centre de protonthérapie d'Orsay, campus universitaire, bâtiment 101, 91898 Orsay, France; Université PSL (Paris Sciences & Lettres), 60, rue Mazarine, 75006 Paris, France
| | - J Thariat
- Service de radiothérapie oncologique, centre François-Baclesse, 3, avenue General-Harris, 14000 Caen, France; Laboratoire de physique corpusculaire de Caen, 6, boulevard du Maréchal-Juin, 14050 Caen cedex, France; Institut national de physique nucléaire et physique des particules (IN2P3), 6, boulevard du Maréchal-Juin, 14050 Caen cedex, France; EnsiCaen, 6, boulevard du Maréchal-Juin, 14050 Caen cedex, France; CNRS, UMR6534, 6, boulevard du Maréchal-Juin, 14050 Caen cedex, France; Unicaen, 6, boulevard du Maréchal-Juin, 14050 Caen cedex, France; Normandie Université, 6, boulevard du Maréchal-Juin, 14050 Caen cedex, France
| | - M Vidal
- Centre Antoine-Lacassagne, 33, avenue Valombrose, 06000 Nice, France
| |
Collapse
|
28
|
Brack FE, Kroll F, Gaus L, Bernert C, Beyreuther E, Cowan TE, Karsch L, Kraft S, Kunz-Schughart LA, Lessmann E, Metzkes-Ng J, Obst-Huebl L, Pawelke J, Rehwald M, Schlenvoigt HP, Schramm U, Sobiella M, Szabó ER, Ziegler T, Zeil K. Spectral and spatial shaping of laser-driven proton beams using a pulsed high-field magnet beamline. Sci Rep 2020; 10:9118. [PMID: 32499539 PMCID: PMC7272427 DOI: 10.1038/s41598-020-65775-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 05/11/2020] [Indexed: 01/19/2023] Open
Abstract
Intense laser-driven proton pulses, inherently broadband and highly divergent, pose a challenge to established beamline concepts on the path to application-adapted irradiation field formation, particularly for 3D. Here we experimentally show the successful implementation of a highly efficient (50% transmission) and tuneable dual pulsed solenoid setup to generate a homogeneous (laterally and in depth) volumetric dose distribution (cylindrical volume of 5 mm diameter and depth) at a single pulse dose of 0.7 Gy via multi-energy slice selection from the broad input spectrum. The experiments were conducted at the Petawatt beam of the Dresden Laser Acceleration Source Draco and were aided by a predictive simulation model verified by proton transport studies. With the characterised beamline we investigated manipulation and matching of lateral and depth dose profiles to various desired applications and targets. Using an adapted dose profile, we performed a first proof-of-technical-concept laser-driven proton irradiation of volumetric in-vitro tumour tissue (SAS spheroids) to demonstrate concurrent operation of laser accelerator, beam shaping, dosimetry and irradiation procedure of volumetric biological samples.
Collapse
Affiliation(s)
- Florian-Emanuel Brack
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany. .,Technische Universität Dresden, 01062, Dresden, Germany.
| | - Florian Kroll
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany
| | - Lennart Gaus
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,Technische Universität Dresden, 01062, Dresden, Germany
| | - Constantin Bernert
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,Technische Universität Dresden, 01062, Dresden, Germany
| | - Elke Beyreuther
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Thomas E Cowan
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,Technische Universität Dresden, 01062, Dresden, Germany
| | - Leonhard Karsch
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Stephan Kraft
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany
| | - Leoni A Kunz-Schughart
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.,National Center for Tumor Diseases (NCT), partner site Dresden, Dresden, Germany
| | | | | | - Lieselotte Obst-Huebl
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,Lawrence Berkeley National Laboratory, Berkeley, California, 94720, USA
| | - Jörg Pawelke
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden and Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Martin Rehwald
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,Technische Universität Dresden, 01062, Dresden, Germany
| | | | - Ulrich Schramm
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,Technische Universität Dresden, 01062, Dresden, Germany
| | | | - Emília Rita Szabó
- ELI-ALPS, ELI-HU Non-Profit Ltd., Wolfgang Sandner utca 3, Szeged, H-6728, Hungary
| | - Tim Ziegler
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany.,Technische Universität Dresden, 01062, Dresden, Germany
| | - Karl Zeil
- Helmholtz-Zentrum Dresden - Rossendorf, 01328, Dresden, Germany
| |
Collapse
|
29
|
The challenge of ionisation chamber dosimetry in ultra-short pulsed high dose-rate Very High Energy Electron beams. Sci Rep 2020; 10:9089. [PMID: 32493952 PMCID: PMC7270129 DOI: 10.1038/s41598-020-65819-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 03/16/2020] [Indexed: 12/04/2022] Open
Abstract
High dose-rate radiotherapy, known as FLASH, has been shown to increase the differential response between healthy and tumour tissue. Moreover, Very High Energy Electrons (VHEEs) provide more favourable dose distributions than conventional radiotherapy electron and photon beams. Plane-parallel ionisation chambers are the recommended secondary standard systems for clinical reference dosimetry of electrons, therefore chamber response to these high energy and high dose-per-pulse beams must be well understood. Graphite calorimetry, the UK primary standard, has been employed to measure the dose delivered from a 200 MeV pulsed electron beam. This was compared to the charge measurements of a plane-parallel ionisation chamber to determine the absolute collection efficiency and infer the ion recombination factor. The dose-per-pulse measured by the calorimeter ranged between 0.03 Gy/pulse and 5.26 Gy/pulse, corresponding to collection efficiencies between 97% and 4%, respectively. Multiple recombination models currently available have been compared with experimental results. This work is directly applicable to the development of standard dosimetry protocols for VHEE radiotherapy, FLASH radiotherapy and other high dose-rate modalities. However, the use of secondary standard ionisation chambers for the dosimetry of high dose-per-pulse VHEEs has been shown to require large corrections for charge collection inefficiency.
Collapse
|
30
|
Cavallone M, Flacco A, Malka V. Shaping of a laser-accelerated proton beam for radiobiology applications via genetic algorithm. Phys Med 2019; 67:123-131. [PMID: 31706148 DOI: 10.1016/j.ejmp.2019.10.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 09/20/2019] [Accepted: 10/13/2019] [Indexed: 11/28/2022] Open
Abstract
Laser-accelerated protons have a great potential for innovative experiments in radiation biology due to the sub-picosecond pulse duration and high dose rate achievable. However, the broad angular divergence makes them not optimal for applications with stringent requirements on dose homogeneity and total flux at the irradiated target. The strategy otherwise adopted to increase the homogeneity is to increase the distance between the source and the irradiation plane or to spread the beam with flat scattering systems or through the transport system itself. Such methods considerably reduce the proton flux and are not optimal for laser-accelerated protons. In this paper we demonstrate the use of a Genetic Algorithm (GA) to design an optimal non-flat scattering system to shape the beam and efficiently flatten the transversal dose distribution at the irradiated target. The system is placed in the magnetic transport system to take advantage of the presence of chromatic focusing elements to further mix the proton trajectories. The effect of a flat scattering system placed after the transport system is also presented for comparison. The general structure of the GA and its application to the shaping of a laser-accelerated proton beam are presented, as well as its application to the optimisation of dose distribution in a water target in air.
Collapse
Affiliation(s)
- M Cavallone
- Laboratoire d'Optique Appliquée, ENSTA-ParisTech, École Polytechnique, CNRS-UMR7639, Institut Polytechnique de Paris, 828 bd des Maréchaux, 91762 Palaiseau cedex, France
| | - A Flacco
- Laboratoire d'Optique Appliquée, ENSTA-ParisTech, École Polytechnique, CNRS-UMR7639, Institut Polytechnique de Paris, 828 bd des Maréchaux, 91762 Palaiseau cedex, France.
| | - V Malka
- Laboratoire d'Optique Appliquée, ENSTA-ParisTech, École Polytechnique, CNRS-UMR7639, Institut Polytechnique de Paris, 828 bd des Maréchaux, 91762 Palaiseau cedex, France; Department of Physics of Complex Systems, Weizmann Institute of Science, Rehovot 7610001, Israel
| |
Collapse
|
31
|
Colangelo NW, Azzam EI. The Importance and Clinical Implications of FLASH Ultra-High Dose-Rate Studies for Proton and Heavy Ion Radiotherapy. Radiat Res 2019; 193:1-4. [PMID: 31657670 DOI: 10.1667/rr15537.1] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The goal of radiation therapy is to provide the highest probability of tumor control while minimizing normal tissue toxicity. Recently, it has been discovered that ultra-high dose rates of ionizing radiation may preferentially spare normal tissue over tumor tissue. This effect, referred to as FLASH radiotherapy, has been observed in various animal models as well as, more recently, in a human patient. This effect may be related to the cell sparing found in vitro at ultra-high dose rates of photons and electrons dating back to the 1960s. Conditions representative of physiologic oxygen were found to be essential for this process to occur. However, there is no conclusive data on whether this effect occurs with protons, as all results to date have been in cells irradiated at ambient oxygen conditions. There have been no ultra-high dose-rate experiments with heavy ions, which would be relevant to the implementation of FLASH to carbon-ion therapy. These basic science results are critical in guiding this rapidly advancing field, since clinical particle therapy machines capable of FLASH dose rates have already been promoted for protons. To help ensure FLASH radiotherapy is reliable and maximally effective, the radiobiology must keep ahead of the clinical implementation to help guide it. In this context, in vitro and in vivo proton and heavy ion experiments involving FLASH dose rates need to be performed to evaluate not only short-term consequences, but also sequelae related to long-term health risks. Critical to these future studies is consideration of relevant oxygen tensions at the time of irradiation, as well as appropriate in silico modeling to assist in understanding the initial physicochemical events.
Collapse
Affiliation(s)
- Nicholas W Colangelo
- Rutgers Biomedical and Health Sciences, New Jersey Medical School, Department of Radiology, Newark, New Jersey
| | - Edouard I Azzam
- Rutgers Biomedical and Health Sciences, New Jersey Medical School, Department of Radiology, Newark, New Jersey
| |
Collapse
|