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Eling L, Verry C, Balosso J, Flandin I, Kefs S, Bouchet A, Adam JF, Laissue JA, Serduc R. Neurologic Changes Induced by Whole-Brain Synchrotron Microbeam Irradiation: 10-Month Behavioral and Veterinary Follow-Up. Int J Radiat Oncol Biol Phys 2024; 120:178-188. [PMID: 38462014 DOI: 10.1016/j.ijrobp.2024.02.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE Novel radiation therapy approaches have increased the therapeutic efficacy for malignant brain tumors over the past decades, but the balance between therapeutic gain and radiotoxicity remains a medical hardship. Synchrotron microbeam radiation therapy, an innovative technique, deposes extremely high (peak) doses in micron-wide, parallel microbeam paths, whereas the diffusing interbeam (valley) doses lie in the range of conventional radiation therapy doses. In this study, we evaluated normal tissue toxicity of whole-brain microbeam irradiation (MBI) versus that of a conventional hospital broad beam (hBB). METHODS AND MATERIALS Normal Fischer rats (n = 6-7/group) were irradiated with one of the two modalities, exposing the entire brain to MBI valley/peak doses of 0/0, 5/200, 10/400, 13/520, 17/680, or 25/1000 Gy or to hBB doses of 7, 10, 13, 17, or 25 Gy. Two additional groups of rats received an MBI valley dose of 10 Gy coupled with an hBB dose of 7 or 15 Gy (groups MBI17* and MBI25*). Behavioral parameters were evaluated for 10 months after irradiation combined with veterinary observations. RESULTS MBI peak doses of ≥680 Gy caused acute toxicity and death. Animals exposed to hBB or MBI dose-dependently gained less weight than controls; rats in the hBB25 and MBI25* groups died within 6 months after irradiation. Increasing doses of MBI caused hyperactivity but no other detectable behavioral alterations in our tests. Importantly, no health concerns were seen up to an MBI valley dose of 17 Gy. CONCLUSIONS While acute toxicity of microbeam exposures depends on very high peak doses, late toxicity mainly relates to delivery of high MBI valley doses. MBI seems to have a low impact on normal rat behavior, but further tests are warranted to fully explore this hypothesis. However, high peak and valley doses are well tolerated from a veterinary point of view. This normal tissue tolerance to whole-brain, high-dose MBI reveals a promising avenue for microbeam radiation therapy, that is, therapeutic applications of microbeams that are poised for translation to a clinical environment.
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Affiliation(s)
- Laura Eling
- Université Grenoble Alpes, Institut National de la Santé et de la Recherche Médicale UA7 Synchrotron Radiation for Biomedicine, Saint-Martin d'Hères, France.
| | - Camille Verry
- Centre Hospitalier Universitaire Grenoble Alpes, Maquis du Grésivaudan, La Tronche, France
| | - Jacques Balosso
- Centre Hospitalier Universitaire Grenoble Alpes, Maquis du Grésivaudan, La Tronche, France
| | - Isabelle Flandin
- Centre Hospitalier Universitaire Grenoble Alpes, Maquis du Grésivaudan, La Tronche, France
| | - Samy Kefs
- Centre Hospitalier Universitaire Grenoble Alpes, Maquis du Grésivaudan, La Tronche, France
| | - Audrey Bouchet
- INSERM U1296, Radiation: Defense, Health, Environment, Lyon, France
| | - Jean François Adam
- Université Grenoble Alpes, Institut National de la Santé et de la Recherche Médicale UA7 Synchrotron Radiation for Biomedicine, Saint-Martin d'Hères, France; Centre Hospitalier Universitaire Grenoble Alpes, Maquis du Grésivaudan, La Tronche, France
| | | | - Raphael Serduc
- Université Grenoble Alpes, Institut National de la Santé et de la Recherche Médicale UA7 Synchrotron Radiation for Biomedicine, Saint-Martin d'Hères, France; Centre Hospitalier Universitaire Grenoble Alpes, Maquis du Grésivaudan, La Tronche, France
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Koksal Akbas C, Vurro F, Fiorino C, Cozzarini C, Cavaliere F, Milani P, Broggi S, Del Vecchio A, Di Muzio N, Tacchetti C, Enrico Spinelli A. Preclinical photon minibeam radiotherapy using a custom collimator: Dosimetry characterization and preliminary in-vivo results on a glioma model. Phys Med 2024; 124:103420. [PMID: 38970950 DOI: 10.1016/j.ejmp.2024.103420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/28/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024] Open
Abstract
PURPOSE The purpose of this study is to investigate the dosimetric characteristics of a collimator for minibeam radiotherapy (MBRT) with film dosimetry and Monte Carlo (MC) simulations. The outcome of MBRT with respect to conventional RT using a glioma preclinical model was also evaluated. METHODS A multi-slit collimator was designed to be used with commercial small animal irradiator. The collimator was built by aligning 0.6 mm wide and 5 mm thick parallel lead leaves at 0.4 mm intervals. Dosimetry characteristics were evaluated by Gafchromic (CG) films and TOPAS Monte Carlo (MC) code. An in vivo experiment was performed using a glioma preclinical model by injecting two million GL261cells subcutaneously and treating with 25 Gy, single fraction, with MBRT and conventional RT. Survival curves and acute radiation damage were measured to compare both treatments. RESULTS A satisfactory agreement between experimental results and MC simulations were obtained, the measured FWHM and distance between the peaks were respectively 0.431 and 1.098 mm. In vivo results show that MBRT can provide local tumor control for three weeks after RT treatment and a similar survival fraction of open beam radiotherapy. No severe acute effects were seen for the MBRT group. CONCLUSIONS We developed a minibeam collimator and presented its dosimetric features. Satisfactory agreement between MC and GC films was found with differences consistent with uncertainties due to fabrication and set-up errors. The survival curves of MBRT and open field RT are similar while atoxicity is dramatically lower with MBRT, preliminarily confirming the expected effect.
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Affiliation(s)
- Canan Koksal Akbas
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Medical Physics Department, Istanbul University Oncology Institute, Istanbul, Turkey
| | - Federica Vurro
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Claudio Fiorino
- Medical Physics Department, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Cesare Cozzarini
- Radiotherapy Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Paolo Milani
- Department of Physics, University of Milan, Milan, Italy
| | - Sara Broggi
- Medical Physics Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Nadia Di Muzio
- Radiotherapy Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Tacchetti
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Jones B. Modelled biological effectiveness comparisons of low, high and ultra-high (FLASH) radiation dose rates. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2023.110944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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4
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The RadScopal Technique as an Immune Adjuvant to Treat Cancer. IMMUNO 2023. [DOI: 10.3390/immuno3010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Since the momentous discovery of X-rays, high-dose radiotherapy (H-XRT) has been a cornerstone for combating cancer. The high-energy electromagnetic waves induce direct damage to tumor-cells’ DNA, thereby halting cell growth and proliferation, and eventually leading to tumor eradication. Furthermore, recent evidence suggests that H-XRT may have immunomodulatory properties which arise from its ability to induce the release of neoantigens, which in turn prime T-cells and contribute to T-cell repertoire diversity. Throughout the years, there have been different treatment modalities introduced as complements to H-XRT that have yielded greater results than monotherapy alone. In this review, we will discuss preclinical and clinical data related to the recently introduced low-dose radiotherapy (L-XRT) modality. We will also explore the justification for combining L-XRT and H-XRT, which became known as the “RadScopal Technique”, as a novel immune adjuvant to treat cancer. In this analysis, we detail and dissect the physiological mechanisms of action of each modality and describe the synergistic amalgamation effect observed on primary and metastatic tumors. Finally, we will explore the impetus for further studies to investigate combinations of the “RadScopal Technique” with various immune-oncology drug candidates.
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Fukunaga H, Yokoya A, Prise KM. A Brief Overview of Radiation-Induced Effects on Spermatogenesis and Oncofertility. Cancers (Basel) 2022; 14:cancers14030805. [PMID: 35159072 PMCID: PMC8834293 DOI: 10.3390/cancers14030805] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Spermatogenesis is one of the most important processes for the propagation of life; however, the testes’ ability to form sperm via this differentiation process is highly radiosensitive and easily impacted by exposure to environmental, occupational, or therapeutic radiation. Furthermore, the possibility that radiation effects on the gonads can be passed on from generation to generation should not be overlooked. This review focuses on the radiation-induced effects on spermatogenesis and the transgenerational effects. We also explore the potential of novel radiobiological approaches to improve male fertility preservation during radiotherapy. Abstract The genotoxicity of radiation on germ cells may be passed on to the next generation, thus its elucidation is not only a scientific issue but also an ethical, legal, and social issue in modern society. In this article, we briefly overview the effects of radiation on spermatogenesis and its associated genotoxicity, including the latest findings in the field of radiobiology. The potential role of transgenerational effects is still poorly understood, and further research in this area is desirable. Furthermore, from the perspective of oncofertility, we discuss the historical background and clinical importance of preserving male fertility during radiation treatment and the potential of microbeam radiotherapy. We hope that this review will contribute to stimulating further discussions and investigations for therapies for pediatric and adolescent/young adult patients.
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Affiliation(s)
- Hisanori Fukunaga
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo 060-0812, Japan
- Correspondence:
| | - Akinari Yokoya
- Institute for Quantum Life Science, National Institutes for Quantum Science and Technology, Ibaraki 319-1106, Japan;
- Graduate School of Science and Engineering, Ibaraki University, Ibaraki 310-8512, Japan
| | - Kevin M. Prise
- Patrick G Johnstone Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK;
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Laissue JA, Barré S, Bartzsch S, Blattmann H, Bouchet AM, Djonov VG, Haberthür D, Hlushchuk R, Kaser-Hotz B, Laissue PP, LeDuc G, Reding SO, Serduc R. Tolerance of Normal Rabbit Facial Bones and Teeth to Synchrotron X-Ray Microbeam Irradiation. Radiat Res 2021; 197:233-241. [PMID: 34755190 DOI: 10.1667/rade-21-00032.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/30/2021] [Indexed: 11/03/2022]
Abstract
Microbeam radiation therapy, an alternative radiosurgical treatment under preclinical investigation, aims to safely treat muzzle tumors in pet animals. This will require data on the largely unknown radiation toxicity of microbeam arrays for bones and teeth. To this end, the muzzle of six young adult New Zealand rabbits was irradiated by a lateral array of microplanar beamlets with peak entrance doses of 200, 330 or 500 Gy. The muzzles were examined 431 days postirradiation by computed microtomographic imaging (micro-CT) ex vivo, and extensive histopathology. The boundaries of the radiation field were identified histologically by microbeam tracks in cartilage and other tissues. There was no radionecrosis of facial bones in any rabbit. Conversely, normal incisor teeth exposed to peak entrance doses of 330 Gy or 500 Gy developed marked caries-like damage, whereas the incisors of the two rabbits exposed to 200 Gy remained unscathed. A single, unidirectional array of microbeams with a peak entrance dose ≤200 Gy (valley dose14 Gy) did not damage normal bone, teeth and soft tissues of the muzzle of normal rabbits longer than one year after irradiation. Because of that, Microbeam radiation therapy of muzzle tumors in pet animals is unlikely to cause sizeable damage to normal teeth, bone and soft tissues, if a single array as used here delivers a limited entrance dose of 200 Gy and a valley dose of ≤14 Gy.
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Affiliation(s)
- Jean Albert Laissue
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, CH -3012 Bern, Switzerland
| | - Sébastien Barré
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, CH -3012 Bern, Switzerland
| | - Stefan Bartzsch
- Department of Radiation Oncology, Klinikum rechts der Isar - TU Munich, Germany
| | - Hans Blattmann
- Niederwiesstrasse 13C, CH-5417 Untersiggenthal, Switzerland
| | - Audrey M Bouchet
- INSERM UA8, "Radiations : Défense, Santé, Environnement," 69008 Lyon, France
| | | | - David Haberthür
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, CH -3012 Bern, Switzerland
| | - Ruslan Hlushchuk
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, CH -3012 Bern, Switzerland
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Fukunaga H. Stem Cell Migration: A Possible Mechanism for the Tissue-Sparing Effect of Spatially Fractionated Radiation. Radiat Res 2021; 196:680-685. [PMID: 34496025 DOI: 10.1667/rade-21-00134.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/17/2021] [Indexed: 11/03/2022]
Abstract
Stem cell responses in tissues after exposure to radiation are of significance for maintaining tissue functions. From the point of view of stem cell characteristics, this article seeks to illustrate some contributions of microbeam research to spatially fractionated radiotherapy (SFRT), such as grid radiotherapy and microbeam radiotherapy. Although the tissue-sparing response after SFRT was first reported more than a century ago, current radiation dose-volume metrics are still unable to accurately predict such tissue-level changes in response to spatially fractionated radiation fields. However, microbeam approaches could contribute to uncovering the mechanisms of tissue response, significantly improving the outcomes of SFRT and reducing its adverse effects. Studies with microbeams have shown that the testicular tissue-sparing effect for maintaining spermatogenesis after exposure to spatially fractionated radiation depends on biological parameters, such as the radiation dose distribution at the microscale level for tissue-specific stem cells and the microenvironment, or niche. This indicates that stem cell survival, migration, and repopulation are involved in the tissue-level changes during or after SFRT. The illustration of microbeam applications in this article focuses on the stem cell migration as a possible mechanism of the tissue-sparing effect for preserving functionality.
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Affiliation(s)
- Hisanori Fukunaga
- Center for Environmental and Health Sciences, Hokkaido University, N12 W7 Kita-ku, Sapporo 060-0812, Japan
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Fukunaga H, Kaminaga K, Sato T, Butterworth KT, Watanabe R, Usami N, Ogawa T, Yokoya A, Prise KM. Spatially Fractionated Microbeam Analysis of Tissue-sparing Effect for Spermatogenesis. Radiat Res 2021; 194:698-706. [PMID: 33348374 DOI: 10.1667/rade-19-00018.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/18/2020] [Indexed: 11/03/2022]
Abstract
Spatially fractionated radiation therapy (SFRT) has been based on the delivery of a single high-dose fraction to a large treatment area that has been divided into several smaller fields, reducing the overall toxicity and adverse effects. Complementary microbeam studies have also shown an effective tissue-sparing effect (TSE) in various tissue types and species after spatially fractionated irradiation at the microscale level; however, the underlying biological mechanism remains elusive. In the current study, using the combination of an ex vivo mouse spermatogenesis model and high-precision X-ray microbeams, we revealed the significant TSE for maintaining spermatogenesis after spatially fractionated microbeam irradiation. We used the following ratios of the irradiated to nonirradiated areas: 50:50, 150:50 and 350:50 µm-slit, where approximately 50, 75 and 87.5% of the sample was irradiated (using center-to-center distances of 100, 200 and 400 µm, respectively). We found that the 50 and 75% micro-slit irradiated testicular tissues showed an almost unadulterated TSE for spermatogenesis, whereas the 87.5% micro-slit irradiated tissues showed an incomplete TSE. This suggests that the TSE efficiency for spermatogenesis is dependent on the size of the nonirradiated spermatogonial stem cell pool in the irradiated testicular tissues. In addition, there would be a spatiotemporal limitation of stem cell migration/competition, resulting in the insufficient TSE for 87.5% micro-slit irradiated tissues. These stem cell characteristics are essential for the accurate prediction of tissue-level responses during or after SFRT, indicating the clinical potential for achieving better outcomes while preventing adverse effects.
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Affiliation(s)
- Hisanori Fukunaga
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast BT9 7AE, United Kingdom.,Shonan Kamakura General Hospital, Kamakura 247-8533, Japan
| | - Kiichi Kaminaga
- Institute for Quantum Life Science, National Institutes for Quantum and Radiological Science and Technology (QST), Tokai 319-1106, Japan
| | - Takuya Sato
- Institute of Molecular Medicine and Life Science, Yokohama City University Association of Medical Science, Yokohama 236-0004, Japan
| | - Karl T Butterworth
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast BT9 7AE, United Kingdom
| | - Ritsuko Watanabe
- Institute for Quantum Life Science, National Institutes for Quantum and Radiological Science and Technology (QST), Tokai 319-1106, Japan
| | - Noriko Usami
- Photon Factory, High Energy Accelerator Research Organization, Tsukuba 305-0801, Japan
| | - Takehiko Ogawa
- Institute of Molecular Medicine and Life Science, Yokohama City University Association of Medical Science, Yokohama 236-0004, Japan
| | - Akinari Yokoya
- Institute for Quantum Life Science, National Institutes for Quantum and Radiological Science and Technology (QST), Tokai 319-1106, Japan
| | - Kevin M Prise
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast BT9 7AE, United Kingdom
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Esplen N, Mendonca MS, Bazalova-Carter M. Physics and biology of ultrahigh dose-rate (FLASH) radiotherapy: a topical review. Phys Med Biol 2020; 65:23TR03. [PMID: 32721941 DOI: 10.1088/1361-6560/abaa28] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Ultrahigh dose-rate radiotherapy (RT), or 'FLASH' therapy, has gained significant momentum following various in vivo studies published since 2014 which have demonstrated a reduction in normal tissue toxicity and similar tumor control for FLASH-RT when compared with conventional dose-rate RT. Subsequent studies have sought to investigate the potential for FLASH normal tissue protection and the literature has been since been inundated with publications on FLASH therapies. Today, FLASH-RT is considered by some as having the potential to 'revolutionize radiotherapy'. FLASH-RT is considered by some as having the potential to 'revolutionize radiotherapy'. The goal of this review article is to present the current state of this intriguing RT technique and to review existing publications on FLASH-RT in terms of its physical and biological aspects. In the physics section, the current landscape of ultrahigh dose-rate radiation delivery and dosimetry is presented. Specifically, electron, photon and proton radiation sources capable of delivering ultrahigh dose-rates along with their beam delivery parameters are thoroughly discussed. Additionally, the benefits and drawbacks of radiation detectors suitable for dosimetry in FLASH-RT are presented. The biology section comprises a summary of pioneering in vitro ultrahigh dose-rate studies performed in the 1960s and early 1970s and continues with a summary of the recent literature investigating normal and tumor tissue responses in electron, photon and proton beams. The section is concluded with possible mechanistic explanations of the FLASH normal-tissue protection effect (FLASH effect). Finally, challenges associated with clinical translation of FLASH-RT and its future prospects are critically discussed; specifically, proposed treatment machines and publications on treatment planning for FLASH-RT are reviewed.
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Affiliation(s)
- Nolan Esplen
- Department of Physics and Astronomy, University of Victoria, Victoria, BC, Canada
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The Tissue-Sparing Effect of Spatially Fractionated X-rays for Maintaining Spermatogenesis: A Radiobiological Approach for the Preservation of Male Fertility after Radiotherapy. J Clin Med 2020; 9:jcm9041089. [PMID: 32290436 PMCID: PMC7231089 DOI: 10.3390/jcm9041089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/10/2020] [Indexed: 01/15/2023] Open
Abstract
Radiotherapy can result in temporary or permanent gonadal toxicity in male cancer patients despite the high precision and accuracy of modern radiation treatment techniques. Previous radiobiological studies have shown an effective tissue-sparing response in various tissue types and species following exposure to spatially fractionated radiation. In the present study, we used an ex vivo mouse testicular tissue culture model and a conventional X-ray irradiation device to evaluate the tissue-sparing effect (TSE) of spatially fractionated X-rays for the protection of male fertility from radiotherapy-related adverse effects. We revealed a significant TSE for maintaining spermatogenesis in the ex vivo testes model following spatially fractionated X-ray irradiation. Moreover, we experimentally propose a possible mechanism by which the migration of spermatogonial cells, from the non-irradiated areas to the irradiated ones, in irradiated testicular tissue, is essential for the TSE and maintaining spermatogenesis. Therefore, our findings demonstrate that the control of TSE following spatially fractionated X-rays in the testes has a considerable potential for clinical application. Interdisciplinary research will be essential for further expanding the applicability of this method as an approach for the preservation of male fertility during or after radiotherapy.
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Chicilo F, Hanson AL, Geisler FH, Belev G, Edgar A, Ramaswami KO, Chapman D, Kasap SO. Dose profiles and x-ray energy optimization for microbeam radiation therapy by high-dose, high resolution dosimetry using Sm-doped fluoroaluminate glass plates and Monte Carlo transport simulation. Phys Med Biol 2020; 65:075010. [PMID: 32242527 DOI: 10.1088/1361-6560/ab7361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Microbeam radiation therapy (MRT) utilizes highly collimated synchrotron generated x-rays to create narrow planes of high dose radiation for the treatment of tumors. Individual microbeams have a typical width of 30-50 µm and are separated by a distance of 200-500 µm. The dose delivered at the center of the beam is lethal to cells in the microbeam path, on the order of hundreds of Grays (Gy). The tissue between each microbeam is spared and helps aid in the repair of adjacent damaged tissue. Radiation interactions within the peak of the microbeam, such as the photoelectric effect and incoherent (atomic Compton) scattering, cause some dose to be delivered to the valley areas adjacent to the microbeams. As the incident x-ray energy is modified, radiation interactions within a material change and affect the probability of interactions, as well as the directionality and energy of ionizing particles (electrons) that deposit energy in the valley regions surrounding the microbeam peaks. It is crucial that the valley dose between microbeams be minimal to maintain the effectiveness of MRT. Using a monochromatic x-ray source with x-ray energies ranging from 30 to 150 keV, a detailed investigation into the effect of incident x-ray energy on the dose profiles of microbeams was performed using samarium doped fluoroaluminate (FA) glass as the medium. All dosimetric measurements were carried out using a purpose-built fluorescence confocal microscope dosimetric technique that used Sm-doped FA glass plates as the irradiated medium. Dose profiles are measured over a very a wide range of x-ray energies at micrometer resolution and dose distribution in the microbeam are mapped. The measured microbeam profiles at different energies are compared with the MCNP6 radiation transport code, a general transport code which can calculate the energy deposition of electrons as they pass through a given material. The experimentally measured distributions can be used to validate the results for electron energy deposition in fluoroaluminate glass. Code validation is necessary for using transport codes in future treatment planning for MRT and other radiation therapies. It is shown that simulated and measured micro beam-profiles are in good agreement, and micrometer level changes can be observed using this high-resolution dosimetry technique. Full width at 10% of the maximum peak (FW@10%) was used to quantify the microbeam width. Experimental measurements on FA glasses and simulations on the dependence of the FW@10% at various energies are in good agreement. Simulations on energy deposited in water indicate that FW@10% reaches a local minimum around energies 140 keV. In addition, variable slit width experiments were carried out at an incident x-ray energy of 100 keV in order to determine the effect of the narrowing slit width on the delivered peak dose. The microbeam width affects the peak dose, which decreases with the width of the microbeam. Experiments suggest that a typical microbeam width for MRT is likely to be between 20-50 µm based on this work.
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Affiliation(s)
- F Chicilo
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, Canada
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12
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Fernandez-Palomo C, Fazzari J, Trappetti V, Smyth L, Janka H, Laissue J, Djonov V. Animal Models in Microbeam Radiation Therapy: A Scoping Review. Cancers (Basel) 2020; 12:cancers12030527. [PMID: 32106397 PMCID: PMC7139755 DOI: 10.3390/cancers12030527] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Microbeam Radiation Therapy (MRT) is an innovative approach in radiation oncology where a collimator subdivides the homogeneous radiation field into an array of co-planar, high-dose beams which are tens of micrometres wide and separated by a few hundred micrometres. OBJECTIVE This scoping review was conducted to map the available evidence and provide a comprehensive overview of the similarities, differences, and outcomes of all experiments that have employed animal models in MRT. METHODS We considered articles that employed animal models for the purpose of studying the effects of MRT. We searched in seven databases for published and unpublished literature. Two independent reviewers screened citations for inclusion. Data extraction was done by three reviewers. RESULTS After screening 5688 citations and 159 full-text papers, 95 articles were included, of which 72 were experimental articles. Here we present the animal models and pre-clinical radiation parameters employed in the existing MRT literature according to their use in cancer treatment, non-neoplastic diseases, or normal tissue studies. CONCLUSIONS The study of MRT is concentrated in brain-related diseases performed mostly in rat models. An appropriate comparison between MRT and conventional radiotherapy (instead of synchrotron broad beam) is needed. Recommendations are provided for future studies involving MRT.
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Affiliation(s)
| | - Jennifer Fazzari
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (C.F.-P.); (J.F.); (V.T.); (J.L.)
| | - Verdiana Trappetti
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (C.F.-P.); (J.F.); (V.T.); (J.L.)
| | - Lloyd Smyth
- Department of Obstetrics & Gynaecology, University of Melbourne, 3057 Parkville, Australia;
| | - Heidrun Janka
- Medical Library, University Library Bern, University of Bern, 3012 Bern, Switzerland;
| | - Jean Laissue
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (C.F.-P.); (J.F.); (V.T.); (J.L.)
| | - Valentin Djonov
- Institute of Anatomy, University of Bern, 3012 Bern, Switzerland; (C.F.-P.); (J.F.); (V.T.); (J.L.)
- Correspondence: ; Tel.: +41-31-631-8432
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Bartzsch S, Corde S, Crosbie JC, Day L, Donzelli M, Krisch M, Lerch M, Pellicioli P, Smyth LML, Tehei M. Technical advances in x-ray microbeam radiation therapy. Phys Med Biol 2020; 65:02TR01. [PMID: 31694009 DOI: 10.1088/1361-6560/ab5507] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In the last 25 years microbeam radiation therapy (MRT) has emerged as a promising alternative to conventional radiation therapy at large, third generation synchrotrons. In MRT, a multi-slit collimator modulates a kilovoltage x-ray beam on a micrometer scale, creating peak dose areas with unconventionally high doses of several hundred Grays separated by low dose valley regions, where the dose remains well below the tissue tolerance level. Pre-clinical evidence demonstrates that such beam geometries lead to substantially reduced damage to normal tissue at equal tumour control rates and hence drastically increase the therapeutic window. Although the mechanisms behind MRT are still to be elucidated, previous studies indicate that immune response, tumour microenvironment, and the microvasculature may play a crucial role. Beyond tumour therapy, MRT has also been suggested as a microsurgical tool in neurological disorders and as a primer for drug delivery. The physical properties of MRT demand innovative medical physics and engineering solutions for safe treatment delivery. This article reviews technical developments in MRT and discusses existing solutions for dosimetric validation, reliable treatment planning and safety. Instrumentation at synchrotron facilities, including beam production, collimators and patient positioning systems, is also discussed. Specific solutions reviewed in this article include: dosimetry techniques that can cope with high spatial resolution, low photon energies and extremely high dose rates of up to 15 000 Gy s-1, dose calculation algorithms-apart from pure Monte Carlo Simulations-to overcome the challenge of small voxel sizes and a wide dynamic dose-range, and the use of dose-enhancing nanoparticles to combat the limited penetrability of a kilovoltage energy spectrum. Finally, concepts for alternative compact microbeam sources are presented, such as inverse Compton scattering set-ups and carbon nanotube x-ray tubes, that may facilitate the transfer of MRT into a hospital-based clinical environment. Intensive research in recent years has resulted in practical solutions to most of the technical challenges in MRT. Treatment planning, dosimetry and patient safety systems at synchrotrons have matured to a point that first veterinary and clinical studies in MRT are within reach. Should these studies confirm the promising results of pre-clinical studies, the authors are confident that MRT will become an effective new radiotherapy option for certain patients.
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Affiliation(s)
- Stefan Bartzsch
- Department of Radiation Oncology, School of Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany. Helmholtz Centre Munich, Institute for Radiation Medicine, Munich, Germany
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Fukunaga H, Kaminaga K, Sato T, Butterworth KT, Watanabe R, Usami N, Ogawa T, Yokoya A, Prise KM. High-precision microbeam radiotherapy reveals testicular tissue-sparing effects for male fertility preservation. Sci Rep 2019; 9:12618. [PMID: 31575926 PMCID: PMC6773706 DOI: 10.1038/s41598-019-48772-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 08/05/2019] [Indexed: 12/24/2022] Open
Abstract
Microbeam radiotherapy (MRT) is based on a spatial fractionation of synchrotron X-ray microbeams at the microscale level. Although the tissue-sparing effect (TSE) in response to non-uniform radiation fields was recognized more than one century ago, the TSE of MRT in the testes and its clinical importance for preventing male fertility remain to be determined. In this study, using the combination of MRT techniques and a unique ex vivo testes organ culture, we show, for the first time, the MRT-mediated TSE for the preservation of spermatogenesis. Furthermore, our high-precision microbeam analysis revealed that the survival and potential migration steps of the non-irradiated germ stem cells in the irradiated testes tissue would be needed for the effective TSE for spermatogenesis. Our findings indicated the distribution of dose irradiated in the testes at the microscale level is of clinical importance for delivering high doses of radiation to the tumor, while still preserving male fertility.
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Affiliation(s)
- Hisanori Fukunaga
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.,Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan
| | - Kiichi Kaminaga
- Institute for Quantum Life Science, National Institutes for Quantum and Radiological Science and Technology, 2-4 Shirakata-Shirane, Tokai, Ibaraki, 319-1195, Japan
| | - Takuya Sato
- Institute of Molecular Medicine and Life Science, Yokohama City University Association of Medical Science, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Karl T Butterworth
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK
| | - Ritsuko Watanabe
- Institute for Quantum Life Science, National Institutes for Quantum and Radiological Science and Technology, 2-4 Shirakata-Shirane, Tokai, Ibaraki, 319-1195, Japan
| | - Noriko Usami
- Institute of Materials Structure Science, High Energy Accelerator Research Organization, 1-1 Oho, Tsukuba, Ibaraki, 305-0801, Japan
| | - Takehiko Ogawa
- Institute of Molecular Medicine and Life Science, Yokohama City University Association of Medical Science, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Akinari Yokoya
- Institute for Quantum Life Science, National Institutes for Quantum and Radiological Science and Technology, 2-4 Shirakata-Shirane, Tokai, Ibaraki, 319-1195, Japan.
| | - Kevin M Prise
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, UK.
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Identifying optimal clinical scenarios for synchrotron microbeam radiation therapy: A treatment planning study. Phys Med 2019; 60:111-119. [DOI: 10.1016/j.ejmp.2019.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/20/2019] [Accepted: 03/19/2019] [Indexed: 12/25/2022] Open
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16
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Comparative toxicity of synchrotron and conventional radiation therapy based on total and partial body irradiation in a murine model. Sci Rep 2018; 8:12044. [PMID: 30104646 PMCID: PMC6089899 DOI: 10.1038/s41598-018-30543-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 07/30/2018] [Indexed: 11/09/2022] Open
Abstract
Synchrotron radiation can facilitate novel radiation therapy modalities such as microbeam radiation therapy (MRT) and high dose-rate synchrotron broad-beam radiation therapy (SBBR). Both of these modalities have unique physical properties that could be exploited for an improved therapeutic effect. While pre-clinical studies report promising normal tissue sparing phenomena, systematic toxicity data are still required. Our objective was to characterise the toxicity of SBBR and MRT and to calculate equivalent doses of conventional radiation therapy (CRT). A dose-escalation study was performed on C57BLJ/6 mice using total body and partial body irradiations. Dose-response curves and TD50 values were subsequently calculated using PROBIT analysis. For SBBR at dose-rates of 37 to 41 Gy/s, we found no evidence of a normal tissue sparing effect relative to CRT. Our findings also show that the MRT valley dose, rather than the peak dose, best correlates with CRT doses for acute toxicity. Importantly, longer-term weight tracking of irradiated animals revealed more pronounced growth impairment following MRT compared to both SBBR and CRT. Overall, this study provides the first in vivo dose-equivalence data between MRT, SBBR and CRT and presents systematic toxicity data for a range of organs that can be used as a reference point for future pre-clinical work.
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The Involvement of NLRP3 on the Effects of Minocycline in an AD-Like Pathology Induced by β-Amyloid Oligomers Administered to Mice. Mol Neurobiol 2018; 56:2606-2617. [DOI: 10.1007/s12035-018-1211-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/26/2018] [Indexed: 12/21/2022]
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18
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Bazyar S, Inscoe CR, O’Brian ET, Zhou O, Lee YZ. Minibeam radiotherapy with small animal irradiators; in vitro and in vivo feasibility studies. ACTA ACUST UNITED AC 2017; 62:8924-8942. [DOI: 10.1088/1361-6560/aa926b] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Fukunaga H, Yokoya A, Taki Y, Prise KM. Radiobiological Implications of Fukushima Nuclear Accident for Personalized Medical Approach. TOHOKU J EXP MED 2017; 242:77-81. [DOI: 10.1620/tjem.242.77] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Hisanori Fukunaga
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast
- Tokai Quantum Beam Science Center, National Institutes for Quantum and Radiological Science and Technology
- Institute of Development, Aging and Cancer, Tohoku University
| | - Akinari Yokoya
- Tokai Quantum Beam Science Center, National Institutes for Quantum and Radiological Science and Technology
| | - Yasuyuki Taki
- Institute of Development, Aging and Cancer, Tohoku University
| | - Kevin M. Prise
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast
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