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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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Inaniwa T, Kanematsu N, Koto M. Biological dose optimization incorporating intra-tumoural cellular radiosensitivity heterogeneity in ion-beam therapy treatment planning. Phys Med Biol 2024; 69:115017. [PMID: 38636504 DOI: 10.1088/1361-6560/ad4085] [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: 12/11/2023] [Accepted: 04/18/2024] [Indexed: 04/20/2024]
Abstract
Objective.Treatment plans of ion-beam therapy have been made under an assumption that all cancer cells within a tumour equally respond to a given radiation dose. However, an intra-tumoural cellular radiosensitivity heterogeneity clearly exists, and it may lead to an overestimation of therapeutic effects of the radiation. The purpose of this study is to develop a biological model that can incorporate the radiosensitivity heterogeneity into biological optimization for ion-beam therapy treatment planning.Approach.The radiosensitivity heterogeneity was modeled as the variability of a cell-line specific parameter in the microdosimetric kinetic model following the gamma distribution. To validate the developed intra-tumoural-radiosensitivity-heterogeneity-incorporated microdosimetric kinetic (HMK) model, a treatment plan with H-ion beams was made for a chordoma case, assuming a radiosensitivity heterogeneous region within the tumour. To investigate the effects of the radiosensitivity heterogeneity on the biological effectiveness of H-, He-, C-, O-, and Ne-ion beams, the relative biological effectiveness (RBE)-weighted dose distributions were planned for a cuboid target with the stated ion beams without considering the heterogeneity. The planned dose distributions were then recalculated by taking the heterogeneity into account.Main results. The cell survival fraction and corresponding RBE-weighted dose were formulated based on the HMK model. The first derivative of the RBE-weighted dose distribution was also derived, which is needed for fast biological optimization. For the patient plan, the biological optimization increased the dose to the radiosensitivity heterogeneous region to compensate for the heterogeneity-induced reduction in biological effectiveness of the H-ion beams. The reduction in biological effectiveness due to the heterogeneity was pronounced for low linear energy transfer (LET) beams but moderate for high-LET beams. The RBE-weighted dose in the cuboid target decreased by 7.6% for the H-ion beam, while it decreased by just 1.4% for the Ne-ion beam.Significance.Optimal treatment plans that consider intra-tumoural cellular radiosensitivity heterogeneity can be devised using the HMK model.
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Affiliation(s)
- Taku Inaniwa
- Department of Accelerator and Medical Physics, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology (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
| | - Nobuyuki Kanematsu
- Department of Accelerator and Medical Physics, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Masashi Koto
- QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
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Peng H, Deng J, Jiang S, Timmerman R. Rethinking the potential role of dose painting in personalized ultra-fractionated stereotactic adaptive radiotherapy. Front Oncol 2024; 14:1357790. [PMID: 38571510 PMCID: PMC10987838 DOI: 10.3389/fonc.2024.1357790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/21/2024] [Indexed: 04/05/2024] Open
Abstract
Fractionated radiotherapy was established in the 1920s based upon two principles: (1) delivering daily treatments of equal quantity, unless the clinical situation requires adjustment, and (2) defining a specific treatment period to deliver a total dosage. Modern fractionated radiotherapy continues to adhere to these century-old principles, despite significant advancements in our understanding of radiobiology. At UT Southwestern, we are exploring a novel treatment approach called PULSAR (Personalized Ultra-Fractionated Stereotactic Adaptive Radiotherapy). This method involves administering tumoricidal doses in a pulse mode with extended intervals, typically spanning weeks or even a month. Extended intervals permit substantial recovery of normal tissues and afford the tumor and tumor microenvironment ample time to undergo significant changes, enabling more meaningful adaptation in response to the evolving characteristics of the tumor. The notion of dose painting in the realm of radiation therapy has long been a subject of contention. The debate primarily revolves around its clinical effectiveness and optimal methods of implementation. In this perspective, we discuss two facets concerning the potential integration of dose painting with PULSAR, along with several practical considerations. If successful, the combination of the two may not only provide another level of personal adaptation ("adaptive dose painting"), but also contribute to the establishment of a timely feedback loop throughout the treatment process. To substantiate our perspective, we conducted a fundamental modeling study focusing on PET-guided dose painting, incorporating tumor heterogeneity and tumor control probability (TCP).
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Affiliation(s)
- Hao Peng
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Medical Artificial Intelligence and Automation Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jie Deng
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Medical Artificial Intelligence and Automation Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Steve Jiang
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Medical Artificial Intelligence and Automation Laboratory, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Robert Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Masuda T, Inaniwa T. Effects of cellular radioresponse on therapeutic helium-, carbon-, oxygen-, and neon-ion beams: a simulation study. Phys Med Biol 2024; 69:045003. [PMID: 38232394 DOI: 10.1088/1361-6560/ad1f87] [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: 11/09/2023] [Accepted: 01/17/2024] [Indexed: 01/19/2024]
Abstract
Objective. Helium, oxygen, and neon ions in addition to carbon ions will be used for hypofractionated multi-ion therapy to maximize the therapeutic effectiveness of charged-particle therapy. To use new ions in cancer treatments based on the dose-fractionation protocols established in carbon-ion therapy, this study examined the cell-line-specific radioresponse to therapeutic helium-, oxygen-, and neon-ion beams within wide dose ranges.Approach. Response of cells to ions was described by the stochastic microdosimetric kinetic model. First, simulations were made for the irradiation of one-field spread-out Bragg peak beams in water with helium, carbon, oxygen, and neon ions to achieve uniform survival fractions at 37%, 10%, and 1% for human salivary gland tumor (HSG) cells, the reference cell line for the Japanese relative biological effectiveness weighted dose system, within the target region defined at depths from 90 to 150 mm. The HSG cells were then replaced by other cell lines with different radioresponses to evaluate differences in the biological dose distributions of each ion beam with respect to those of carbon-ion beams.Main results. For oxygen- and neon-ion beams, the biological dose distributions within the target region were almost equivalent to those of carbon-ion beams, differing by less than 5% in most cases. In contrast, for helium-ion beams, the biological dose distributions within the target region were largely different from those of carbon-ion beams, more than 10% in several cases.Significance.From the standpoint of tumor control evaluated by the clonogenic cell survival, this study suggests that the dose-fractionation protocols established in carbon-ion therapy could be reasonably applied to oxygen- and neon-ion beams while some modifications in dose prescription would be needed when the protocols are applied to helium-ion beams. This study bridges the gap between carbon-ion therapy and hypofractionated multi-ion therapy.
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Affiliation(s)
- Takamitsu Masuda
- Department of Accelerator and Medical Physics, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
| | - Taku Inaniwa
- Department of Accelerator and Medical Physics, National Institutes for Quantum Science and Technology (QST), Chiba, Japan
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Geser FA, Stabilini A, Christensen JB, Muñoz ID, Yukihara EG, Jäkel O, Vedelago J. A Monte Carlo study on the secondary neutron generation by oxygen ion beams for radiotherapy and its comparison to lighter ions. Phys Med Biol 2024; 69:015027. [PMID: 37995363 DOI: 10.1088/1361-6560/ad0f45] [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: 08/16/2023] [Accepted: 11/23/2023] [Indexed: 11/25/2023]
Abstract
Objective.To study the secondary neutrons generated by primary oxygen beams for cancer treatment and compare the results to those from primary protons, helium, and carbon ions. This information can provide useful insight into the positioning of neutron detectors in phantom for future experimental dose assessments.Approach.Mono-energetic oxygen beams and spread-out Bragg peaks were simulated using the Monte Carlo particle transport codesFLUktuierende KAskade, tool for particle simulation, and Monte Carlo N-Particle, with energies within the therapeutic range. The energy and angular distribution of the secondary neutrons were quantified.Main results.The secondary neutron spectra generated by primary oxygen beams present the same qualitative trend as for other primary ions. The energy distributions resemble continuous spectra with one peak in the thermal/epithermal region, and one other peak in the fast/relativistic region, with the most probable energy ranging from 94 up to 277 MeV and maximum energies exceeding 500 MeV. The angular distribution of the secondary neutrons is mainly downstream-directed for the fast/relativistic energies, whereas the thermal/epithermal neutrons present a more isotropic propagation. When comparing the four different primary ions, there is a significant increase in the most probable energy as well as the number of secondary neutrons per primary particle when increasing the mass of the primaries.Significance.Most previous studies have only presented results of secondary neutrons generated by primary proton beams. In this work, secondary neutrons generated by primary oxygen beams are presented, and the obtained energy and angular spectra are added as supplementary material. Furthermore, a comparison of the secondary neutron generation by the different primary ions is given, which can be used as the starting point for future studies on treatment plan comparison and secondary neutron dose optimisation. The distal penumbra after the maximum dose deposition appears to be a suitable location for in-phantom dose assessments.
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Affiliation(s)
- Federico A Geser
- Department of Radiation Safety and Security, Paul Scherrer Institute (PSI), Forschungsstrasse 111, Villigen PSI 5232, Switzerland
| | - Alberto Stabilini
- Department of Radiation Safety and Security, Paul Scherrer Institute (PSI), Forschungsstrasse 111, Villigen PSI 5232, Switzerland
| | - Jeppe B Christensen
- Department of Radiation Safety and Security, Paul Scherrer Institute (PSI), Forschungsstrasse 111, Villigen PSI 5232, Switzerland
| | - Iván D Muñoz
- Department of Physics and Astronomy, Heidelberg University, Im Neuenheimer Feld 226, Heidelberg D-69120, Germany
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany
| | - Eduardo G Yukihara
- Department of Radiation Safety and Security, Paul Scherrer Institute (PSI), Forschungsstrasse 111, Villigen PSI 5232, Switzerland
| | - Oliver Jäkel
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany
- Heidelberg Ion Beam Therapy Center (HIT), Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Im Neuenheimer Feld 450, Heidelberg D-69120, Germany
| | - José Vedelago
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg D-69120, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany
- Department of Radiation Oncology, Heidelberg University Hospital (UKHD), Im Neuenheimer Feld 400, Heidelberg D-69120, Germany
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6
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Helm A, Fournier C. High-LET charged particles: radiobiology and application for new approaches in radiotherapy. Strahlenther Onkol 2023; 199:1225-1241. [PMID: 37872399 PMCID: PMC10674019 DOI: 10.1007/s00066-023-02158-7] [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: 03/02/2023] [Accepted: 09/17/2023] [Indexed: 10/25/2023]
Abstract
The number of patients treated with charged-particle radiotherapy as well as the number of treatment centers is increasing worldwide, particularly regarding protons. However, high-linear energy transfer (LET) particles, mainly carbon ions, are of special interest for application in radiotherapy, as their special physical features result in high precision and hence lower toxicity, and at the same time in increased efficiency in cell inactivation in the target region, i.e., the tumor. The radiobiology of high-LET particles differs with respect to DNA damage repair, cytogenetic damage, and cell death type, and their increased LET can tackle cells' resistance to hypoxia. Recent developments and perspectives, e.g., the return of high-LET particle therapy to the US with a center planned at Mayo clinics, the application of carbon ion radiotherapy using cost-reducing cyclotrons and the application of helium is foreseen to increase the interest in this type of radiotherapy. However, further preclinical research is needed to better understand the differential radiobiological mechanisms as opposed to photon radiotherapy, which will help to guide future clinical studies for optimal exploitation of high-LET particle therapy, in particular related to new concepts and innovative approaches. Herein, we summarize the basics and recent progress in high-LET particle radiobiology with a focus on carbon ions and discuss the implications of current knowledge for charged-particle radiotherapy. We emphasize the potential of high-LET particles with respect to immunogenicity and especially their combination with immunotherapy.
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Affiliation(s)
- Alexander Helm
- Biophysics Department, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany
| | - Claudia Fournier
- Biophysics Department, GSI Helmholtz Center for Heavy Ion Research, Darmstadt, Germany.
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7
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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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8
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Kasanda E, Bildstein V, Hymers D, Easter J, Richard AL, Baumann T, Spyrou A, Höhr C, Mücher D. Range verification in heavy-ion therapy using a hadron tumour marker. Phys Med Biol 2023; 68:195018. [PMID: 37747082 DOI: 10.1088/1361-6560/acf557] [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: 03/02/2023] [Accepted: 08/30/2023] [Indexed: 09/26/2023]
Abstract
Objective.A new method to estimate the range of an ion beam in a patient during heavy-ion therapy was investigated, which was previously verified for application in proton therapy.Approach.The method consists of placing a hadron tumour marker (HTM) close to the tumour. As the treatment beam impinges on the HTM, the marker undergoes nuclear reactions. When the HTM material is carefully chosen, the activation results in the emission of several delayed, characteristicγrays, whose intensities are correlated with the remaining range inside the patient. When not just one but two reaction channels are investigated, the ratio between these twoγray emissions can be measured, and the ratio is independent of any beam delivery uncertainties.Main results.A proof-of-principle experiment with an16O ion beam and Ag foils as HTM was successfully executed. The107Ag(16O,x)112Sb and the107Ag(16O,x)114Sb reaction channels were identified as suitable for the HTM technique. When only oneγ-ray emission is measured, the resulting range-uncertainty estimation is at the 0.5 mm scale. When both channels are considered, a theoretical limit on the range uncertainty of a clinical fiducal marker was found to be ±290μm.Significance.Range uncertainty of a heavy-ion beam limits the prescribed treatment plan for cancer patients, especially the direction of the ion beam in relation to any organ at risk. An easy to implement range-verification technique which can be utilized during clinical treatment would allow treatment plans to take full advantage of the sharp fall-off of the Bragg peak without the risk of depositing excessive dose into healthy tissue.
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Affiliation(s)
- E Kasanda
- Department of Physics, University of Guelph, 50 Stone Rd E, Guelph, Ontario, N1G 2W1, Canada
- Laboratory for High Energy Physics, Universität Bern, Sidlerstrasse 5, 3012 Bern, Switzerland
| | - V Bildstein
- Department of Physics, University of Guelph, 50 Stone Rd E, Guelph, Ontario, N1G 2W1, Canada
| | - D Hymers
- Department of Physics, University of Guelph, 50 Stone Rd E, Guelph, Ontario, N1G 2W1, Canada
- Institut für Kernphysik der Universität zu Köln, Zülpicher Strasse 77, D-50937 Köln, Germany
| | - J Easter
- Department of Physics, University of Guelph, 50 Stone Rd E, Guelph, Ontario, N1G 2W1, Canada
| | - A L Richard
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, MI 48824, United States of America
- Department of Physics and Astronomy, Michigan State University, East Lansing, MI 48824, United States of America
| | - T Baumann
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, MI 48824, United States of America
| | - A Spyrou
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, MI 48824, United States of America
- Department of Physics and Astronomy, Michigan State University, East Lansing, MI 48824, United States of America
| | - C Höhr
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia, V6T 2A3, Canada
- Department of Physics and Astronomy, University of Victoria, 3800 Finnerty Road, Victoria, British Columbia, V8P 5C2, Canada
| | - D Mücher
- Department of Physics, University of Guelph, 50 Stone Rd E, Guelph, Ontario, N1G 2W1, Canada
- Institut für Kernphysik der Universität zu Köln, Zülpicher Strasse 77, D-50937 Köln, Germany
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia, V6T 2A3, Canada
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9
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Sokol O, Durante M. Carbon Ions for Hypoxic Tumors: Are We Making the Most of Them? Cancers (Basel) 2023; 15:4494. [PMID: 37760464 PMCID: PMC10526811 DOI: 10.3390/cancers15184494] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Hypoxia, which is associated with abnormal vessel growth, is a characteristic feature of many solid tumors that increases their metastatic potential and resistance to radiotherapy. Carbon-ion radiation therapy, either alone or in combination with other treatments, is one of the most promising treatments for hypoxic tumors because the oxygen enhancement ratio decreases with increasing particle LET. Nevertheless, current clinical practice does not yet fully benefit from the use of carbon ions to tackle hypoxia. Here, we provide an overview of the existing experimental and clinical evidence supporting the efficacy of C-ion radiotherapy in overcoming hypoxia-induced radioresistance, followed by a discussion of the strategies proposed to enhance it, including different approaches to maximize LET in the tumors.
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Affiliation(s)
- Olga Sokol
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforchung, Planckstraße 1, 64291 Darmstadt, Germany;
| | - Marco Durante
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforchung, Planckstraße 1, 64291 Darmstadt, Germany;
- Institute for Condensed Matter Physics, Technische Universität Darmstadt, Hochschulstraße 8, 64289 Darmstadt, Germany
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10
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Lozano AI, Álvarez L, García-Abenza A, Guerra C, Kossoski F, Rosado J, Blanco F, Oller JC, Hasan M, Centurion M, Weber T, Slaughter DS, Mootheril DM, Dorn A, Kumar S, Limão-Vieira P, Colmenares R, García G. Electron Scattering from 1-Methyl-5-Nitroimidazole: Cross-Sections for Modeling Electron Transport through Potential Radiosensitizers. Int J Mol Sci 2023; 24:12182. [PMID: 37569557 PMCID: PMC10418670 DOI: 10.3390/ijms241512182] [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] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
In this study, we present a complete set of electron scattering cross-sections from 1-Methyl-5-Nitroimidazole (1M5NI) molecules for impact energies ranging from 0.1 to 1000 eV. This information is relevant to evaluate the potential role of 1M5NI as a molecular radiosensitizers. The total electron scattering cross-sections (TCS) that we previously measured with a magnetically confined electron transmission apparatus were considered as the reference values for the present analysis. Elastic scattering cross-sections were calculated by means of two different schemes: The Schwinger multichannel (SMC) method for the lower energies (below 15 eV) and the independent atom model-based screening-corrected additivity rule with interferences (IAM-SCARI) for higher energies (above 15 eV). The latter was also applied to calculate the total ionization cross-sections, which were complemented with experimental values of the induced cationic fragmentation by electron impact. Double differential ionization cross-sections were measured with a reaction microscope multi-particle coincidence spectrometer. Using a momentum imaging spectrometer, direct measurements of the anion fragment yields and kinetic energies by the dissociative electron attachment are also presented. Cross-sections for the other inelastic channels were derived with a self-consistent procedure by sampling their values at a given energy to ensure that the sum of the cross-sections of all the scattering processes available at that energy coincides with the corresponding TCS. This cross-section data set is ready to be used for modelling electron-induced radiation damage at the molecular level to biologically relevant media containing 1M5NI as a potential radiosensitizer. Nonetheless, a proper evaluation of its radiosensitizing effects would require further radiobiological experiments.
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Affiliation(s)
- Ana I. Lozano
- Instituto de Física Fundamental, Consejo Superior de Investigaciones Científicas-CSIC, Serrano 113-bis, 28006 Madrid, Spain or (A.I.L.); (L.Á.); (A.G.-A.); (C.G.)
- Laboratório de Colisões Atómicas e Moleculares, CEFITEC, Departamento de Física, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal (P.L.-V.)
| | - Lidia Álvarez
- Instituto de Física Fundamental, Consejo Superior de Investigaciones Científicas-CSIC, Serrano 113-bis, 28006 Madrid, Spain or (A.I.L.); (L.Á.); (A.G.-A.); (C.G.)
| | - Adrián García-Abenza
- Instituto de Física Fundamental, Consejo Superior de Investigaciones Científicas-CSIC, Serrano 113-bis, 28006 Madrid, Spain or (A.I.L.); (L.Á.); (A.G.-A.); (C.G.)
| | - Carlos Guerra
- Instituto de Física Fundamental, Consejo Superior de Investigaciones Científicas-CSIC, Serrano 113-bis, 28006 Madrid, Spain or (A.I.L.); (L.Á.); (A.G.-A.); (C.G.)
| | - Fábris Kossoski
- Laboratoire de Chimie et Physique Quantiques (UMR 5626), Université de Toulouse, CNRS, UPS, 31062 Toulouse, France;
| | - Jaime Rosado
- Departamento de Estructura de la Materia, Física Térmica y Electrónica e IPARCOS, Universidad Complutense de Madrid, Avenida Complutense, 28040 Madrid, Spain; (J.R.); (F.B.)
| | - Francisco Blanco
- Departamento de Estructura de la Materia, Física Térmica y Electrónica e IPARCOS, Universidad Complutense de Madrid, Avenida Complutense, 28040 Madrid, Spain; (J.R.); (F.B.)
| | - Juan Carlos Oller
- Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 22, 28040 Madrid, Spain;
| | - Mahmudul Hasan
- Chemical Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; (M.H.); (T.W.); (D.S.S.)
- Department of Physics and Astronomy, University of Nebraska-Lincoln, Lincoln, NE 68588, USA;
| | - Martin Centurion
- Department of Physics and Astronomy, University of Nebraska-Lincoln, Lincoln, NE 68588, USA;
| | - Thorsten Weber
- Chemical Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; (M.H.); (T.W.); (D.S.S.)
| | - Daniel S. Slaughter
- Chemical Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; (M.H.); (T.W.); (D.S.S.)
| | | | - Alexander Dorn
- Max Planck Institute for Nuclear Physics, 69117 Heidelberg, Germany; (D.M.M.)
| | - Sarvesh Kumar
- Laboratório de Colisões Atómicas e Moleculares, CEFITEC, Departamento de Física, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal (P.L.-V.)
- Chemical Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA; (M.H.); (T.W.); (D.S.S.)
| | - Paulo Limão-Vieira
- Laboratório de Colisões Atómicas e Moleculares, CEFITEC, Departamento de Física, Universidade NOVA de Lisboa, 2829-516 Caparica, Portugal (P.L.-V.)
| | - Rafael Colmenares
- Servicio de Radiofísica, IRYCIS-Hospital Universitario Ramón y Cajal, Carretera de Colmenar Viejo Km. 9.100, 28034 Madrid, Spain
| | - Gustavo García
- Instituto de Física Fundamental, Consejo Superior de Investigaciones Científicas-CSIC, Serrano 113-bis, 28006 Madrid, Spain or (A.I.L.); (L.Á.); (A.G.-A.); (C.G.)
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522, Australia
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11
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Ounoughi N, Boukhellout A, Kharfi F. Neutron shielding assessment of a 16O hadron therapy room by means of Monte Carlo simulations with the PHITS code. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:011506. [PMID: 36599152 DOI: 10.1088/1361-6498/acaff0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Hadron radiation therapy is of great interest worldwide. Heavy-ion beams provide ideal therapeutic conditions for deep-seated local tumours. At the Heidelberg Ion Beam Therapy Center (HIT, Germany), protons and carbon ions are already integrated into the clinical routine, while16O ions are still used for research only. To ensure the protection of the technical staff and members of the public, it is required to estimate the neutron dose distribution for optimal working conditions and at different locations. The Particle and Heavy Ion Transport Code System (PHITS) is used in this work to evaluate the dose rate distribution of secondary neutrons in a treatment room at HIT where16O ions are used: an equivalent target in soft tissue is considered in the shielding assessment to simulate the interaction of the beam with patients. The angular dependence of neutron fluences and energy spectra around the considered phantom were calculated. Alongside the spatial distribution of the neutron and photon fluence, a map of the effective dose rate was estimated using the ICRP fluence-to-effective dose conversion coefficients, exploiting the PHITS code's built-in capabilities. The capability of the actual shielding design of the studied HIT treatment room was approved.
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Affiliation(s)
- Nabil Ounoughi
- Radiation Physics and Applications Laboratory, Mohammed Seddik Benyahia University, Jijel, Algeria
| | - Abdelmalek Boukhellout
- Radiation Physics and Applications Laboratory, Mohammed Seddik Benyahia University, Jijel, Algeria
| | - Faycal Kharfi
- Laboratory of Dosing, Analysis and Characterization in High Resolution (DAC), Ferhat Abbas Setif1 University, Setif, Algeria
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12
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Attili A, Scifoni E, Tommasino F. Modelling the HPRT-gene mutation induction of particle beams: systematic in vitro data collection, analysis and microdosimetric kinetic model implementation. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac8c80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/24/2022] [Indexed: 11/11/2022]
Abstract
Abstract
Objective. Since the early years, particle therapy treatments have been associated with concerns for late toxicities, especially secondary cancer risk (SCR). Nowadays, this concern is related to patients for whom long-term survival is expected (e.g. breast cancer, lymphoma, paediatrics). In the aim to contribute to this research, we present a dedicated statistical and modelling analysis aiming at improving our understanding of the RBE for mutation induction (
RBE
M
˜
) for different particle species. Approach. We built a new database based on a systematic collection of RBE data for mutation assays of the gene encoding for the purine salvage enzyme hypoxanthine-guanine phosphoribosyltransferase from literature (105 entries, distributed among 3 cell lines and 16 particle species). The data were employed to perform statistical and modelling analysis. For the latter, we adapted the microdosimetric kinetic model (MKM) to describe the mutagenesis in analogy to lethal lesion induction. Main results. Correlation analysis between RBE for survival (RBES) and
RBE
M
˜
reveals significant correlation between these two quantities (ρ = 0.86, p < 0.05). The correlation gets stronger when looking at subsets of data based on cell line and particle species. We also show that the MKM can be successfully employed to describe
RBE
M
˜
,
obtaining comparably good agreement with the experimental data. Remarkably, to improve the agreement with experimental data the MKM requires, consistently in all the analysed cases, a reduced domain size for the description of mutation induction compared to that adopted for survival. Significance. We were able to show that RBES and
RBE
M
˜
are strongly related quantities. We also showed for the first time that the MKM could be successfully applied to the description of mutation induction, representing an endpoint different from the more traditional cell killing. In analogy to the RBES,
RBE
M
˜
can be implemented into treatment planning system evaluations.
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13
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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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14
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Fattori S, Petringa G, Agosteo S, Bortot D, Conte V, Cuttone G, Di Fini A, Farokhi F, Mazzucconi D, Pandola L, Petrović I, Ristić-Fira A, Rosenfeld A, Weber U, Cirrone GAP. 4He dose- and track-averaged linear energy transfer: Monte Carlo algorithms and experimental verification. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac776f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 06/09/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. In the present hadrontherapy scenario, there is a growing interest in exploring the capabilities of different ion species other than protons and carbons. The possibility of using different ions paves the way for new radiotherapy approaches, such as the multi-ions treatment, where radiation could vary according to target volume, shape, depth and histologic characteristics of the tumor. For these reasons, in this paper, the study and understanding of biological-relevant quantities was extended for the case of 4He ion. Approach. Geant4 Monte Carlo based algorithms for dose- and track-averaged LET (Linear Energy Transfer) calculations, were validated for 4He ions and for the case of a mixed field characterised by the presence of secondary ions from both target and projectile fragmentation. The simulated dose and track averaged LETs were compared with the corresponding dose and frequency mean values of the lineal energy,
y
D
¯
and
y
¯
F
, derived from experimental microdosimetric spectra. Two microdosimetric experimental campaigns were carried out at the Italian eye proton therapy facility of the Laboratori Nazionali del Sud of Istituto Nazionale di Fisica Nucleare (INFN-LNS, Catania, I) using two different microdosimeters: the MicroPlus probe and the nano-TEPC (Tissue Equivalent Proportional Counter). Main results. A good agreement of
L
¯
d
Total
and
L
¯
t
Total
with
y
¯
D
and
y
¯
T
experimentally measured with both microdosimetric detectors MicroPlus and nano-TEPC in two configurations: full energy and modulated 4He ion beam, was found. Significance. The results of this study certify the use of a very effective tool for the precise calculation of LET, given by a Monte Carlo approach which has the advantage of allowing detailed simulation and tracking of nuclear interactions, even in complex clinical scenarios.
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15
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Battestini M, Schwarz M, Krämer M, Scifoni E. Including Volume Effects in Biological Treatment Plan Optimization for Carbon Ion Therapy: Generalized Equivalent Uniform Dose-Based Objective in TRiP98. Front Oncol 2022; 12:826414. [PMID: 35387111 PMCID: PMC8979211 DOI: 10.3389/fonc.2022.826414] [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: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
We describe a way to include biologically based objectives in plan optimization specific for carbon ion therapy, beyond the standard voxel-dose-based criteria already implemented in TRiP98, research planning software for ion beams. The aim is to account for volume effects—tissue architecture-dependent response to damage—in the optimization procedure, using the concept of generalized equivalent uniform dose (gEUD), which is an expression to convert a heterogeneous dose distribution (e.g., in an organ at risk (OAR)) into a uniform dose associated with the same biological effect. Moreover, gEUD is closely related to normal tissue complication probability (NTCP). The multi-field optimization problem here takes also into account the relative biological effectiveness (RBE), which in the case of ion beams is not factorizable and introduces strong non-linearity. We implemented the gEUD-based optimization in TRiP98, allowing us to control the whole dose–volume histogram (DVH) shape of OAR with a single objective by adjusting the prescribed gEUD0 and the volume effect parameter a, reducing the volume receiving dose levels close to mean dose when a = 1 (large volume effect) while close to maximum dose for a >> 1 (small volume effect), depending on the organ type considered. We studied the role of gEUD0 and a in the optimization, and we compared voxel-dose-based and gEUD-based optimization in chordoma cases with different anatomies. In particular, for a plan containing multiple OARs, we obtained the same target coverage and similar DVHs for OARs with a small volume effect while decreasing the mean dose received by the proximal parotid, thus reducing its NTCP by a factor of 2.5. Further investigations are done for this plan, considering also the distal parotid gland, obtaining a NTCP reduction by a factor of 1.9 for the proximal and 2.9 for the distal one. In conclusion, this novel optimization method can be applied to different OARs, but it achieves the largest improvement for organs whose volume effect is larger. This allows TRiP98 to perform a double level of biologically driven optimization for ion beams, including at the same time RBE-weighted dose and volume effects in inverse planning. An outlook is presented on the possible extension of this method to the target.
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Affiliation(s)
- Marco Battestini
- Department of Physics, University of Trento, Trento, Italy.,Trento Institute for Fundamental Physics and Applications (TIFPA), Istituto Nazionale di Fisica Nucleare (INFN), Trento, Italy
| | - Marco Schwarz
- Trento Institute for Fundamental Physics and Applications (TIFPA), Istituto Nazionale di Fisica Nucleare (INFN), Trento, Italy.,Trento Proton Therapy Center, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Michael Krämer
- Biophysics Department, GSI - Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Applications (TIFPA), Istituto Nazionale di Fisica Nucleare (INFN), Trento, Italy
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16
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Chen G, Cui J, Qian J, Zhu J, Zhao L, Luo B, Cui T, Zhong L, Yang F, Yang G, Zhao X, Zhou Y, Geng M, Sun J. Rapid Progress in Intelligent Radiotherapy and Future Implementation. Cancer Invest 2022; 40:425-436. [PMID: 35225723 DOI: 10.1080/07357907.2022.2044842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Radiotherapy is one of the major approaches to cancer treatment. Artificial intelligence in radiotherapy (shortly, Intelligent radiotherapy) mainly involves big data, deep learning, extended reality, digital twin, radiomics, Internet plus and Internet of Things (IoT), which establish an automatic and intelligent network platform consisting of radiotherapy preparation, target volume delineation, treatment planning, radiation delivery, quality assurance (QA) and quality control (QC), prognosis judgment and post-treatment follow-up. Intelligent radiotherapy is an interdisciplinary frontier discipline in infancy. The review aims to summary the important implements of intelligent radiotherapy in various areas and put forward the future of unmanned radiotherapy center.
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Affiliation(s)
- Guangpeng Chen
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Jianxiong Cui
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China.,Department of Oncology, Sichuan Provincial Crops Hospital of Chinese People's Armed Police Forces, Leshan 614000, Sichuan, P.R. China
| | - Jindong Qian
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Jianbo Zhu
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Lirong Zhao
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Bangyu Luo
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Tianxiang Cui
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Liangzhi Zhong
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Fan Yang
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Guangrong Yang
- Qijiang District People's Hospital, Chongqing 401420, P.R. China
| | - Xianlan Zhao
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Yibing Zhou
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
| | - Mingying Geng
- Department of Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, P.R. China
| | - Jianguo Sun
- Department of Oncology, Xinqiao Hospital, Army Medical University, Chongqing 400037, P.R. China
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17
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Boukhellout A, Ounoughi N, Kharfi F. MONTE-CARLO SIMULATION USING PHITS OF SECONDARY NEUTRONS PRODUCED IN-PATIENT DURING 16O ION THERAPY. RADIATION PROTECTION DOSIMETRY 2022; 198:31-36. [PMID: 35037066 DOI: 10.1093/rpd/ncab188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
In hadrontherapy, oxygen ions 16O can be currently considered as an alternative to carbon ions 12C designed specifically for the treatment of deep and radioresistant tumors. Secondary particles, particularly neutrons constitute a serious problem of undesirable additional irradiation to surrounding healthy tissue. The objective of this study is to evaluate, by Monte-Carlo simulation [code Particle and Heavy Ion Transport code System (PHITS)], the contribution in terms of dose of secondary neutrons produced during interaction 16O ion of 300 MeV u-1 in a soft tissue phantom. The dose of 16O ion, secondary particles and neutrons is evaluated, as well as the particle fluence and energy spectra of neutrons. The contribution to the total dose of secondary neutrons in a soft tissue phantom represents 0.1%. This dose, although apparently insignificant, is essential to conduct even more in-depth studies to understand the long-term effects of these secondary neutrons on the patient's body especially in pediatric case.
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Affiliation(s)
- A Boukhellout
- Radiation Physics and Applications Laboratory, Mohammed Seddik Benyahia University, BP 98, Ouled, Aissa Jijel 18000, Algeria
| | - N Ounoughi
- Radiation Physics and Applications Laboratory, Mohammed Seddik Benyahia University, BP 98, Ouled, Aissa Jijel 18000, Algeria
| | - F Kharfi
- Laboratory of Dosing, Analysis and Characterization in High Resolution (DAC), Ferhat Abbas, Setif1 University, Setif 19000, Algeria
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18
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Hymers D, Kasanda E, Bildstein V, Easter J, Richard A, Spyrou A, Höhr C, Mücher D. Intra- and inter-fraction relative range verification in heavy-ion therapy using filtered interaction vertex imaging. Phys Med Biol 2021; 66. [PMID: 34794127 DOI: 10.1088/1361-6560/ac3b33] [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: 06/07/2021] [Accepted: 11/18/2021] [Indexed: 12/09/2022]
Abstract
Heavy-ion therapy, particularly using scanned (active) beam delivery, provides a precise and highly conformal dose distribution, with maximum dose deposition for each pencil beam at its endpoint (Bragg peak), and low entrance and exit dose. To take full advantage of this precision, robust range verification methods are required; these methods ensure that the Bragg peak is positioned correctly in the patient and the dose is delivered as prescribed. Relative range verification allows intra-fraction monitoring of Bragg peak spacing to ensure full coverage with each fraction, as well as inter-fraction monitoring to ensure all fractions are delivered consistently. To validate the proposed filtered interaction vertex imaging (IVI) method for relative range verification, a16O beam was used to deliver 12 Bragg peak positions in a 40 mm poly-(methyl methacrylate) phantom. Secondary particles produced in the phantom were monitored using position-sensitive silicon detectors. Events recorded on these detectors, along with a measurement of the treatment beam axis, were used to reconstruct the sites of origin of these secondary particles in the phantom. The distal edge of the depth distribution of these reconstructed points was determined with logistic fits, and the translation in depth required to minimize theχ2statistic between these fits was used to compute the range shift between any two Bragg peak positions. In all cases, the range shift was determined with sub-millimeter precision, to a standard deviation of the mean of 220(10)μm. This result validates filtered IVI as a reliable relative range verification method, which should be capable of monitoring each energy step in each fraction of a scanned heavy-ion treatment plan.
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Affiliation(s)
- Devin Hymers
- Department of Physics, University of Guelph, Guelph, ON, Canada
| | - Eva Kasanda
- Department of Physics, University of Guelph, Guelph, ON, Canada
| | | | - Joelle Easter
- Department of Physics, University of Guelph, Guelph, ON, Canada
| | - Andrea Richard
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI, United States of America.,Lawrence Livermore National Laboratory, Livermore, CA, United States of America
| | - Artemis Spyrou
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI, United States of America
| | | | - Dennis Mücher
- Department of Physics, University of Guelph, Guelph, ON, Canada.,TRIUMF, Vancouver, BC, Canada
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19
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Durante M, Debus J, Loeffler JS. Physics and biomedical challenges of cancer therapy with accelerated heavy ions. NATURE REVIEWS. PHYSICS 2021; 3:777-790. [PMID: 34870097 PMCID: PMC7612063 DOI: 10.1038/s42254-021-00368-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Radiotherapy should have low toxicity in the entrance channel (normal tissue) and be very effective in cell killing in the target region (tumour). In this regard, ions heavier than protons have both physical and radiobiological advantages over conventional X-rays. Carbon ions represent an excellent combination of physical and biological advantages. There are a dozen carbon-ion clinical centres in Europe and Asia, and more under construction or at the planning stage, including the first in the USA. Clinical results from Japan and Germany are promising, but a heated debate on the cost-effectiveness is ongoing in the clinical community, owing to the larger footprint and greater expense of heavy ion facilities compared with proton therapy centres. We review here the physical basis and the clinical data with carbon ions and the use of different ions, such as helium and oxygen. Research towards smaller and cheaper machines with more effective beam delivery is necessary to make particle therapy affordable. The potential of heavy ions has not been fully exploited in clinics and, rather than there being a single 'silver bullet', different particles and their combination can provide a breakthrough in radiotherapy treatments in specific cases.
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Affiliation(s)
- Marco Durante
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Institute of Condensed Matter Physics, Technische Universität Darmstadt, Darmstadt, Germany
| | - Jürgen Debus
- Department of Radiation Oncology and Heidelberg Ion Beam Therapy Center, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jay S. Loeffler
- Departments of Radiation Oncology and Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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20
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Ultra-High Dose Rate (FLASH) Carbon Ion Irradiation: Dosimetry and First Cell Experiments. Int J Radiat Oncol Biol Phys 2021; 112:1012-1022. [PMID: 34813912 DOI: 10.1016/j.ijrobp.2021.11.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 11/07/2021] [Accepted: 11/15/2021] [Indexed: 01/05/2023]
Abstract
PURPOSE To establish a beam monitoring and dosimetry system to enable the FLASH dose rate carbon ion irradiation and investigate, at different oxygen concentrations, the in vitro biological response in comparison to the conventional dose rate. METHODS AND MATERIALS CHO-K1 cell response to irradiation at different dose rates and at different levels of oxygenation was studied using clonogenic assay. The Heidelberg Ion-Beam Therapy Center (HIT) synchrotron, after technical improvements, was adjusted to extract ≥5 × 108 12C ions within approximately 150 milliseconds. The beam monitors were filled with helium. RESULTS The FLASH irradiation with beam scanning yields a dose of 7.5 Gy (homogeneity of ±5%) for a 280 MeV/u beam in a volume of at least 8 mm in diameter and a corresponding dose rate of 70 Gy/s (±20%). The dose repetition accuracy is better than 2%, the systematic uncertainty is better than 2%. Clonogenic assay demonstrates a significant FLASH sparing effect which is strongly oxygenation-dependent and mostly pronounced at 0.5% O2 but absent at 0% and 21% O2. CONCLUSION The FLASH dose rates >40 Gy/s were achieved with carbon beams. Cell survival analysis revealed FLASH dose rate sparing in hypoxia (0.5%-4% O2).
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21
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Inaniwa T, Kanematsu N, Shinoto M, Koto M, Yamada S. Adaptation of stochastic microdosimetric kinetic model to hypoxia for hypo-fractionated multi-ion therapy treatment planning. Phys Med Biol 2021; 66. [PMID: 34560678 DOI: 10.1088/1361-6560/ac29cc] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/24/2021] [Indexed: 11/11/2022]
Abstract
For hypo-fractionated multi-ion therapy (HFMIT), the stochastic microdosimetric kinetic (SMK) model had been developed to estimate the biological effectiveness of radiation beams with wide linear energy transfer (LET) and dose ranges. The HFMIT will be applied to radioresistant tumors with oxygen-deficient regions. The response of cells to radiation is strongly dependent on the oxygen condition in addition to radiation type, LET and absorbed dose. This study presents an adaptation of the SMK model to account for oxygen-pressure dependent cell responses, and develops the oxygen-effect-incorporated stochastic microdosimetric kinetic (OSMK) model. In the model, following assumptions were made: the numbers of radiation-induced sublethal lesions (double-strand breaks) are reduced due to lack of oxygen, and the numbers of oxygen-mediated lesions are reduced for radiation with high LET. The model parameters were determined by fitting survival data under aerobic and anoxic conditions for human salivary gland tumor cells and V79 cells exposed to helium-, carbon-, and neon-ion beams over the LET range of 18.5-654.0 keVμm-1. The OSMK model provided good agreement with the experimental survival data of the cells with determination coefficients >0.9. In terms of oxygen enhancement ratio, the OSMK model reproduced the experimental data behavior, including slight dependence on particle type at the same LET. The OSMK model was then implemented into the in-house treatment planning software for the HFMIT to validate its applicability in clinical practice. A treatment plan with helium- and neon-ion beams was made for a pancreatic cancer case assuming an oxygen-deficient region within the tumor. The biological optimization based on the OSMK model preferentially placed the neon-ion beam to the hypoxic region, while it placed both helium- and neon-ion beams to the surrounding normoxic region. The OSMK model offered the accuracy and usability required for hypoxia-based biological optimization in HFMIT treatment planning.
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Affiliation(s)
- Taku Inaniwa
- Department of Accelerator and Medical Physics, Institute for Quantum Medical Science, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Nobuyuki Kanematsu
- Department of Accelerator and Medical Physics, Institute for Quantum Medical Science, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Makoto Shinoto
- QST Hospital, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.,Department of Charged Particle Therapy Research, Institute for Quantum Medical Science, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Masashi Koto
- QST Hospital, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.,Department of Charged Particle Therapy Research, Institute for Quantum Medical Science, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Shigeru Yamada
- QST Hospital, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan.,Department of Charged Particle Therapy Research, Institute for Quantum Medical Science, QST, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
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22
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Bellinzona EV, Grzanka L, Attili A, Tommasino F, Friedrich T, Krämer M, Scholz M, Battistoni G, Embriaco A, Chiappara D, Cirrone GAP, Petringa G, Durante M, Scifoni E. Biological Impact of Target Fragments on Proton Treatment Plans: An Analysis Based on the Current Cross-Section Data and a Full Mixed Field Approach. Cancers (Basel) 2021; 13:cancers13194768. [PMID: 34638254 PMCID: PMC8507563 DOI: 10.3390/cancers13194768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 01/15/2023] Open
Abstract
Simple Summary Proton therapy is now an established external radiotherapy modality for cancer treatment. Clinical routine currently neglects the radiobiological impact of nuclear target fragments even if experimental evidences show a significant enhancement in cell-killing effect due to secondary particles. This paper quantifies the contribution of proton target fragments of different charge in different irradiation scenarios and compares the computationally predicted corrections to the overall biological dose with experimental data. Abstract Clinical routine in proton therapy currently neglects the radiobiological impact of nuclear target fragments generated by proton beams. This is partially due to the difficult characterization of the irradiation field. The detection of low energetic fragments, secondary protons and fragments, is in fact challenging due to their very short range. However, considering their low residual energy and therefore high LET, the possible contribution of such heavy particles to the overall biological effect could be not negligible. In this context, we performed a systematic analysis aimed at an explicit assessment of the RBE (relative biological effectiveness, i.e., the ratio of photon to proton physical dose needed to achieve the same biological effect) contribution of target fragments in the biological dose calculations of proton fields. The TOPAS Monte Carlo code has been used to characterize the radiation field, i.e., for the scoring of primary protons and fragments in an exemplary water target. TRiP98, in combination with LEM IV RBE tables, was then employed to evaluate the RBE with a mixed field approach accounting for fragments’ contributions. The results were compared with that obtained by considering only primary protons for the pristine beam and spread out Bragg peak (SOBP) irradiations, in order to estimate the relative weight of target fragments to the overall RBE. A sensitivity analysis of the secondary particles production cross-sections to the biological dose has been also carried out in this study. Finally, our modeling approach was applied to the analysis of a selection of cell survival and RBE data extracted from published in vitro studies. Our results indicate that, for high energy proton beams, the main contribution to the biological effect due to the secondary particles can be attributed to secondary protons, while the contribution of heavier fragments is mainly due to helium. The impact of target fragments on the biological dose is maximized in the entrance channels and for small α/β values. When applied to the description of survival data, model predictions including all fragments allowed better agreement to experimental data at high energies, while a minor effect was observed in the peak region. An improved description was also obtained when including the fragments’ contribution to describe RBE data. Overall, this analysis indicates that a minor contribution can be expected to the overall RBE resulting from target fragments. However, considering the fragmentation effects can improve the agreement with experimental data for high energy proton beams.
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Affiliation(s)
- Elettra Valentina Bellinzona
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), 38123 Trento, Italy; (E.V.B.); (F.T.)
- Department of Physics, University of Trento, 38123 Trento, Italy;
| | - Leszek Grzanka
- The Department of Radiation Research and Proton Radiotherapy, Institute of Nuclear Physics, Polish Academy of Sciences, 31-342 Krakow, Poland;
| | - Andrea Attili
- “Roma Tre” Section, INFN—National Institute for Nuclear Physics, 00146 Roma, Italy;
| | - Francesco Tommasino
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), 38123 Trento, Italy; (E.V.B.); (F.T.)
- Department of Physics, University of Trento, 38123 Trento, Italy;
| | - Thomas Friedrich
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (T.F.); (M.K.); (M.S.); (M.D.)
| | - Michael Krämer
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (T.F.); (M.K.); (M.S.); (M.D.)
| | - Michael Scholz
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (T.F.); (M.K.); (M.S.); (M.D.)
| | | | - Alessia Embriaco
- “Pavia” Section, INFN—National Institute for Nuclear Physics, 6-27100 Pavia, Italy;
| | - Davide Chiappara
- Laboratori Nazionali del Sud, INFN—National Institute for Nuclear Physics, 95125 Catania, Italy; (D.C.); (G.A.P.C.); (G.P.)
| | - Giuseppe A. P. Cirrone
- Laboratori Nazionali del Sud, INFN—National Institute for Nuclear Physics, 95125 Catania, Italy; (D.C.); (G.A.P.C.); (G.P.)
| | - Giada Petringa
- Laboratori Nazionali del Sud, INFN—National Institute for Nuclear Physics, 95125 Catania, Italy; (D.C.); (G.A.P.C.); (G.P.)
| | - Marco Durante
- Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (T.F.); (M.K.); (M.S.); (M.D.)
- Institut für Physik Kondensierter Materie, Technische Universität, 64289 Darmstadt, Germany
| | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), 38123 Trento, Italy; (E.V.B.); (F.T.)
- Department of Physics, University of Trento, 38123 Trento, Italy;
- Correspondence:
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23
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Boscolo D, Kostyleva D, Safari MJ, Anagnostatou V, Äystö J, Bagchi S, Binder T, Dedes G, Dendooven P, Dickel T, Drozd V, Franczack B, Geissel H, Gianoli C, Graeff C, Grahn T, Greiner F, Haettner E, Haghani R, Harakeh MN, Horst F, Hornung C, Hucka JP, Kalantar-Nayestanaki N, Kazantseva E, Kindler B, Knöbel R, Kuzminchuk-Feuerstein N, Lommel B, Mukha I, Nociforo C, Ishikawa S, Lovatti G, Nitta M, Ozoemelam I, Pietri S, Plaß WR, Prochazka A, Purushothaman S, Reidel CA, Roesch H, Schirru F, Schuy C, Sokol O, Steinsberger T, Tanaka YK, Tanihata I, Thirolf P, Tinganelli W, Voss B, Weber U, Weick H, Winfield JS, Winkler M, Zhao J, Scheidenberger C, Parodi K, Durante M. Radioactive Beams for Image-Guided Particle Therapy: The BARB Experiment at GSI. Front Oncol 2021; 11:737050. [PMID: 34504803 PMCID: PMC8422860 DOI: 10.3389/fonc.2021.737050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022] Open
Abstract
Several techniques are under development for image-guidance in particle therapy. Positron (β+) emission tomography (PET) is in use since many years, because accelerated ions generate positron-emitting isotopes by nuclear fragmentation in the human body. In heavy ion therapy, a major part of the PET signals is produced by β+-emitters generated via projectile fragmentation. A much higher intensity for the PET signal can be obtained using β+-radioactive beams directly for treatment. This idea has always been hampered by the low intensity of the secondary beams, produced by fragmentation of the primary, stable beams. With the intensity upgrade of the SIS-18 synchrotron and the isotopic separation with the fragment separator FRS in the FAIR-phase-0 in Darmstadt, it is now possible to reach radioactive ion beams with sufficient intensity to treat a tumor in small animals. This was the motivation of the BARB (Biomedical Applications of Radioactive ion Beams) experiment that is ongoing at GSI in Darmstadt. This paper will present the plans and instruments developed by the BARB collaboration for testing the use of radioactive beams in cancer therapy.
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Affiliation(s)
- Daria Boscolo
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Daria Kostyleva
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | | | | | - Juha Äystö
- University of Jyväskylä, Jyväskylä, Finland.,Helsinki Institute of Physics, Helsinki, Finland
| | | | - Tim Binder
- Ludwig-Maximilians-Universität München, Munich, Germany
| | | | | | - Timo Dickel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Vasyl Drozd
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,University of Groningen, Groningen, Netherlands
| | | | - Hans Geissel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Justus-Liebig-Universität Gießen, Gießen, Germany
| | | | - Christian Graeff
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Tuomas Grahn
- University of Jyväskylä, Jyväskylä, Finland.,Helsinki Institute of Physics, Helsinki, Finland
| | - Florian Greiner
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Emma Haettner
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | | | | | - Felix Horst
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Christine Hornung
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Technische Universität Darmstadt, Darmstadt, Germany
| | - Jan-Paul Hucka
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Technische Universität Darmstadt, Darmstadt, Germany
| | | | - Erika Kazantseva
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Birgit Kindler
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Ronja Knöbel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | | | - Bettina Lommel
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Ivan Mukha
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Chiara Nociforo
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | | | | | | | | | - Stephane Pietri
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Wolfgang R Plaß
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Justus-Liebig-Universität Gießen, Gießen, Germany
| | | | | | | | - Heidi Roesch
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Technische Universität Darmstadt, Darmstadt, Germany
| | - Fabio Schirru
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Christoph Schuy
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Olga Sokol
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Timo Steinsberger
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Technische Universität Darmstadt, Darmstadt, Germany
| | | | - Isao Tanihata
- Research Center for Nuclear Physics, Osaka University, Osaka, Japan.,Peking University, Beijing, China.,Institute of Modern Physics, Lanzhou, China
| | - Peter Thirolf
- Ludwig-Maximilians-Universität München, Munich, Germany
| | | | - Bernd Voss
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Uli Weber
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Helmut Weick
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - John S Winfield
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Martin Winkler
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Jianwei Zhao
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Peking University, Beijing, China
| | - Christoph Scheidenberger
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Katia Parodi
- Ludwig-Maximilians-Universität München, Munich, Germany
| | - Marco Durante
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Technische Universität Darmstadt, Darmstadt, Germany
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24
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Nickoloff JA, Sharma N, Allen CP, Taylor L, Allen SJ, Jaiswal AS, Hromas R. Roles of homologous recombination in response to ionizing radiation-induced DNA damage. Int J Radiat Biol 2021; 99:903-914. [PMID: 34283012 PMCID: PMC9629169 DOI: 10.1080/09553002.2021.1956001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/04/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Ionizing radiation induces a vast array of DNA lesions including base damage, and single- and double-strand breaks (SSB, DSB). DSBs are among the most cytotoxic lesions, and mis-repair causes small- and large-scale genome alterations that can contribute to carcinogenesis. Indeed, ionizing radiation is a 'complete' carcinogen. DSBs arise immediately after irradiation, termed 'frank DSBs,' as well as several hours later in a replication-dependent manner, termed 'secondary' or 'replication-dependent DSBs. DSBs resulting from replication fork collapse are single-ended and thus pose a distinct problem from two-ended, frank DSBs. DSBs are repaired by error-prone nonhomologous end-joining (NHEJ), or generally error-free homologous recombination (HR), each with sub-pathways. Clarifying how these pathways operate in normal and tumor cells is critical to increasing tumor control and minimizing side effects during radiotherapy. CONCLUSIONS The choice between NHEJ and HR is regulated during the cell cycle and by other factors. DSB repair pathways are major contributors to cell survival after ionizing radiation, including tumor-resistance to radiotherapy. Several nucleases are important for HR-mediated repair of replication-dependent DSBs and thus replication fork restart. These include three structure-specific nucleases, the 3' MUS81 nuclease, and two 5' nucleases, EEPD1 and Metnase, as well as three end-resection nucleases, MRE11, EXO1, and DNA2. The three structure-specific nucleases evolved at very different times, suggesting incremental acceleration of replication fork restart to limit toxic HR intermediates and genome instability as genomes increased in size during evolution, including the gain of large numbers of HR-prone repetitive elements. Ionizing radiation also induces delayed effects, observed days to weeks after exposure, including delayed cell death and delayed HR. In this review we highlight the roles of HR in cellular responses to ionizing radiation, and discuss the importance of HR as an exploitable target for cancer radiotherapy.
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Affiliation(s)
- Jac A. Nickoloff
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Neelam Sharma
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Christopher P. Allen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
- Department of Microbiology, Immunology and Pathology, Flow Cytometry and Cell Sorting Facility, Colorado State University, Fort Collins, CO, USA
| | - Lynn Taylor
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sage J. Allen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Aruna S. Jaiswal
- Division of Hematology and Medical Oncology, Department of Medicine and the Mays Cancer Center, University of Texas Health Science Center, San Antonio, TX, USA
| | - Robert Hromas
- Division of Hematology and Medical Oncology, Department of Medicine and the Mays Cancer Center, University of Texas Health Science Center, San Antonio, TX, USA
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25
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Hufnagl A, Scholz M, Friedrich T. Modeling Radiation-Induced Neoplastic Cell Transformation In Vitro and Tumor Induction In Vivo with the Local Effect Model. Radiat Res 2021; 195:427-440. [PMID: 33760917 DOI: 10.1667/rade-20-00160.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/22/2021] [Indexed: 11/03/2022]
Abstract
Ionizing radiation induces DNA damage to cycling cells which, if left unrepaired or misrepaired, can cause cell inactivation or heritable, viable mutations. The latter can lead to cell transformation, which is thought to be an initial step of cancer formation. Consequently, the study of radiation-induced cell transformation promises to offer insights into the general properties of radiation carcinogenesis. As for other end points, the effectiveness in inducing cell transformation is elevated for radiation qualities with high linear energy transfer (LET), and the same is true for cancer induction. In considering DNA damage as a common cause of both cell death and transformations, a worthwhile approach is to apply mathematical models for the relative biological effectiveness (RBE) of cell killing to also assess the carcinogenic potential of high-LET radiation. In this work we used an established RBE model for cell survival and clinical end points, the local effect model (LEM), to estimate the transformation probability and the carcinogenic potential of ion radiation. The provided method consists of accounting for the competing processes of cell inactivation and induction of transformations or carcinogenic events after radiation exposure by a dual use of the LEM. Correlations between both processes inferred by the number of particle impacts to individual cells were considered by summing over the distribution of hits that individual cells receive. RBE values for cell transformation in vitro were simulated for three independent data sets, which were also used to gauge the approach. The simulations reflect the general RBE systematics both in magnitude and in energy and LET dependence. To challenge the developed method, in vivo carcinogenesis was investigated using the same concepts, where the probability for cancer induction within an irradiated organ was derived from the probability of finding carcinogenic events in individual cells. The predictions were compared with experimental data of carcinogenesis in Harderian glands of mice. Again, the developed method shows the same characteristics as the experimental data. We conclude that the presented method is helpful to predictively assess RBE for both neoplastic cell transformation and tumor induction after ion exposure within a wide range of LET values. The theoretical concept requires a non-linear component in the photon dose response for carcinogenic end points as a precondition for the observed enhanced effects after ion exposure, thus contributing to a long debate in epidemiology. Future work will use the method for assessing cancer induction in radiation therapy and exposure scenarios frequently discussed in radiation protection.
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Affiliation(s)
- Antonia Hufnagl
- GSI Helmholtz Centre for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
| | - Michael Scholz
- GSI Helmholtz Centre for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
| | - Thomas Friedrich
- GSI Helmholtz Centre for Heavy Ion Research, Department of Biophysics, Darmstadt, Germany
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26
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Durante M. Failla Memorial Lecture: The Many Facets of Heavy-Ion Science. Radiat Res 2021; 195:403-411. [PMID: 33979440 DOI: 10.1667/rade-21-00029.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/22/2021] [Indexed: 11/03/2022]
Abstract
Heavy ions are riveting in radiation biophysics, particularly in the areas of radiotherapy and space radiation protection. Accelerated charged particles can indeed penetrate deeply in the human body to sterilize tumors, exploiting the favorable depth-dose distribution of ions compared to conventional X rays. Conversely, the high biological effectiveness in inducing late effects presents a hazard for manned space exploration. Even after half a century of accelerator-based experiments, clinical applications and flight research, these two topics remain both fascinating and baffling. Heavy-ion therapy is very expensive, and despite the clinical success it remains controversial. Research on late radiation morbidity in spaceflight led to a reduction in uncertainty, but also pointed to new risks previously underestimated, such as possible damage to the central nervous system. Recently, heavy ions have also been used in other, unanticipated biomedical fields, such as treatment of heart arrhythmia or inactivation of viruses for vaccine development. Heavy-ion science nicely merges physics and biology and remains an extraordinary research field for the 21st century.
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Affiliation(s)
- Marco Durante
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; and Technische Universität Darmstadt, Institute of Condensed Matter Physics, 64289 Darmstadt, Germany
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27
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Lee SH, Mizushima K, Kohno R, Iwata Y, Yonai S, Shirai T, Pan VA, Bolst D, Tran LT, Rosenfeld AB, Suzuki M, Inaniwa T. Estimating the biological effects of helium, carbon, oxygen, and neon ion beams using 3D silicon microdosimeters. Phys Med Biol 2021; 66:045017. [PMID: 33361575 DOI: 10.1088/1361-6560/abd66f] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this study, the survival fraction (SF) and relative biological effectiveness (RBE) of pancreatic cancer cells exposed to spread-out Bragg peak helium, carbon, oxygen, and neon ion beams are estimated from the measured microdosimetric spectra using a microdosimeter and the application of the microdosimetric kinetic (MK) model. To measure the microdosimetric spectra, a 3D mushroom silicon-on-insulator microdosimeter connected to low noise readout electronics (MicroPlus probe) was used. The parameters of the MK model were determined for pancreatic cancer cells such that the calculated SFs reproduced previously reported in vitro SF data. For a cuboid target of 10 × 10 × 6 cm3, treatment plans of helium, carbon, oxygen, and neon ion beams were designed using in-house treatment planning software (TPS) to achieve a 10% SF of pancreatic cancer cells throughout the target. The physical doses and microdosimetric spectra of the planned fields were measured at different depths in polymethyl methacrylate phantoms. The biological effects, such as SF, RBE, and RBE-weighted dose at different depths along the fields were predicted from the measurements. The predicted SFs at the target region were generally in good agreement with the planned SF from the TPS in most cases.
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Affiliation(s)
- Sung Hyun Lee
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, QST, Japan
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28
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Inaniwa T, Abe Y, Suzuki M, Lee SH, Mizushima K, Nakaji T, Sakata D, Sato S, Iwata Y, Kanematsu N, Shirai T. Application of lung substitute material as ripple filter for multi-ion therapy with helium-, carbon-, oxygen-, and neon-ion beams. Phys Med Biol 2021; 66. [PMID: 33477116 DOI: 10.1088/1361-6560/abde99] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/21/2021] [Indexed: 12/19/2022]
Abstract
A development project for hypo-fractionated multi-ion therapy has been initiated at the National Institute of Radiological Sciences in Japan. In the treatment, helium, carbon, oxygen, and neon ions will be used as primary beams with pencil beam scanning. A ripple filter (RiFi), consisting of a thin plastic or aluminum plate with a fine periodic ridge and groove structure, has been used to broaden the Bragg peak of heavy-ion beams in the beam direction. To sufficiently broaden the Bragg peak of helium-, carbon-, oxygen-, and neon-ion beams with suppressed lateral scattering and surface dose inhomogeneity, in this study, we tested a plate made of a lung substitute material, Gammex LN300, as the RiFi. The planar integrated dose distribution of a 183.5-MeV/u neon-ion beam was measured behind a 3-cm-thick LN300 plate in water. The Bragg peak of the pristine beam was broadened following the normal distribution with the standard deviation value of 1.29 mm, while the range of the beam was reduced by 8.8 mm by the plate. To verify the LN300 performance as the RiFi in multi-ion therapy, we measured the pencil beam data of helium-, carbon-, oxygen, and neon-ion beams penetrating the 3-cm-thick LN300 plate. The data were then modeled and used in a treatment planning system to achieve a uniform 10% survival of human undifferentiated carcinoma cells within a cuboid target by the beam for each of the different ion species. The measured survival fractions were reasonably reproduced by the planned ones for all the ion species. No surface dose inhomogeneity was observed for any ion species even when the plate was placed close to the phantom surface. The plate made of lung substitute material, Gammex LN300, is applicable as the RiFi in multi-ion therapy with helium-, carbon-, oxygen, and neon-ion beams.
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Affiliation(s)
- Taku Inaniwa
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, JAPAN
| | - Yasushi Abe
- National Institute of Radiological Sciences, Department of Accelerator and Medical Physics, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, JAPAN
| | - Masao Suzuki
- Department of Basic Medical Sciences for Radiation Damages, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology National Institute of Radiological Sciences, Chiba, Chiba, JAPAN
| | - Sung Hyun Lee
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, JAPAN
| | - Kota Mizushima
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, JAPAN
| | - Taku Nakaji
- Quality Control Section, QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, JAPAN
| | - Dousatsu Sakata
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, JAPAN
| | - Shinji Sato
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, JAPAN
| | - Yoshiyuki Iwata
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, JAPAN
| | - Nobuyuki Kanematsu
- Department of Accelerator and Medical Physics, National Institutes for Quantum and Radiological Science and Technology National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, JAPAN
| | - Toshiyuki Shirai
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Chiba, JAPAN
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Kartini DA, Sokol O, Wiedemann J, Tinganelli W, Witt M, Camazzola G, Krämer M, Talabnin C, Kobdaj C, Fuss MC. Validation of a pseudo-3D phantom for radiobiological treatment plan verifications. Phys Med Biol 2020; 65:225039. [PMID: 32937608 DOI: 10.1088/1361-6560/abb92d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Performing realistic and reliable in vitro biological dose verification with good resolution for a complex treatment plan remains a challenge in particle beam therapy. Here, a new 3D bio-phantom consisting of 96-well plates containing cells embedded into Matrigel matrix was investigated as an alternative tool for biological dose verification. Feasibility tests include cell growth in the Matrigel as well as film dosimetric experiments that rule out the appearance of field inhomogeneities due to the presence of the well plate irregular structure. The response of CHO-K1 cells in Matrigel to radiation was studied by obtaining survival curves following x-ray and monoenergetic 12C ion irradiation, which showed increased radioresistance of 3D cell cultures in Matrigel as compared to a monolayer. Finally, as a proof of concept, a 12C treatment plan was optimized using in-house treatment planning system TRiP98 for uniform cell survival in a rectangular volume and employed to irradiate the 3D phantom. Cell survival distribution in the Matrigel-based phantom was analyzed and compared to cell survival in a reference setup using cell monolayers. Results of both methods were in good agreement and followed the TRiP98 calculation. Therefore, we conclude that this 3D bio-phantom can be a suitable, accurate alternative tool for verifying the biological effect calculated by treatment planning systems, which could be applied to test novel treatment planning approaches involving multiple fields, multiple ion modalities, complex geometries, or unconventional optimization strategies.
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Affiliation(s)
- D A Kartini
- School of Physics, Suranaree University of Technology, 111 University Avenue, Muang, Nakhon Ratchasima 30000, Thailand. Thailand Center of Excellence in Physics, Ministry of Higher Education, Science, Research and Innovation, 328 Si Ayutthaya Road, Bangkok 10400, Thailand. Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstrasse 1, 64291 Darmstadt, Germany
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Carbon Ion Radiobiology. Cancers (Basel) 2020; 12:cancers12103022. [PMID: 33080914 PMCID: PMC7603235 DOI: 10.3390/cancers12103022] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Radiotherapy with carbon ions has been used for over 20 years in Asia and Europe and is now planned in the USA. The physics advantages of carbon ions compared to X-rays are similar to those of protons, but their radiobiological features are quite distinct and may lead to a breakthrough in the treatment of some cancers characterized by high mortality. Abstract Radiotherapy using accelerated charged particles is rapidly growing worldwide. About 85% of the cancer patients receiving particle therapy are irradiated with protons, which have physical advantages compared to X-rays but a similar biological response. In addition to the ballistic advantages, heavy ions present specific radiobiological features that can make them attractive for treating radioresistant, hypoxic tumors. An ideal heavy ion should have lower toxicity in the entrance channel (normal tissue) and be exquisitely effective in the target region (tumor). Carbon ions have been chosen because they represent the best combination in this direction. Normal tissue toxicities and second cancer risk are similar to those observed in conventional radiotherapy. In the target region, they have increased relative biological effectiveness and a reduced oxygen enhancement ratio compared to X-rays. Some radiobiological properties of densely ionizing carbon ions are so distinct from X-rays and protons that they can be considered as a different “drug” in oncology, and may elicit favorable responses such as an increased immune response and reduced angiogenesis and metastatic potential. The radiobiological properties of carbon ions should guide patient selection and treatment protocols to achieve optimal clinical results.
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31
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Schaub L, Harrabi SB, Debus J. Particle therapy in the future of precision therapy. Br J Radiol 2020; 93:20200183. [PMID: 32795176 DOI: 10.1259/bjr.20200183] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The first hospital-based treatment facilities for particle therapy started operation about thirty years ago. Since then, the clinical experience with protons and carbon ions has grown continuously and more than 200,000 patients have been treated to date. The promising clinical results led to a rapidly increasing number of treatment facilities and many new facilities are planned or under construction all over the world. An inverted depth-dose profile combined with potential radiobiological advantages make charged particles a precious tool for the treatment of tumours that are particularly radioresistant or located nearby sensitive structures. A rising number of trials have already confirmed the benefits of particle therapy in selected clinical situations and further improvements in beam delivery, image guidance and treatment planning are expected. This review summarises some physical and biological characteristics of accelerated charged particles and gives some examples of their clinical application. Furthermore, challenges and future perspectives of particle therapy will be discussed.
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Affiliation(s)
- Lukas Schaub
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.,National Center for Tumor diseases (NCT), Heidelberg, Germany
| | - Semi Ben Harrabi
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.,National Center for Tumor diseases (NCT), Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg University Hospital, Heidelberg, Germany
| | - Juergen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.,National Center for Tumor diseases (NCT), Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg University Hospital, Heidelberg, Germany.,German Cancer Consortium (DKTK), partner site Heidelberg, Heidelberg, Germany
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32
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Fiorino C, Guckemberger M, Schwarz M, van der Heide UA, Heijmen B. Technology-driven research for radiotherapy innovation. Mol Oncol 2020; 14:1500-1513. [PMID: 32124546 PMCID: PMC7332218 DOI: 10.1002/1878-0261.12659] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/27/2020] [Accepted: 02/10/2020] [Indexed: 12/16/2022] Open
Abstract
Technology has a pivotal role in the continuous development of radiotherapy. The long road toward modern ‘high‐tech’ radiation oncology has been studded with discoveries and technological innovations that resulted from the interaction of various disciplines. In the last decades, a dramatic technology‐driven revolution has hugely improved the capability of accurately and safely delivering complex‐shaped dose distributions. This has contributed to many clinical improvements, such as the successful management of lung cancer and oligometastatic disease through stereotactic body radiotherapy. Technology‐driven research is an active and lively field with promising potential in several domains, including image guidance, adaptive radiotherapy, integration of artificial intelligence, heavy‐particle therapy, and ‘flash’ ultra‐high dose‐rate radiotherapy. The evolution toward personalized Oncology will deeply influence technology‐driven research, aiming to integrate predictive models and omics analyses into fast and efficient solutions to deliver the best treatment for each single patient. Personalized radiation oncology will need affordable technological solutions for middle‐/low‐income countries, as these are expected to experience the highest increase of cancer incidence and mortality. Moreover, technology solutions for automation of commissioning, quality assurance, safety tests, image segmentation, and plan optimization will be required. Although a large fraction of cancer patients receive radiotherapy, this is certainly not reflected in the worldwide budget for radiotherapy research. Differently from the pharmaceutical companies‐driven research, resources for research in radiotherapy are highly limited to equipment vendors, who can, in turn, initiate a limited number of collaborations with academic research centers. Thus, enhancement of investments in technology‐driven radiotherapy research via public funds, national governments, and the European Union would have a crucial societal impact. It would allow for radiotherapy to further strengthen its role as a highly effective and cost‐efficient cancer treatment modality, and it could facilitate a rapid and equalitarian large‐scale transfer of technology to clinic, with direct impact on patient care.
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Affiliation(s)
- Claudio Fiorino
- Medical Physics, San Raffaele Scientific Institute, Milano, Italy
| | - Matthias Guckemberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland
| | - Marco Schwarz
- Protontherapy Department, Trento Hospital and TIFPA-INFN, Trento, Italy
| | - Uulke A van der Heide
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ben Heijmen
- Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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33
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Scholz M. State-of-the-Art and Future Prospects of Ion Beam Therapy: Physical and Radiobiological Aspects. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2020. [DOI: 10.1109/trpms.2019.2935240] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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34
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Inaniwa T, Suzuki M, Hyun Lee S, Mizushima K, Iwata Y, Kanematsu N, Shirai T. Experimental validation of stochastic microdosimetric kinetic model for multi-ion therapy treatment planning with helium-, carbon-, oxygen-, and neon-ion beams. ACTA ACUST UNITED AC 2020; 65:045005. [DOI: 10.1088/1361-6560/ab6eba] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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35
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Inaniwa T, Lee SH, Mizushima K, Sakata D, Iwata Y, Kanematsu N, Shirai T. Nuclear-interaction correction for patient dose calculations in treatment planning of helium-, carbon-, oxygen-, and neon-ion beams. Phys Med Biol 2020; 65:025004. [PMID: 31816612 DOI: 10.1088/1361-6560/ab5fee] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In charged-particle therapy treatment planning, the patient is conventionally modeled as variable-density water, i.e. stopping effective density ρ S, and the planar integrated dose distribution measured in water (PID) is applied for patient dose calculation based on path length scaling with the ρ S. This approximation assures the range accuracy of charged-particle beams. However, it causes dose calculation errors due to water nonequivalence of body tissues in nuclear interactions originating from compositional differences. We had previously proposed and validated a PID correction method for the errors in carbon-ion radiotherapy. In the present study, we verify the PID correction method for helium-, oxygen-, and neon-ion beams. The one-to-one relationships between ρ S and the nuclear effective density ρ N of body tissues were constructed for helium-, carbon-, oxygen-, and neon-ion beams, and were used to correct the PIDs to account for the dose calculation errors in patient. The correction method was tested for non-water materials with un-scanned and scanned ion beams. In un-scanned beams penetrating the materials, the dose calculation errors of up to 5.9% were observed at the Bragg peak region, while they were reduced to ⩽0.9% by the PID correction method. In scanned beams penetrating olive oil, the dose calculation errors of up to 2.7% averaged over the spread-out Bragg peak were observed, while they were reduced to ⩽0.4% by the correction method. To investigate the influence of water nonequivalence of body tissues on tumor dose, we carried out a treatment planning study for prostate and uterine cases. The tumor over-doses of 0.9%, 1.8%, 2.0%, and 2.2% were observed in the uterine case for the helium-, carbon-, oxygen-, and neon-ion beams, respectively. These dose errors could be diminished by the PID correction method. The present results verify that the PID correction method is simple, practical, and accurate for treatment planning of these four ion species.
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Affiliation(s)
- Taku Inaniwa
- Author to whom any correspondence should be addressed
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36
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Boscolo D, Krämer M, Fuss MC, Durante M, Scifoni E. Impact of Target Oxygenation on the Chemical Track Evolution of Ion and Electron Radiation. Int J Mol Sci 2020; 21:ijms21020424. [PMID: 31936545 PMCID: PMC7014692 DOI: 10.3390/ijms21020424] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/04/2020] [Accepted: 01/07/2020] [Indexed: 12/26/2022] Open
Abstract
The radiosensitivity of biological systems is strongly affected by the system oxygenation. On the nanoscopic scale and molecular level, this effect is considered to be strongly related to the indirect damage of radiation. Even though particle track radiolysis has been the object of several studies, still little is known about the nanoscopic impact of target oxygenation on the radical yields. Here we present an extension of the chemical module of the Monte Carlo particle track structure code TRAX, taking into account the presence of dissolved molecular oxygen in the target material. The impact of the target oxygenation level on the chemical track evolution and the yields of all the relevant chemical species are studied in water under different irradiation conditions: different linear energy transfer (LET) values, different oxygenation levels, and different particle types. Especially for low LET radiation, a large production of two highly toxic species ( HO 2 • and O 2 • - ), which is not produced in anoxic conditions, is predicted and quantified in oxygenated solutions. The remarkable correlation between the HO 2 • and O 2 • - production yield and the oxygen enhancement ratio observed in biological systems suggests a direct or indirect involvement of HO 2 • and O 2 • - in the oxygen sensitization effect. The results are in agreement with available experimental data and previous computational approaches. An analysis of the oxygen depletion rate in different radiation conditions is also reported. The radiosensitivity of biological systems is strongly affected by the system oxygenation. On the nanoscopic scale and molecular level, this effect is considered to be strongly related to the indirect damage of radiation. Even though particle track radiolysis has been the object of several studies, still little is known about the nanoscopic impact of target oxygenation on the radical yields. Here we present an extension of the chemical module of the Monte Carlo particle track structure code TRAX, taking into account the presence of dissolved molecular oxygen in the target material. The impact of the target oxygenation level on the chemical track evolution and the yields of all the relevant chemical species are studied in water under different irradiation conditions: different linear energy transfer (LET) values, different oxygenation levels, and different particle types. Especially for low LET radiation, a large production of two highly toxic species ( HO 2 • and O 2 • - ), which is not produced in anoxic conditions, is predicted and quantified in oxygenated solutions. The remarkable correlation between the HO 2 • and O 2 • - production yield and the oxygen enhancement ratio observed in biological systems suggests a direct or indirect involvement of HO 2 • and O 2 • - in the oxygen sensitization effect. The results are in agreement with available experimental data and previous computational approaches. An analysis of the oxygen depletion rate in different radiation conditions is also reported.
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Affiliation(s)
- Daria Boscolo
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (M.K.); (M.C.F.); (M.D.)
- Correspondence:
| | - Michael Krämer
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (M.K.); (M.C.F.); (M.D.)
| | - Martina C. Fuss
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (M.K.); (M.C.F.); (M.D.)
| | - Marco Durante
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung, 64291 Darmstadt, Germany; (M.K.); (M.C.F.); (M.D.)
- Institut für Festkörperphysik, TUDarmstadt, 64289 Darmstadt, Germany
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), 3812 Povo, Italy;
| | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics, (INFN), 3812 Povo, Italy;
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37
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Rezaee L. Optimization of treatment planning for hypoxic tumours and re-modulation of radiation intensity in heavy-ion radiotherapy. Rep Pract Oncol Radiother 2020; 25:68-78. [PMID: 31889925 DOI: 10.1016/j.rpor.2019.12.014] [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: 04/05/2019] [Revised: 09/30/2019] [Accepted: 12/13/2019] [Indexed: 12/26/2022] Open
Abstract
Aim The purpose of this study is to optimize treatment planning in carbon ion radiotherapy, taking into account the effect of tumour hypoxia. Background In conventional hadron therapy, the goal is to create a homogenous dose in the tumour area and, thus, achieve a uniform cell survival level. Since the induction of a specific damage to cells is directly influenced by the level of hypoxia in the tissue, the varying oxygen pressure in the different regions of hypoxic tumours would disrupt the uniformity of the cell survival level. Materials and methods Using the Geant4 Monte Carlo Code, the physical dose profile and dose-averaged linear energy transfer were calculated in the tumour. Then, the oxygen enhancement ratio in different areas of the tumour were compared with different pressures. Results Modulations of radiation intensities as well as energies of ion beams were calculated, both considering and disregarding the effect of hypoxia, and the required dose profiles were compared with each other. Cell survival levels were also compared between the two methods. An equation was obtained for re-modulating the beams in the presence of hypoxia, and radiation weighting factors were extracted for the beam intensities. Conclusion The results show that taking the effect of hypoxia into account would cause the reduction of average doses delivered to the tumour tissues up to 1.54 times. In this regard, the required dose is reduced by 1.63 times in the healthy tissues before the tumour. This will result in an effective protection of healthy tissues around the tumour.
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Affiliation(s)
- Ladan Rezaee
- Department of Physics, Shiraz Branch, Islamic Azad University, Shiraz, Iran
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38
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Pfuhl T, Friedrich T, Scholz M. Prediction of Cell Survival after Exposure to Mixed Radiation Fields with the Local Effect Model. Radiat Res 2019; 193:130-142. [PMID: 31804150 DOI: 10.1667/rr15456.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Mixed radiation fields comprise the most common form of radiation exposure. Given their relevance in radiation protection, cancer radiotherapy and space research, accurate predictions of the corresponding radiation effects are essential. The local effect model (LEM) allows the prediction of cell survival after ion irradiation based on the knowledge of the cells' response to photon radiation. The assumption is made that the same spatial DNA double-strand break (DSB) distributions in the cell nucleus lead to the same effects, independent of the radiation quality that produced the DSBs. This makes the LEM an ideal tool for predictions of cell survival after exposure to any mixed radiation field. In this work, the LEM is applied to calculate cell survival for extreme mixed irradiation scenarios, i.e., high-linear energy transfer (LET) ion radiation combined with low-LET photon radiation, which can be understood as a consistency test for the high-LET model. Available experimental data covering several ion species and energies in combination with photon exposure are predicted with the LEM. Furthermore, the results are compared to the microdosimetric model by Zaider and Rossi and the lesion additivity model by Lam, which allow the prediction of cell survival after exposure to mixed radiation fields based on the knowledge of the survival curves of the two radiation components. Although the LEM uses only photon dose-response data as input, it is able to compete with the empirical radiobiological models that additionally require ion dose-response curves as input. Certain experimental scenarios are presented in which the specific consideration of spatial DSB distributions could be essential for an accurate prediction of the effect of mixed radiation fields.
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Affiliation(s)
- Tabea Pfuhl
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany.,Technische Universität Darmstadt, Darmstadt, Germany
| | - Thomas Friedrich
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
| | - Michael Scholz
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
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39
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Bachi N, Otranto S, Otero GS, Olson RE. The role of multiple ionization of H 2O in heavy ion collisions. Phys Med Biol 2019; 64:205020. [PMID: 31487696 DOI: 10.1088/1361-6560/ab41db] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Collisional ionization processes involving H2O molecules and C6+, O8+, Si13+ ions are studied by means of the classical trajectory Monte Carlo method using molecular orbital calculations to define the ionization stages of the water molecule. Net total and single-differential cross sections in energy and angle are obtained by using a newly developed model that goes beyond the commonly applied one-active electron approximation. This model allows us to access the fraction of electron emission arising from single and multiple electron ionization. Calculated cross sections are contrasted and benchmarked against available experimental data at impact energies in the MeV/u range. The present results highlight the important role of multiple ionization in the emission of electrons where we find the majority of electrons emitted with energies greater than ~50 eV arise from multiple ionization collisions.
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Affiliation(s)
- N Bachi
- Instituto de Física del Sur (IFISUR), Departamento de Física, Universidad Nacional del Sur (UNS), CONICET, Av. L. N. Alem 1253, B8000CPB-Bahía Blanca, Argentina. Author to whom any correspondence should be addressed
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40
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Rucinski A, Traini G, Roldan AB, Battistoni G, De Simoni M, Dong Y, Fischetti M, Frallicciardi PM, Gioscio E, Mancini-Terracciano C, Marafini M, Mattei I, Mirabelli R, Muraro S, Sarti A, Schiavi A, Sciubba A, Solfaroli Camillocci E, Valle SM, Patera V. Secondary radiation measurements for particle therapy applications: Charged secondaries produced by 16O ion beams in a PMMA target at large angles. Phys Med 2019; 64:45-53. [PMID: 31515035 DOI: 10.1016/j.ejmp.2019.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/23/2019] [Accepted: 06/07/2019] [Indexed: 11/27/2022] Open
Abstract
Particle therapy is a therapy technique that exploits protons or light ions to irradiate tumor targets with high accuracy. Protons and 12C ions are already used for irradiation in clinical routine, while new ions like 4He and 16O are currently being considered. Despite the indisputable physical and biological advantages of such ion beams, the planning of charged particle therapy treatments is challenged by range uncertainties, i.e. the uncertainty on the position of the maximal dose release (Bragg Peak - BP), during the treatment. To ensure correct 'in-treatment' dose deposition, range monitoring techniques, currently missing in light ion treatment techniques, are eagerly needed. The results presented in this manuscript indicate that charged secondary particles, mainly protons, produced by an 16O beam during target irradiation can be considered as candidates for 16O beam range monitoring. Hereafter, we report on the first yield measurements of protons, deuterons and tritons produced in the interaction of an 16O beam impinging on a PMMA target, as a function of detected energy and particle production position. Charged particles were detected at 90° and 60° with respect to incoming beam direction, and homogeneous and heterogeneous PMMA targets were used to probe the sensitivity of the technique to target inhomogeneities. The reported secondary particle yields provide essential information needed to assess the accuracy and resolution achievable in clinical conditions by range monitoring techniques based on secondary charged radiation.
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Affiliation(s)
- A Rucinski
- INFN - Sezione di Roma 1, Italy; Institute of Nuclear Physics PAN, Krakow, Poland
| | - G Traini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy; INFN - Sezione di Roma 1, Italy; Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy.
| | | | | | - M De Simoni
- Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy; INFN - Sezione di Roma 1, Italy
| | - Y Dong
- INFN - Sezione di Milano, Italy; Dipartimento di Fisica, Università di Milano, Milano, Italy
| | - M Fischetti
- Dipartimento di Scienze di Base e Applicate per Ingegneria, Sapienza Università di Roma, Roma, Italy; INFN - Sezione di Roma 1, Italy
| | - P M Frallicciardi
- Azienda Ospedaliero-Universitaria 'Ospedali Riuniti di Foggia', Foggia, Italy; Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy
| | - E Gioscio
- Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy
| | - C Mancini-Terracciano
- INFN - Sezione di Roma 1, Italy; Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy
| | - M Marafini
- Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy; INFN - Sezione di Roma 1, Italy
| | | | - R Mirabelli
- Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy; INFN - Sezione di Roma 1, Italy; Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy
| | | | - A Sarti
- Dipartimento di Scienze di Base e Applicate per Ingegneria, Sapienza Università di Roma, Roma, Italy; Laboratori Nazionali di Frascati dell'INFN, Frascati, Italy; Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy
| | - A Schiavi
- Dipartimento di Scienze di Base e Applicate per Ingegneria, Sapienza Università di Roma, Roma, Italy; INFN - Sezione di Roma 1, Italy
| | - A Sciubba
- Dipartimento di Scienze di Base e Applicate per Ingegneria, Sapienza Università di Roma, Roma, Italy; INFN - Sezione di Roma 1, Italy; Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy
| | - E Solfaroli Camillocci
- INFN - Sezione di Roma 1, Italy; Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy; Scuola di Specializzazione in Fisica Medica, Sapienza Università di Roma, Roma, Italy
| | - S M Valle
- INFN - Sezione di Milano, Italy; Dipartimento di Fisica, Università di Milano, Milano, Italy
| | - V Patera
- Dipartimento di Scienze di Base e Applicate per Ingegneria, Sapienza Università di Roma, Roma, Italy; INFN - Sezione di Roma 1, Italy; Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy
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Durante M, Flanz J. Charged particle beams to cure cancer: Strengths and challenges. Semin Oncol 2019; 46:219-225. [DOI: 10.1053/j.seminoncol.2019.07.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/23/2019] [Indexed: 12/28/2022]
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Kjellsson Lindblom E, Ureba A, Dasu A, Wersäll P, Even AJG, van Elmpt W, Lambin P, Toma-Dasu I. Impact of SBRT fractionation in hypoxia dose painting - Accounting for heterogeneous and dynamic tumor oxygenation. Med Phys 2019; 46:2512-2521. [PMID: 30924937 DOI: 10.1002/mp.13514] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 02/18/2019] [Accepted: 03/13/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Tumor hypoxia, often found in nonsmall cell lung cancer (NSCLC), implies an increased resistance to radiotherapy. Pretreatment assessment of tumor oxygenation is, therefore, warranted in these patients, as functional imaging of hypoxia could be used as a basis for dose painting. This study aimed at investigating the feasibility of using a method for calculating the dose required in hypoxic subvolumes segmented on 18 F-HX4 positron emission tomography (PET) imaging of NSCLC. METHODS Positron emission tomography imaging data based on the hypoxia tracer 18 F-HX4 of 19 NSCLC patients were included in the study. Normalized tracer uptake was converted to oxygen partial pressure (pO2 ) and hypoxic target volumes (HTVs) were segmented using a threshold of 10 mmHg. Uniform doses required to overcome the hypoxic resistance in the target volumes were calculated based on a previously proposed method taking into account the effect of interfraction reoxygenation, for fractionation schedules ranging from extremely hypofractionated stereotactic body radiotherapy (SBRT) to conventionally fractionated radiotherapy. RESULTS Gross target volumes ranged between 6.2 and 859.6 cm3 , and the hypoxic fraction < 10 mmHg between 1.2% and 72.4%. The calculated doses for overcoming the resistance of cells in the HTVs were comparable to those currently prescribed in clinical practice as well as those previously tested in feasibility studies on dose escalation in NSCLC. Depending on the size of the HTV and the distribution of pO2 , HTV doses were calculated as 43.6-48.4 Gy for a three-fraction schedule, 51.7-57.6 Gy for five fractions, and 59.5-66.4 Gy for eight fractions. For patients in whom the HTV pO2 distribution was more favorable, a lower dose was required despite a bigger volume. Tumor control probability was lower for single-fraction schedules, while higher levels of tumor control probability were found for schedules employing several fractions. CONCLUSIONS The method to account for heterogeneous and dynamic hypoxia in target volume segmentation and dose prescription based on 18 F-HX4-PET imaging appears feasible in NSCLC patients. The distribution of oxygen partial pressure within HTV could impact the required prescribed dose more than the size of the volume.
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Affiliation(s)
- Emely Kjellsson Lindblom
- Medical Radiation Physics, Department of Physics, Stockholm University, Stockholm, S-17176, Sweden
| | - Ana Ureba
- Medical Radiation Physics, Department of Physics, Stockholm University, Stockholm, S-17176, Sweden
| | | | - Peter Wersäll
- Department of Oncology, Karolinska University Hospital, Stockholm, S-17176, Sweden
| | - Aniek J G Even
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, 6229, The Netherlands
| | - Wouter van Elmpt
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, 6229, The Netherlands
| | - Philippe Lambin
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, 6229, The Netherlands
| | - Iuliana Toma-Dasu
- Medical Radiation Physics, Department of Physics, Stockholm University, Stockholm, S-17176, Sweden.,Medical Radiation Physics, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, S-17176, Sweden
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Sokol O, Krämer M, Hild S, Durante M, Scifoni E. Kill painting of hypoxic tumors with multiple ion beams. Phys Med Biol 2019; 64:045008. [PMID: 30641490 DOI: 10.1088/1361-6560/aafe40] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We report on a novel method for simultaneous biological optimization of treatment plans for hypoxic tumors using multiple ion species. Our previously introduced kill painting approach, where the overall cell killing is optimized on biologically heterogeneous targets, was expanded with the capability of handling different ion beams simultaneously. The current version (MIBO) of the research treatment planning system TRiP98 has now been augmented to handle 3D (voxel-by-voxel) target oxygenation data. We present a case of idealized geometries where this method can identify optimal combinations leading to an improved peak-to-entrance effective dose ratio. This is achieved by the redistribution of particle fluences, when the heavier ions are preferentially forwarded to hypoxic target areas, while the lighter ions deliver the remaining dose to its normoxic regions. Finally, we present an in silico skull base chordoma patient case study with a combination of 4He and 16O beams, demonstrating specific indications for its potential clinical application. In this particular case, the mean dose, received by the brainstem, was reduced by 3%-5% and by 10%-12% as compared to the pure 4He and 16O plans, respectively. The new method allows a full biological optimization of different ion beams, exploiting the capabilities of actively scanned ion beams of modern particle therapy centers. The possible experimental verification of the present approach at ion beam facilities disposing of fast ion switch is presented and discussed.
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Affiliation(s)
- O Sokol
- Biophysics Department, GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planckstraße 1, D-64291 Darmstadt, Germany
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Stewart RD, Carlson DJ, Butkus MP, Hawkins R, Friedrich T, Scholz M. A comparison of mechanism-inspired models for particle relative biological effectiveness (RBE). Med Phys 2018; 45:e925-e952. [PMID: 30421808 DOI: 10.1002/mp.13207] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/05/2018] [Accepted: 09/13/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND SIGNIFICANCE The application of heavy ion beams in cancer therapy must account for the increasing relative biological effectiveness (RBE) with increasing penetration depth when determining dose prescriptions and organ at risk (OAR) constraints in treatment planning. Because RBE depends in a complex manner on factors such as the ion type, energy, cell and tissue radiosensitivity, physical dose, biological endpoint, and position within and outside treatment fields, biophysical models reflecting these dependencies are required for the personalization and optimization of treatment plans. AIM To review and compare three mechanism-inspired models which predict the complexities of particle RBE for various ion types, energies, linear energy transfer (LET) values and tissue radiation sensitivities. METHODS The review of models and mechanisms focuses on the Local Effect Model (LEM), the Microdosimetric-Kinetic (MK) model, and the Repair-Misrepair-Fixation (RMF) model in combination with the Monte Carlo Damage Simulation (MCDS). These models relate the induction of potentially lethal double strand breaks (DSBs) to the subsequent interactions and biological processing of DSB into more lethal forms of damage. A key element to explain the increased biological effectiveness of high LET ions compared to MV x rays is the characterization of the number and local complexity (clustering) of the initial DSB produced within a cell. For high LET ions, the spatial density of DSB induction along an ion's trajectory is much greater than along the path of a low LET electron, such as the secondary electrons produced by the megavoltage (MV) x rays used in conventional radiation therapy. The main aspects of the three models are introduced and the conceptual similarities and differences are critiqued and highlighted. Model predictions are compared in terms of the RBE for DSB induction and for reproductive cell survival. RESULTS AND CONCLUSIONS Comparisons of the RBE for DSB induction and for cell survival are presented for proton (1 H), helium (4 He), and carbon (12 C) ions for the therapeutically most relevant range of ion beam energies. The reviewed models embody mechanisms of action acting over the spatial scales underlying the biological processing of potentially lethal DSB into more lethal forms of damage. Differences among the number and types of input parameters, relevant biological targets, and the computational approaches among the LEM, MK and RMF models are summarized and critiqued. Potential experiments to test some of the seemingly contradictory aspects of the models are discussed.
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Affiliation(s)
- Robert D Stewart
- Department of Radiation Oncology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356043, Seattle, WA, 98195, USA
| | - David J Carlson
- Department of Therapeutic Radiology, Yale University, New Haven, CT, USA
| | - Michael P Butkus
- Department of Therapeutic Radiology, Yale University, New Haven, CT, USA
| | - Roland Hawkins
- Radiation Oncology Center, Ochsner Clinic Foundation, New Orleans, LA, 70121, USA
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Sokol O, Scifoni E, Hild S, Durante M, Krämer M. 216. Biological treatment planning with multiple ion beams. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Helm A, Ebner DK, Tinganelli W, Simoniello P, Bisio A, Marchesano V, Durante M, Yamada S, Shimokawa T. Combining Heavy-Ion Therapy with Immunotherapy: An Update on Recent Developments. Int J Part Ther 2018; 5:84-93. [PMID: 31773022 PMCID: PMC6871592 DOI: 10.14338/ijpt-18-00024.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/05/2018] [Indexed: 12/18/2022] Open
Abstract
Clinical trials and case reports of cancer therapies combining radiation therapy with immunotherapy have at times demonstrated total reduction or elimination of metastatic disease. While virtually all trials focus on the use of immunotherapy combined with conventional photon irradiation, the dose-distributive benefits of particles, in particular the distinct biological effects of heavy ions, have unknown potential vis-a-vis systemic disease response. Here, we review recent developments and evidence with a focus on the potential for heavy-ion combination therapy.
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Affiliation(s)
- Alexander Helm
- Trento Institute for Fundamental Physics and Applications-National Institute for Nuclear Physics, Trento, Italy
| | - Daniel K. Ebner
- Brown University Alpert Medical School, Providence, RI, USA
- Hospital of the National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology, Chiba, Japan
| | - Walter Tinganelli
- Trento Institute for Fundamental Physics and Applications-National Institute for Nuclear Physics, Trento, Italy
| | - Palma Simoniello
- Department of Science and Technology, Parthenope University of Naples, Naples, Italy
| | - Alessandra Bisio
- Center for Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Valentina Marchesano
- Trento Institute for Fundamental Physics and Applications-National Institute for Nuclear Physics, Trento, Italy
- Center for Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Marco Durante
- Trento Institute for Fundamental Physics and Applications-National Institute for Nuclear Physics, Trento, Italy
| | - Shigeru Yamada
- Hospital of the National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology, Chiba, Japan
| | - Takashi Shimokawa
- National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology, Chiba, Japan
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Mohamad O, Yamada S, Durante M. Clinical Indications for Carbon Ion Radiotherapy. Clin Oncol (R Coll Radiol) 2018; 30:317-329. [DOI: 10.1016/j.clon.2018.01.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 11/20/2017] [Indexed: 12/16/2022]
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