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Shiraishi Y, Matsuya Y, Fukunaga H. Possible mechanisms and simulation modeling of FLASH radiotherapy. Radiol Phys Technol 2024; 17:11-23. [PMID: 38184508 DOI: 10.1007/s12194-023-00770-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 12/01/2023] [Accepted: 12/02/2023] [Indexed: 01/08/2024]
Abstract
FLASH radiotherapy (FLASH-RT) has great potential to improve patient outcomes. It delivers radiation doses at an ultra-high dose rate (UHDR: ≥ 40 Gy/s) in a single instant or a few pulses. Much higher irradiation doses can be administered to tumors with FLASH-RT than with conventional dose rate (0.01-0.40 Gy/s) radiotherapy. UHDR irradiation can suppress toxicity in normal tissues while sustaining antitumor efficiency, which is referred to as the FLASH effect. However, the mechanisms underlying the effects of the FLASH remain unclear. To clarify these mechanisms, the development of simulation models that can contribute to treatment planning for FLASH-RT is still underway. Previous studies indicated that transient oxygen depletion or augmented reactions between secondary reactive species produced by irradiation may be involved in this process. To discuss the possible mechanisms of the FLASH effect and its clinical potential, we summarized the physicochemical, chemical, and biological perspectives as well as the development of simulation modeling for FLASH-RT.
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Affiliation(s)
- Yuta Shiraishi
- Graduate School of Health Sciences, Hokkaido University, N12 W5 Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan
- Faculty of Health Sciences, Japan Healthcare University, 3-11-1-50 Tsukisamu-Higashi, Toyohira-Ku, Sapporo, Hokkaido, 062-0053, Japan
| | - Yusuke Matsuya
- Faculty of Health Sciences, Hokkaido University, N12 W5 Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Hisanori Fukunaga
- Faculty of Health Sciences, Hokkaido University, N12 W5 Kita-Ku, Sapporo, Hokkaido, 060-0812, Japan.
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Hu S, Lan X, Zheng J, Bi Y, Ye Y, Si M, Fang Y, Wang J, Liu J, Chen Y, Chen Y, Xiang P, Niu T, Huang Y. The dose-related plateau effect of surviving fraction in normal tissue during the ultra-high-dose-rate radiotherapy. Phys Med Biol 2023; 68:185004. [PMID: 37586385 DOI: 10.1088/1361-6560/acf112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/16/2023] [Indexed: 08/18/2023]
Abstract
Objective.Ultra-high-dose-rate radiotherapy, referred to as FLASH therapy, has been demonstrated to reduce the damage of normal tissue as well as inhibiting tumor growth compared with conventional dose-rate radiotherapy. The transient hypoxia may be a vital explanation for sparing the normal tissue. The heterogeneity of oxygen distribution for different doses and dose rates in the different radiotherapy schemes are analyzed. With these results, the influence of doses and dose rates on cell survival are evaluated in this work.Approach.The two-dimensional reaction-diffusion equations are used to describe the heterogeneity of the oxygen distribution in capillaries and tissue. A modified linear quadratic model is employed to characterize the surviving fraction at different doses and dose rates.Main results.The reduction of the damage to the normal tissue can be observed if the doses exceeds a minimum dose threshold under the ultra-high-dose-rate radiation. Also, the surviving fraction exhibits the 'plateau effect' under the ultra-high dose rates radiation, which signifies that within a specific range of doses, the surviving fraction either exhibits minimal variation or increases with the dose. For a given dose, the surviving fraction increases with the dose rate until tending to a stable value, which means that the protection in normal tissue reaches saturation.Significance.The emergence of the 'plateau effect' allows delivering the higher doses while minimizing damage to normal tissue. It is necessary to develop appropriate program of doses and dose rates for different irradiated tissue to achieve more efficient protection.
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Affiliation(s)
- Shuai Hu
- School of Physics and Astronomy, China West Normal University, Nanchong 637009, People's Republic of China
- School of Science, Sun Yat-Sen University, Shenzhen 518107, People's Republic of China
| | - Xiaofei Lan
- School of Physics and Astronomy, China West Normal University, Nanchong 637009, People's Republic of China
| | - Jinfen Zheng
- Dermatology, Center for Chronic Disease Prevention of Shenzhen, Guangdong Shenzhen 518020, People's Republic of China
| | - Yuanjie Bi
- School of Science, Sun Yat-Sen University, Shenzhen 518107, People's Republic of China
| | - Yuanchun Ye
- Department of Hematology, Oncology and Cancer Immunology Campus Benjamin Franklin Charité-Universitätsmedizin Berlin Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin Hindenburgdamm, 30,12203, Berlin Germany
| | - Meiyu Si
- School of Science, Sun Yat-Sen University, Shenzhen 518107, People's Republic of China
- Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, People's Republic of China
- University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Yuhong Fang
- School of Science, Sun Yat-Sen University, Shenzhen 518107, People's Republic of China
| | - Jinghui Wang
- Varian Medical Systems, Palo Alto, CA 94304, United States of America
| | - Junyan Liu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94304, United States of America
| | - Yuan Chen
- The Institute for Advanced Studies of Wuhan University, 299, Bayi Road, Wuhan, 430072, People's Republic of China
| | - Yuling Chen
- Department of Rheumatology and Immunology, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen 518107, People's Republic of China
| | - Pai Xiang
- The Institute for Advanced Studies of Wuhan University, 299, Bayi Road, Wuhan, 430072, People's Republic of China
| | - Tianye Niu
- Shenzhen Bay Laboratory, Shenzhen 518107, People's Republic of China
| | - Yongsheng Huang
- School of Science, Sun Yat-Sen University, Shenzhen 518107, People's Republic of China
- Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, People's Republic of China
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Camazzola G, Boscolo D, Scifoni E, Dorn A, Durante M, Krämer M, Abram V, Fuss MC. TRAX-CHEMxt: Towards the Homogeneous Chemical Stage of Radiation Damage. Int J Mol Sci 2023; 24:ijms24119398. [PMID: 37298351 DOI: 10.3390/ijms24119398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/18/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
The indirect effect of radiation plays an important role in radio-induced biological damages. Monte Carlo codes have been widely used in recent years to study the chemical evolution of particle tracks. However, due to the large computational efforts required, their applicability is typically limited to simulations in pure water targets and to temporal scales up to the µs. In this work, a new extension of TRAX-CHEM is presented, namely TRAX-CHEMxt, able to predict the chemical yields at longer times, with the capability of exploring the homogeneous biochemical stage. Based on the species coordinates produced around one track, the set of reaction-diffusion equations is solved numerically with a computationally light approach based on concentration distributions. In the overlapping time scale (500 ns-1 µs), a very good agreement to standard TRAX-CHEM is found, with deviations below 6% for different beam qualities and oxygenations. Moreover, an improvement in the computational speed by more than three orders of magnitude is achieved. The results of this work are also compared with those from another Monte Carlo-based algorithm and a fully homogeneous code (Kinetiscope). TRAX-CHEMxt will allow for studying the variation in chemical endpoints at longer timescales with the introduction, as the next step, of biomolecules, for more realistic assessments of biological response under different radiation and environmental conditions.
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Affiliation(s)
- Gianmarco Camazzola
- Biophysics Department, GSI Helmholtz Centre for Heavy Ion Research GmbH, 64291 Darmstadt, Germany
- Quantum Dynamics and Control Division, Max Planck Institute for Nuclear Physics, 69117 Heidelberg, Germany
- Department of Physics and Astronomy, Heidelberg University, 69120 Heidelberg, Germany
| | - Daria Boscolo
- Biophysics Department, GSI Helmholtz Centre for Heavy Ion Research GmbH, 64291 Darmstadt, Germany
| | - Emanuele Scifoni
- Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute for Nuclear Physics (INFN), 38123 Povo, Italy
| | - Alexander Dorn
- Quantum Dynamics and Control Division, Max Planck Institute for Nuclear Physics, 69117 Heidelberg, Germany
| | - Marco Durante
- Biophysics Department, GSI Helmholtz Centre for Heavy Ion Research GmbH, 64291 Darmstadt, Germany
- Institute for Condensed Matter Physics, Technical University of Darmstadt, 64289 Darmstadt, Germany
| | - Michael Krämer
- Biophysics Department, GSI Helmholtz Centre for Heavy Ion Research GmbH, 64291 Darmstadt, Germany
| | - Valentino Abram
- Department of Mathematics, University of Trento, 38123 Povo, Italy
| | - Martina C Fuss
- Biophysics Department, GSI Helmholtz Centre for Heavy Ion Research GmbH, 64291 Darmstadt, Germany
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Cooper CR, Jones DJL, Jones GDD, Petersson K. Comet Assay Profiling of FLASH-Induced Damage: Mechanistic Insights into the Effects of FLASH Irradiation. Int J Mol Sci 2023; 24:7195. [PMID: 37108360 PMCID: PMC10138874 DOI: 10.3390/ijms24087195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Numerous studies have demonstrated the normal tissue-sparing effects of ultra-high dose rate 'FLASH' irradiation in vivo, with an associated reduction in damage burden being reported in vitro. Towards this, two key radiochemical mechanisms have been proposed: radical-radical recombination (RRR) and transient oxygen depletion (TOD), with both being proposed to lead to reduced levels of induced damage. Previously, we reported that FLASH induces lower levels of DNA strand break damage in whole-blood peripheral blood lymphocytes (WB-PBL) ex vivo, but our study failed to distinguish the mechanism(s) involved. A potential outcome of RRR is the formation of crosslink damage (particularly, if any organic radicals recombine), whilst a possible outcome of TOD is a more anoxic profile of induced damage resulting from FLASH. Therefore, the aim of the current study was to profile FLASH-induced damage via the Comet assay, assessing any DNA crosslink formation as a putative marker of RRR and/or anoxic DNA damage formation as an indicative marker of TOD, to determine the extent to which either mechanism contributes to the "FLASH effect". Following FLASH irradiation, we see no evidence of any crosslink formation; however, FLASH irradiation induces a more anoxic profile of induced damage, supporting the TOD mechanism. Furthermore, treatment of WB-PBLs pre-irradiation with BSO abrogates the reduced strand break damage burden mediated by FLASH exposures. In summary, we do not see any experimental evidence to support the RRR mechanism contributing to the reduced damage burden induced by FLASH. However, the observation of a greater anoxic profile of damage following FLASH irradiation, together with the BSO abrogation of the reduced strand break damage burden mediated by FLASH, lends further support to TOD being a driver of the reduced damage burden plus a change in the damage profile mediated by FLASH.
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Affiliation(s)
- Christian R. Cooper
- Leicester Cancer Research Centre, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK; (D.J.L.J.); (G.D.D.J.)
- MRC Oxford Institute for Radiation Oncology, University of Oxford, Old Road Campus Research Building, Oxford OX3 7DQ, UK
| | - Donald J. L. Jones
- Leicester Cancer Research Centre, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK; (D.J.L.J.); (G.D.D.J.)
| | - George D. D. Jones
- Leicester Cancer Research Centre, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK; (D.J.L.J.); (G.D.D.J.)
| | - Kristoffer Petersson
- MRC Oxford Institute for Radiation Oncology, University of Oxford, Old Road Campus Research Building, Oxford OX3 7DQ, UK
- Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital Lund University, 221 85 Lund, Sweden
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Zhang Q, Gerweck LE, Cascio E, Yang Q, Huang P, Niemierko A, Bertolet A, Nesteruk KP, McNamara A, Schuemann J. Proton FLASH effects on mouse skin at different oxygen tensions. Phys Med Biol 2023; 68:10.1088/1361-6560/acb888. [PMID: 36731139 PMCID: PMC11164666 DOI: 10.1088/1361-6560/acb888] [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: 05/06/2022] [Accepted: 02/02/2023] [Indexed: 02/04/2023]
Abstract
Objective. Irradiation at FLASH dose rates (>40 Gy s-1) has received great attention due to its reported normal tissue sparing effect. The FLASH effect was originally observed in electron irradiations but has since been shown to also occur with both photon and proton beams. Several mechanisms have been proposed to explain the tissue sparing at high dose rates, including effects involving oxygen, such as depletion of oxygen within the irradiated cells. In this study, we investigated the protective role of FLASH proton irradiation on the skin when varying the oxygen concentration.Approach. Our double scattering proton system provided a 1.2 × 1.6 cm2elliptical field at a dose rate of ∼130 Gy s-1. The conventional dose rate was ∼0.4 Gy s-1. The legs of the FVB/N mice were marked with two tattooed dots and fixed in a holder for exposure. To alter the skin oxygen concentration, the mice were breathing pure oxygen or had their legs tied to restrict blood flow. The distance between the two dots was measured to analyze skin contraction over time.Main results. FLASH irradiation mitigated skin contraction by 15% compared to conventional dose rate irradiation. The epidermis thickness and collagen deposition at 75 d following 25 to 30 Gy exposure suggested a long-term protective function in the skin from FLASH irradiation. Providing the mice with oxygen or reducing the skin oxygen concentration removed the dose-rate-dependent difference in response.Significance. FLASH proton irradiation decreased skin contraction, epidermis thickness and collagen deposition compared to standard dose rate irradiations. The observed oxygen-dependence of the FLASH effect is consistent with, but not conclusive of, fast oxygen depletion during the exposure.
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Affiliation(s)
- Qixian Zhang
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
| | - Leo E Gerweck
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
| | - Ethan Cascio
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
| | - Qingyuan Yang
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
| | - Peigen Huang
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
| | - Andrzej Niemierko
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
| | - Alejandro Bertolet
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
| | - Konrad Pawel Nesteruk
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
| | - Aimee McNamara
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
| | - Jan Schuemann
- Physics Division, Department of Radiation Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, United States of America
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Hu A, Qiu R, Wu Z, Zhang H, Li J. CPU-GPU coupling independent reaction times method in NASIC and application in water radiolysis by FLASH irradiation. Biomed Phys Eng Express 2022; 8. [DOI: 10.1088/2057-1976/ac52d9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 02/08/2022] [Indexed: 11/11/2022]
Abstract
Abstract
The mechanism of the FLASH effect remains unclear and could be revealed by studying chemical reactions during irradiation. Monte Carlo simulation of the radiolytic species is an effective tool to analyze chemical reactions, but the simulation is limited by computing costs of the step-by-step simulation of radiolytic species, especially when considering beam with complex time structure. The complexity of the time structure of beams from accelerators in FLASH radiotherapy requires a high-performance Monte Carlo code. In this work, we develop a CPU-GPU coupling accelerating code with the independent reaction times (IRT) method to extend the chemical module of our nanodosimetry Monte Carlo code NASIC. Every chemical molecule in the microenvironment contains time information to consider the reactions from different tracks and simulate beams with complex time structures. Performance test shows that our code significantly improved the computing efficiency of the chemical module by four orders of magnitude. Then the code is used to study the oxygen depletion hypothesis in FLASH radiotherapy for different conditions by setting different parameters. The transient oxygen consumption rate values in the water are calculated when the pulses width ranges from 2 ps to 2 μs, the total dose ranges from 0.5 Gy to 100 Gy and the initial oxygen concentration ranges from 0.1% to 21%. The time evolution curves are simulated to study the effect of the time structure of an electron linear accelerator. Results show that the total dose in several microseconds is a better indicator reflecting the radiolytic oxygen consumption rate than the dose rate. The initial oxygen greatly affects the oxygen consumption rate because of the reaction competition. The diffusion of oxygen determined by the physiological parameters is the key factor affecting oxygen depletion during the radiation using electron linear accelerators. Our code provides an efficient tool for simulating water radiolysis in different conditions
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Sultana A, Alanazi A, Meesungnoen J, Jay-Gerin JP. On the Transient Radiolytic Oxygen Depletion in the Ultra-High (FLASH) Dose-Rate Radiolysis of Water in a Cell-Like Environment: Effect of e−aq and •OH Competing Scavengers. Radiat Res 2022; 197:566-567. [DOI: 10.1667/rade-21-00229.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/24/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Abida Sultana
- Département de Médecine Nucléaire et de Radiobiologie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke (Québec), Canada
| | - Ahmed Alanazi
- Département de Médecine Nucléaire et de Radiobiologie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke (Québec), Canada
| | - Jintana Meesungnoen
- Département de Médecine Nucléaire et de Radiobiologie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke (Québec), Canada
| | - Jean-Paul Jay-Gerin
- Département de Médecine Nucléaire et de Radiobiologie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke (Québec), Canada
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Wardman P. Approaches to modeling chemical reaction pathways in radiobiology. Int J Radiat Biol 2022; 98:1399-1413. [DOI: 10.1080/09553002.2022.2033342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Peter Wardman
- 20 Highover Park, Amersham, Buckinghamshire HP7 0BN, United Kingdom
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