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Chow JCL, Ruda HE. Mechanisms of Action in FLASH Radiotherapy: A Comprehensive Review of Physicochemical and Biological Processes on Cancerous and Normal Cells. Cells 2024; 13:835. [PMID: 38786057 PMCID: PMC11120005 DOI: 10.3390/cells13100835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
The advent of FLASH radiotherapy (FLASH-RT) has brought forth a paradigm shift in cancer treatment, showcasing remarkable normal cell sparing effects with ultra-high dose rates (>40 Gy/s). This review delves into the multifaceted mechanisms underpinning the efficacy of FLASH effect, examining both physicochemical and biological hypotheses in cell biophysics. The physicochemical process encompasses oxygen depletion, reactive oxygen species, and free radical recombination. In parallel, the biological process explores the FLASH effect on the immune system and on blood vessels in treatment sites such as the brain, lung, gastrointestinal tract, skin, and subcutaneous tissue. This review investigated the selective targeting of cancer cells and the modulation of the tumor microenvironment through FLASH-RT. Examining these mechanisms, we explore the implications and challenges of integrating FLASH-RT into cancer treatment. The potential to spare normal cells, boost the immune response, and modify the tumor vasculature offers new therapeutic strategies. Despite progress in understanding FLASH-RT, this review highlights knowledge gaps, emphasizing the need for further research to optimize its clinical applications. The synthesis of physicochemical and biological insights serves as a comprehensive resource for cell biology, molecular biology, and biophysics researchers and clinicians navigating the evolution of FLASH-RT in cancer therapy.
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Affiliation(s)
- James C. L. Chow
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 1X6, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada
| | - Harry E. Ruda
- Centre of Advance Nanotechnology, Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON M5S 3E4, Canada;
- Department of Materials Science and Engineering, University of Toronto, Toronto, ON M5S 3E4, Canada
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Kayed JE, Akl T, Massoud C, Margossian C, Fayad H, Fares G, Felefly T, Rihana S. Serious game for radiotherapy training. BMC MEDICAL EDUCATION 2024; 24:463. [PMID: 38671374 PMCID: PMC11055359 DOI: 10.1186/s12909-024-05430-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Cancer patients are often treated with radiation, therefore increasing their exposure to high energy emissions. In such cases, medical errors may be threatening or fatal, inducing the need to innovate new methods for maximum reduction of irreversible events. Training is an efficient and methodical tool to subject professionals to the real world and heavily educate them on how to perform with minimal errors. An evolving technique for this is Serious Gaming that can fulfill this purpose, especially with the rise of COVID-19 and the shift to the online world, by realistic and visual simulations built to present engaging scenarios. This paper presents the first Serious Game for Lung Cancer Radiotherapy training that embodies Biomedical Engineering principles and clinical experience to create a realistic and precise platform for coherent training. METHODS To develop the game, thorough 3D modeling, animation, and gaming fundamentals were utilized to represent the whole clinical process of treatment, along with the scores and progress of every player. The model's goal is to output coherency and organization for students' ease of use and progress tracking, and to provide a beneficial educational experience supplementary to the users' training. It aims to also expand their knowledge and use of skills in critical cases where they must perform crucial decision-making and procedures on patients of different cases. RESULTS At the end of this research, one of the accomplished goals consists of building a realistic model of the different equipment and tools accompanied with the radiotherapy process received by the patient on Maya 2018, including the true beam table, gantry, X-ray tube, CT Scanner, and so on. The serious game itself was then implemented on Unity Scenes with the built models to create a gamified authentic environment that incorporates the 5 main series of steps; Screening, Contouring, External Beam Planning, Plan Evaluation, Treatment, to simulate the practical workflow of an actual Oncology treatment delivery for lung cancer patients. CONCLUSION This serious game provides an educational and empirical space for training and practice that can be used by students, trainees, and professionals to expand their knowledge and skills in the aim of reducing potential errors.
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Affiliation(s)
- Jessika El Kayed
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon
| | - Tony Akl
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon
| | - Chadi Massoud
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon.
- Faculty of Public Health, Université La Sagesse, Furn-El-Chebak, Lebanon.
| | - Christelle Margossian
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon
| | | | - Georges Fares
- Radiation Oncology Department, Hôtel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
- Radiation Oncology Department, Mount Lebanon Hospital, Hazmieh, Lebanon
| | - Tony Felefly
- Radiation Oncology Department, Hôtel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
- Radiation Oncology Department, Mount Lebanon Hospital, Hazmieh, Lebanon
| | - Sandy Rihana
- Biomedical Engineering Department, Holy Spirit University of Kaslik, USEK, Jounieh, Lebanon.
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Tan M, Chen Y, Du T, Wang Q, Wu X, Zhang Q, Luo H, Liu Z, Sun S, Yang K, Tian J, Wang X. Assessing the Impact of Charged Particle Radiation Therapy for Head and Neck Adenoid Cystic Carcinoma: A Systematic Review and Meta-Analysis. Technol Cancer Res Treat 2024; 23:15330338241246653. [PMID: 38773763 PMCID: PMC11113043 DOI: 10.1177/15330338241246653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/26/2024] [Accepted: 02/18/2024] [Indexed: 05/24/2024] Open
Abstract
Purpose: Head and neck adenoid cystic carcinoma (HNACC) is a radioresistant tumor. Particle therapy, primarily proton beam therapy and carbon-ion radiation, is a potential radiotherapy treatment for radioresistant malignancies. This study aims to conduct a meta-analysis to evaluate the impact of charged particle radiation therapy on HNACC. Methods: A comprehensive search was conducted in Pubmed, Cochrane Library, Web of Science, Embase, and Medline until December 31, 2022. The primary endpoints were overall survival (OS), local control (LC), and progression-free survival (PFS), while secondary outcomes included treatment-related toxicity. Version 17.0 of STATA was used for all analyses. Results: A total of 14 studies, involving 1297 patients, were included in the analysis. The pooled 5-year OS and PFS rates for primary HNACC were 78% (95% confidence interval [CI] = 66-91%) and 62% (95% CI = 47-77%), respectively. For all patients included, the pooled 2-year and 5-year OS, LC, and PFS rates were as follows: 86.1% (95% CI = 95-100%) and 77% (95% CI = 73-82%), 92% (95% CI = 84-100%) and 73% (95% CI = 61-85%), and 76% (95% CI = 68-84%) and 55% (95% CI = 48-62%), respectively. The rates of grade 3 and above acute toxicity were 22% (95% CI = 13-32%), while late toxicity rates were 8% (95% CI = 3-13%). Conclusions: Particle therapy has the potential to improve treatment outcomes and raise the quality of life for HNACC patients. However, further research and optimization are needed due to the limited availability and cost considerations associated with this treatment modality.
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Affiliation(s)
- Mingyu Tan
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Yanliang Chen
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Tianqi Du
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Qian Wang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Xun Wu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Qiuning Zhang
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
- Graduate School, University of Chinese Academy of Sciences, Beijing, China
| | - Hongtao Luo
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
- Graduate School, University of Chinese Academy of Sciences, Beijing, China
| | - Zhiqiang Liu
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
- Graduate School, University of Chinese Academy of Sciences, Beijing, China
| | - Shilong Sun
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
- Graduate School, University of Chinese Academy of Sciences, Beijing, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Xiaohu Wang
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
- Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
- Graduate School, University of Chinese Academy of Sciences, Beijing, China
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Shi Y, Zhang C, Liu C, Ma X, Liu Z. Image-Guided Precision Treatments. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1199:59-86. [PMID: 37460727 DOI: 10.1007/978-981-32-9902-3_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Chemotherapy, radiotherapy, and surgery are traditional cancer treatments, which usually produce unpredictable side effects and potential risks to normal healthy organs/tissues. Thus, safe and reliable treatment strategies are urgently required for maximized therapeutic efficiency to lesions and minimized risks to healthy regions. To this end, molecular imaging is responsible to undertake a specific targeting therapy. Besides that, the image guidance as a precision visualized approach for real-time in situ evaluations as well as an intraoperational navigation approach has earned attractive attention in the past decade. Along with the rapid development of multifunctional micro-/nanobiomaterials, versatile cutting-edge and advanced therapy strategies (e.g., thermal therapy, dynamic therapy, gas therapy, etc.) have been achieved and greatly contributed to the image-guided precision treatments in every aspect. Therefore, this chapter aims to discuss about both traditional and advanced cancer treatments and especially to elucidate the important roles that visualized medicine has been playing in the image-guided precision treatments.
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Affiliation(s)
- Yu Shi
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Chen Zhang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Chenxi Liu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Xinyong Ma
- Division of Academic & Cultural Activities, Academic Divisions of the Chinese Academy of Sciences, Beijing, China
| | - Zhe Liu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
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Wang B, Liu W, Liu C, Du K, Guo Z, Zhang G, Huang Z, Lin S, Cen B, Tian Y, Yuan Y, Bu J. Cancer-Associated Fibroblasts Promote Radioresistance of Breast Cancer Cells via the HGF/c-Met Signaling Pathway. Int J Radiat Oncol Biol Phys 2022:S0360-3016(22)03679-3. [PMID: 36586496 DOI: 10.1016/j.ijrobp.2022.12.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 12/10/2022] [Accepted: 12/17/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE Cancer-associated fibroblasts (CAFs) are an integral part of the tumor microenvironment (TME), which is involved in therapy resistance. This study aimed to investigate the role of CAFs in radiosensitivity of breast cancer cells. METHODS AND MATERIALS The CAFs were isolated from the breast cancer tissues, and the conditioned medium was collected to culture breast cancer cells. Radiation-induced DNA damage was evaluated by immunofluorescence and western blotting. Cytokine array and enzyme-linked immunosorbent assay were performed to analyze the secretion of cytokines and growth factors. An in vitro clonogenic survival assay and in vivo xenograft mouse model were performed to determine the radiosensitivity of breast cancer cells. Finally, the expression of hepatocyte growth factor (HGF) and c-Met in the breast cancer tissues were detected by immunohistochemistry. RESULTS The CAFs were found to secrete HGF to activate the c-Met signaling pathway, which induced epithelial-to-mesenchymal transition, growth, and radioresistance of breast cancer cells. Furthermore, radiation was observed to enhance HGF secretion by CAFs and increase c-Met expression in breast cancer cells, which led to HGF/c-Met signaling pathway activation. Moreover, radiation-induced tumor necrosis factor α (TNFα) secretion by breast cancer cells promoted CAF proliferation and HGF secretion. Additionally, HGF and c-Met high expression were associated with worse recurrence-free survival in patients with breast cancer who had received radiation therapy. CONCLUSIONS The findings revealed that HGF and TNFα are critical for the crosstalk between breast cancer cells and CAFs in the TME and that the HGF/c-Met signaling pathway is a promising therapeutic target for radiosensitizing breast cancer.
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Affiliation(s)
- Baiyao Wang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Wei Liu
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Chunshan Liu
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Kunpeng Du
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Zhaoze Guo
- Breast Center, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Guoqian Zhang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Zhong Huang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Shuhui Lin
- Department of Oncology, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen, Guangdong Province, China
| | - Bohong Cen
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Yunhong Tian
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Yawei Yuan
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, Guangdong Province, China; Department of Oncology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong Province, China.
| | - Junguo Bu
- Department of Oncology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong Province, China.
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Wang S, Tang W, Luo H, Jin F, Wang Y. The Role of Image-guided Radiotherapy in Prostate Cancer: A Systematic Review and Meta-Analysis. Clin Transl Radiat Oncol 2022; 38:81-89. [DOI: 10.1016/j.ctro.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/12/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
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Girotti AW, Fahey JF, Korytowski W. Role of nitric oxide in hyper-aggressiveness of tumor cells that survive various anti-cancer therapies. Crit Rev Oncol Hematol 2022; 179:103805. [PMID: 36087851 DOI: 10.1016/j.critrevonc.2022.103805] [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: 05/13/2022] [Revised: 08/10/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
Low level nitric oxide (NO) produced by inducible NO synthase (iNOS) in many malignant tumors is known to play a key role in the survival and proliferation of tumor cells. NO can also induce or augment resistance to anti-tumor treatments such as platinum-based chemotherapy (CT), ionizing radiotherapy (RT), and non-ionizing photodynamic therapy (PDT). In each of these treatments, tumor cells that survive the challenge may exhibit a striking increase in NO-dependent proliferative, migratory, and invasive aggressiveness compared with non-challenged controls. Moreover, NO from cells directly targeted by PDT can often stimulate aggressiveness in non- or poorly targeted bystander cells. Although NO-mediated resistance to many of these therapies is fairly-well recognized by now, the hyper-aggressiveness of surviving cells and bystander counterparts is not. We will focus on these negative aspects in this review, citing examples from the PDT, CT, and RT publications. Increased aggressiveness of cells that escape therapeutic elimination is a concern because it could enhance tumor progression and metastatic dissemination. Pharmacologic approaches for suppressing these negative responses will also be discussed, e.g., administering inhibitors of iNOS activity or iNOS expression as therapeutic adjuvants.
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Affiliation(s)
- Albert W Girotti
- Depatrment of Biochemistry, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Jonathan F Fahey
- Department of Pathology, University of Colorado, Aurora, CO, USA
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Mehri-Kakavand G, Pursamimi M, Parwaie W, Ghorbani M, Khosravi M, Hosseini SM, Soleimani Meigooni A. Assessment of Field-in-Field, 3-Field, and 4-Field Treatment Planning Methods for Radiotherapy of Gastro-Esophageal Junction Cancer. J Biomed Phys Eng 2022; 12:439-454. [PMID: 36313414 PMCID: PMC9589079 DOI: 10.31661/jbpe.v0i0.2206-1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/17/2022] [Indexed: 11/06/2022]
Abstract
Background Gastro-esophageal (GE) junction cancer is the fastest-growing tumor, particularly in the United States (US). Objective This study aimed to compare dosimetric and radiobiological factors among field-in-field (FIF), three-field (3F), and four-field box (4FB) radiotherapy planning techniques for gastro-esophageal junction cancer. Material and Methods In this experimental study, thirty patients with GE junction cancer were evaluated, and three planning techniques (field-in-field (FIF), three-field (3F), and four-field box (4FB)) were performed for each patient for a 6-MV photon beam. Dose distribution in the target volume, the monitor units (MUs) required, and the dose delivered to organs at risk (OARs) were compared for these techniques using the paired-sample t-test. Results A significant difference was measured between the FIF and 3F techniques with respect to conformity index (CI), dose homogeneity index (HI), and tumor control probability (TCP) for the target organ, as well as the Dmean for the heart, kidneys, and liver. For the spinal cord, the FIF technique showed a slight reduction in the maximum dose compared to the other two techniques. In addition, the V20 Gy of the lungs and the normal tissue complication probability (NTCP) of all OARs were reduced with FIF method. Conclusion The FIF technique showed better performance for treating patients with gastro-esophageal junction tumors, in terms of dose homogeneity in the target, conformity of the radiation field with the target volume, TCP, less dose to healthy organs, and fewer MU.
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Affiliation(s)
- Ghazal Mehri-Kakavand
- MSc, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohamad Pursamimi
- MSc, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Wrya Parwaie
- PhD, Department of Medical Physics, Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran
| | - Mahdi Ghorbani
- PhD, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khosravi
- MSc, Vali-e-Asr Radiotherapy and Oncology Center, Qom University of Medical Sciences, Qom, Iran
| | - Seyyed Mohammad Hosseini
- PhD Candidate, Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- PhD Candidate, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
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Masterson M, Wood-stott G, Jafari SM, Bradley D. A review of micro silica beads in radiation dosimetry applications. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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10
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Compact and very high dose-rate plasma focus radiation sources for medical applications. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Li J, Sun J, Liu Z, Zeng Z, Ouyang S, Zhang Z, Ma M, Kang W. The Roles of Non-Coding RNAs in Radiotherapy of Gastrointestinal Carcinoma. Front Cell Dev Biol 2022; 10:862563. [PMID: 35517505 PMCID: PMC9065280 DOI: 10.3389/fcell.2022.862563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/22/2022] [Indexed: 12/19/2022] Open
Abstract
Radiotherapy (RT), or radiation therapy, has been widely used in clinical practice for the treatment of local advanced gastrointestinal carcinoma. RT causes DNA double-strand breaks leading to cell cytotoxicity and indirectly damages tumor cells by activating downstream genes. Non-coding RNA (including microRNAs, long non-coding RNAs (ncRNAs), and circular RNAs) is a type of RNA that does not encode a protein. As the field of ncRNAs increasingly expands, new complex roles have gradually emerged for ncRNAs in RT. It has been shown that ncRNAs can act as radiosensitivity regulators in gastrointestinal carcinoma by affecting DNA damage repair, cell cycle arrest, irradiation-induced apoptosis, cell autophagy, stemness, EMT, and cell pyroptosis. Here, we review the complex roles of ncRNAs in RT and gastrointestinal carcinoma. We also discuss the potential clinical significance and predictive value of ncRNAs in response to RT for guiding the individualized treatment of patients. This review can serve as a guide for the application of ncRNAs as radiosensitivity enhancers, radioresistance inducers, and predictors of response in RT of gastrointestinal carcinoma.
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Karaca S, Koca T, Sarpün İH, Tunçel N, Korcum Şahin AF. Hybrid Tomo-Helical and Tomo-Direct radiotherapy for localized prostate cancer. J Appl Clin Med Phys 2021; 22:136-143. [PMID: 34498363 PMCID: PMC8504587 DOI: 10.1002/acm2.13406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The aim of the study is to present a new planning approach to provide better planning target volume (PTV) coverage and reduce bladder and rectum dose with hybrid Tomo-Helical (TH)/Tomo-Direct (TD) radiotherapy (RT) for localized prostate cancer (LPC). METHODS Twenty-five LPC patients were included in this retrospective study. TH plans, TD plans, and hybrid TH/TD plans were created. Lateral beams were used for the hybrid TD plan and the prescribed dose was 70 Gy in 28 fractions (hybrid plans were combined 45 Gy/ 18 fxs for TH and 25 Gy/10 fxs for TD). Doses of PTV (D2%, D98%, D50%, homogeneity index (HI), conformity index (CI), coverage) and organs at risk (OARs) (V50%, V35%, V25%, V5%, and V95%) were analyzed. The Wilcoxon signed-rank test was used to analyze the difference in dosimetric parameters. p-Value < 0.05 was considered statistically significant. RESULTS TH plans showed better CI, and target coverage (p < 0.01) than TD and hybrid plans in all patient plan evaluations. However, TD plans D2%, D98%, and D50% doses were better than TH and hybrid plans. The HI values were similar between the three plans. Significant reductions in bladder and rectum V50%, V35%, and V25% doses (p < 0.001) were observed with hybrid plans compared to TH and TD. Penile bulb V95% and bowel V5% doses were better in the hybrid plans. Left and right femoral head V5% doses were higher in the hybrid plan compared to others (p < 0.001). CONCLUSION Concurrently hybrid TH/TD RT plan can be a good option to reduce the doses of the rectum and bladder in the RT of LPC.
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Affiliation(s)
- Sibel Karaca
- Department of Radiation OncologyFaculty of MedicineAkdeniz UniversityAntalyaTurkey
| | - Timur Koca
- Department of Radiation OncologyFaculty of MedicineAkdeniz UniversityAntalyaTurkey
| | - İsmail Hakkı Sarpün
- Department of Radiation OncologyFaculty of MedicineAkdeniz UniversityAntalyaTurkey
| | - Nina Tunçel
- Department of Radiation OncologyFaculty of MedicineAkdeniz UniversityAntalyaTurkey
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Vijayan M, Joseph S, James E, Dutta D. A review on radiation induced nausea and vomiting: "Current management strategies and prominence of radio sensitizers". J Oncol Pharm Pract 2021; 27:1061-1072. [PMID: 33947288 DOI: 10.1177/10781552211011539] [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] [Indexed: 11/17/2022]
Abstract
Radiations dissipated are high energy waves used mostly as treatment intervention in controlling the unwanted multiplication of cell. About 60%-65% of cancer treatment requires radiation therapy and 40%-80% of radiation therapy causes RINV which are true troublemakers. Radiation therapy (RT) is targeted therapy mostly used to treat early stages of tumour and prevent their reoccurrence. They mainly destroy the genetic material (DNA) of cancerous cells to avoid their unwanted growth and division. The RINV affects the management and quality of life of patients which further reduces the patient outcome. RINV depends on RT related factors (dose, fractionation, irradiation volume, RT techniques) and patient related factors like (gender, health conditions, age, concurrent chemotherapy, psychological state, and tumour stage). RT is an active area of research and there is only limited progress in tackling the RINV crisis. Advanced technological methods are adopted that led to better understanding of total lethal doses. Radiation therapy also affects the immunity system that leads to radiation induced immune responses and inflammation. Radio sensitizers are used to sensitize the tumour cells to radiations that further prevent the normal cell damage from radiation exposure. There is a need for future studies and researches to re-evaluate the data available from previous trials in RINV to make better effective antiemetic regimen. The article focuses on radiation therapy induced nausea and vomiting along with their mechanism of action and treatment strategies in order to have a remarkable patient care.
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Affiliation(s)
- Meenu Vijayan
- Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Sherin Joseph
- Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Emmanuel James
- Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Debnarayan Dutta
- Department of Radiation Oncology, Amrita Vishwa Vidyapeetham, Kochi, India
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Kazimova T, Tschanz F, Sharma A, Telarovic I, Wachtel M, Pedot G, Schäfer B, Pruschy M. Paracrine Placental Growth Factor Signaling in Response to Ionizing Radiation Is p53-Dependent and Contributes to Radioresistance. Mol Cancer Res 2021; 19:1051-1062. [PMID: 33619227 DOI: 10.1158/1541-7786.mcr-20-0403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 01/05/2021] [Accepted: 02/16/2021] [Indexed: 11/16/2022]
Abstract
Placental growth factor (PlGF) is a pro-angiogenic, N-glycosylated growth factor, which is secreted under pathologic situations. Here, we investigated the regulation of PlGF in response to ionizing radiation (IR) and its role for tumor angiogenesis and radiosensitivity. Secretion and expression of PlGF was induced in multiple tumor cell lines (medulloblastoma, colon and lung adenocarcinoma) in response to irradiation in a dose- and time-dependent manner. Early upregulation of PlGF expression and secretion in response to irradiation was primarily observed in p53 wild-type tumor cells, whereas tumor cells with mutated p53 only showed a minimal or delayed response. Mechanistic investigations with genetic and pharmacologic targeting of p53 corroborated regulation of PlGF by the tumor suppressor p53 in response to irradiation under normoxic and hypoxic conditions, but with so far unresolved mechanisms relevant for its minimal and delayed expression in tumor cells with a p53-mutated genetic background. Probing a paracrine role of IR-induced PlGF secretion in vitro, migration of endothelial cells was specifically increased towards irradiated PlGF wild type but not towards irradiated PlGF-knockout (PIGF-ko) medulloblastoma cells. Tumors derived from these PlGF-ko cells displayed a reduced growth rate, but similar tumor vasculature formation as in their wild-type counterparts. Interestingly though, high-dose irradiation strongly reduced microvessel density with a concomitant high rate of complete tumor regression only in the PlGF-ko tumors. IMPLICATIONS: Our study shows a strong paracrine vasculature-protective role of PlGF as part of a p53-regulated IR-induced resistance mechanism and suggest PlGF as a promising target for a combined treatment modality with RT.
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Affiliation(s)
- Tamara Kazimova
- Laboratory for Applied Radiobiology, Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Fabienne Tschanz
- Laboratory for Applied Radiobiology, Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ashish Sharma
- Clinical Science Oncology, Medical & Scientific Affairs, Roche Diagnostics International Ltd., Rotkreuz Switzerland
| | - Irma Telarovic
- Laboratory for Applied Radiobiology, Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marco Wachtel
- Department of Oncology and Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Gloria Pedot
- Department of Oncology and Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Beat Schäfer
- Department of Oncology and Children's Research Center, University Children's Hospital, Zurich, Switzerland
| | - Martin Pruschy
- Laboratory for Applied Radiobiology, Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
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15
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Yang S, Yang Y, Yang Y, Zhao X, Wang Q, Li B, Dong L, Tian R, Bao Z. Iron-Palladium Decorated Carbon Nanotubes Achieve Radiosensitization via Reactive Oxygen Species Burst. Front Bioeng Biotechnol 2021; 9:683363. [PMID: 34095102 PMCID: PMC8176102 DOI: 10.3389/fbioe.2021.683363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Radiotherapy is recommended as a modality for cancer treatment in clinic. However, cancerous cells were resistant to therapeutic irradiation due to its DNA repair. In this work, single-walled carbon nanotubes with unique physical properties of hollow structures and high specific surface area were introduced as carrier for iron-palladium (FePd) to obtain iron-palladium decorated carbon nanotubes (FePd@CNTs). On one hand, FePd nanoparticles possess significant ability in radiosensitization as previously reported. On the other hand, carbon nanotubes offer higher efficiency in crossing biological barriers, inducing the accumulation and retention of FePd nanoparticles within tumor tissue. In order to verify the radiosensitization effect of FePd@CNTs, both in vitro and in vivo experiments were conducted. These experiments showed that the FePd@CNTs exhibited remarkably better radiosensitization effect and more obvious accumulation than FePd NPs, suggesting a potential of FePd@CNTs in radiosensitization.
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Affiliation(s)
- Shengnan Yang
- Department of Geriatric Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yiling Yang
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yi Yang
- Department of Geriatric Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiangya Zhao
- Department of Geriatric Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qian Wang
- Department of Geriatric Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bing Li
- Department of Geriatric Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ling Dong
- Department of Geriatric Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rui Tian
- Department of Geriatric Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhirong Bao
- Hubei Key Laboratory of Tumor Biological Behaviors, Department of Radiation and Medical Oncology, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China
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16
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He C, Li L, Wang L, Meng W, Hao Y, Zhu G. Exosome-mediated cellular crosstalk within the tumor microenvironment upon irradiation. Cancer Biol Med 2021; 18:21-33. [PMID: 33628582 PMCID: PMC7877182 DOI: 10.20892/j.issn.2095-3941.2020.0150] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/09/2020] [Indexed: 02/06/2023] Open
Abstract
Radiotherapy is one of the most effective treatment methods for various solid tumors. Bidirectional signal transduction between cancer cells and stromal cells within the irradiated microenvironment is important in cancer development and treatment responsiveness. Exosomes, initially considered as “garbage bins” for unwanted from cells, are now understood to perform a variety of functions in interactions within the tumor microenvironment. Exosome-mediated regulation processes are rebuilt under the irradiation stimuli, because the exosome production, uptake, and contents are markedly modified by irradiation. In turn, irradiation-modified exosomes may modulate the cell response to irradiation through feedback regulation. Here, we review current knowledge and discuss the roles of exosome-mediated interactions between cells under radiotherapy conditions.
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Affiliation(s)
- Chuanshi He
- Department of Stomatology, Sichuan Cancer Hospital, Sichuan Key Laboratory of Radiation Oncology, School of Medicine, University of Electronic Science and Technology of China
| | - Ling Li
- Department of Stomatology, Sichuan Cancer Hospital, Sichuan Key Laboratory of Radiation Oncology, School of Medicine, University of Electronic Science and Technology of China
| | - Linlin Wang
- Department of Stomatology, Sichuan Cancer Hospital, Sichuan Key Laboratory of Radiation Oncology, School of Medicine, University of Electronic Science and Technology of China
| | - Wanrong Meng
- Department of Stomatology, Sichuan Cancer Hospital, Sichuan Key Laboratory of Radiation Oncology, School of Medicine, University of Electronic Science and Technology of China
| | - Yaying Hao
- Department of Stomatology, Sichuan Cancer Hospital, Sichuan Key Laboratory of Radiation Oncology, School of Medicine, University of Electronic Science and Technology of China
| | - Guiquan Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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17
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Differential Effects of Gold Nanoparticles and Ionizing Radiation on Cell Motility between Primary Human Colonic and Melanocytic Cells and Their Cancerous Counterparts. Int J Mol Sci 2021; 22:ijms22031418. [PMID: 33572551 PMCID: PMC7866826 DOI: 10.3390/ijms22031418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 02/07/2023] Open
Abstract
This study examined the effects of gold nanoparticles (AuNPs) and/or ionizing radiation (IR) on the viability and motility of human primary colon epithelial (CCD841) and colorectal adenocarcinoma (SW48) cells as well as human primary epidermal melanocytes (HEM) and melanoma (MM418-C1) cells. AuNPs up to 4 mM had no effect on the viability of these cell lines. The viability of the cancer cells was ~60% following exposure to 5 Gy. Exposure to 5 Gy X-rays or 1 mM AuNPs showed the migration of the cancer cells ~85% that of untreated controls, while co-treatment with AuNPs and IR decreased migration to ~60%. In the non-cancerous cell lines gap closure was enhanced by ~15% following 1 mM AuNPs or 5 Gy treatment, while for co-treatment it was ~22% greater than that for the untreated controls. AuNPs had no effect on cell re-adhesion, while IR enhanced only the re-adhesion of the cancer cell lines but not their non-cancerous counterparts. The addition of AuNPs did not enhance cell adherence. This different reaction to AuNPs and IR in the cancer and normal cells can be attributed to radiation-induced adhesiveness and metabolic differences between tumour cells and their non-cancerous counterparts.
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18
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Mackenzie P, Vajdic C, Delaney G, Gabriel G, Agar M, Comans T, Barton M. Factors affecting radiotherapy utilisation in geriatric oncology patients in NSW, Australia. Tech Innov Patient Support Radiat Oncol 2021; 16:17-23. [PMID: 33385070 PMCID: PMC7769853 DOI: 10.1016/j.tipsro.2020.09.003] [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: 04/09/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 12/26/2022] Open
Abstract
Background and Purpose Large non-age-specific radiotherapy utilisation rate (RTU) studies have demonstrated that actual RTU is below the optimal recommended utilisation rate for both curative and palliative intent radiotherapy indications. The optimal utilisation rate for the geriatric oncology cohort of patients has not yet been determined. The purpose of this research was to examine the actual RTU for patients treated in New South Wales (NSW), Australia as a function of increasing age, and the relationship between RTU and tumour site, travelling distance and socio-economic status. Materials & Methods NSW Central Cancer Registry data (2009-2011) were linked to the NSW Radiotherapy Dataset (2009-2012). RTU was calculated for patients aged <80 years and ≥80 years. RTU was defined as the proportion of patients receiving at least a single course of radiotherapy within 12 months of a cancer diagnosis. Results 110,645 patients were diagnosed with cancer, of whom 27,721 received at least one course of radiotherapy. The overall RTU was 25%. RTU for patients aged <80 years was 28% compared to 14% for patients aged 80+ years (p < 0.001). On both univariate and multivariate analysis, increasing age, residential address in disadvantaged socioeconomic areas and increasing distance to the nearest radiotherapy department were associated with a reduction in RTU. Conclusion Geriatric oncology patients are less likely to receive radiotherapy than their younger counterparts. Some of the reduction in RTU may be justifiable on the basis of limited life expectancy and co-morbidity. Further research is required to determine the co-morbidity adjusted optimal RTU in older patients.
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Affiliation(s)
- Penny Mackenzie
- St Andrew's Hospital, Icon Cancer Care, Toowoomba, QLD, Australia.,Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | | | - Geoff Delaney
- Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Gabriel Gabriel
- Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Meera Agar
- University of Technology, Sydney, Australia
| | | | - Michael Barton
- Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
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19
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Marland JR, Gray ME, Dunare C, Blair EO, Tsiamis A, Sullivan P, González-Fernández E, Greenhalgh SN, Gregson R, Clutton RE, Parys MM, Dyson A, Singer M, Kunkler IH, Potter MA, Mitra S, Terry JG, Smith S, Mount AR, Underwood I, Walton AJ, Argyle DJ, Murray AF. Real-time measurement of tumour hypoxia using an implantable microfabricated oxygen sensor. SENSING AND BIO-SENSING RESEARCH 2020. [DOI: 10.1016/j.sbsr.2020.100375] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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20
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Ong CL, Giaj-Levra N, Nicosia L, Figlia V, Tomasini D, Franken EM, Alongi F. Intra-fraction and Inter-fraction analysis of a dedicated immobilization device for intracranial radiation treatment. Radiat Oncol 2020; 15:200. [PMID: 32811519 PMCID: PMC7437162 DOI: 10.1186/s13014-020-01639-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 08/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Immobilization devices are crucial to minimize patient positioning uncertainties in radiotherapy (RT) treatments. Accurate inter and intra-fraction motions is particularly important for intracranial and stereotactic radiation treatment which require high precision in dose delivery. Recently, a new immobilization device has been developed specifically for the radiation treatment of intracranial malignancies. To date, no data are available on the use of this device in daily clinical practice. The aim of this study is to investigate the intra and inter-fraction variations, patient comfort and radiographer confidence of the immobilization system from two distinct institutions: HagaZiekenhuis, Den Haag, Netherlands and IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy. Material and method Sixteen patients (10 diagnosed with brain metastases and 6 with primary central nervous systemic tumor) from IRCCS Ospedale Sacro Cuore Don Calabria and 17 patients (all diagnosed with brain metastases tumor) from HagaZiekenhuis were included in this study. The median target volume was 436 cc (range 3.2–1628 cc) and 4.58 cc (range 0.4–27.19 cc) for IRCCS and Haga, respectively. For patients treated in IRCCS Sacro Cuore Don Calabria, the median dose prescription was 30 Gy (range 27–60 Gy) and median number of fractions 10 (range 3–30). In Haga the median dose prescription was 21 Gy (range 8–21 Gy) and the median number of fraction was 1 (range 1–3). The immobilization device was assembled during CT simulation. A short interview to the patient regarding the device’s comfort level was conducted at the end of the simulation procedure. Additionally, simulation setup time and radiographer (RTT) procedures (i.e. mask preparation) were evaluated. Prior to radiation treatment delivery, an automatic rigid match on the cranial bones between cone beam computed tomography (CBCT) and planning-CT was performed. A couch shift was performed subsequently. An extra post-treatment CBCT was acquire after the treatment delivery. This post-treatment CBCT was matched with pre-treatment CBCT to identify any possible intra-fraction motion. All online matches were validated by experienced radiation oncologist or RTT. A total of 126 CBCT’s were analyzed offline by radiation oncologist/medical physicist. The data of the pre-treatment CBCT match was used to quantify inter-fraction motion. The post-treatment CBCT was matched with pre-treatment CBCT to identify any possible intra-fraction motion. Results During the molding of the mask, all patients responded positive to the comfort. Median time required by the RTTs to assemble the immobilization system was 9 min (range 6–12 min). In terms of comfort, all patients reported a good-to high level of satisfaction. The RTTs also respond positively towards the use of the locking mechanism and clips. Results of positioning uncertainties were comparable between the two institutes. The mean inter-fraction motion for all translational and rotational directions were < 2 mm (SD < 4 mm) and < 0.5°(SD < 1.5°), respectively, while the mean intra-fraction motions were < 0.4 mm (SD < 0.6 mm) and 0.3° (SD < 0.5°). Conclusions This study demonstrates the efficacy and feasibility of the immobilization device in the intracranial radiation treatment. Both patient comfort and preparation time by RTTs are considered adequate. In combination with online daily imaging procedure, this device can achieve submillimeter accuracy required for intracranial and stereotactic treatments.
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Affiliation(s)
- Chin Loon Ong
- Department of Radiotherapy, HagaZiekenhuis, Den Haag, The Netherlands
| | - Niccolò Giaj-Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A.Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy.
| | - Luca Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A.Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Vanessa Figlia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A.Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Davide Tomasini
- Radiation Oncology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Eric M Franken
- Department of Radiotherapy, HagaZiekenhuis, Den Haag, The Netherlands
| | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A.Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy.,University of Brescia, Brescia, Italy
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21
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Kearney M, Coffey M, Leong A. A review of Image Guided Radiation Therapy in head and neck cancer from 2009-201 - Best Practice Recommendations for RTTs in the Clinic. Tech Innov Patient Support Radiat Oncol 2020; 14:43-50. [PMID: 32566769 PMCID: PMC7296359 DOI: 10.1016/j.tipsro.2020.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/17/2020] [Accepted: 02/11/2020] [Indexed: 02/06/2023] Open
Abstract
Radiation therapy (RT) is beneficial in Head and Neck Cancer (HNC) in both the definitive and adjuvant setting. Highly complex and conformal planning techniques are becoming standard practice in delivering increased doses in HNC. A sharp falloff in dose outside the high dose area is characteristic of highly complex techniques and geometric uncertainties must be minimised to prevent under dosage of the target volume and possible over dosage of surrounding critical structures. CTV-PTV margins are employed to account for geometric uncertainties such as set up errors and both interfraction and intrafraction motion. Robust immobilisation and Image Guided Radiation Therapy (IGRT) is also essential in this group of patients to minimise discrepancies in patient position during the treatment course. IGRT has evolved with increased 2-Dimensional (2D) and 3-Dimensional (3D) IGRT modalities available for geometric verification. 2D and 3D IGRT modalities are both beneficial in geometric verification while 3D imaging is a valuable tool in assessing volumetric changes that may have dosimetric consequences for this group of patients. IGRT if executed effectively and efficiently provides clinicians with confidence to reduce CTV-PTV margins thus limiting treatment related toxicities in patients. Accumulated exposure dose from IGRT vary considerably and may be incorporated into the treatment plan to avoid excess dose. However, there are considerable variations in the application of IGRT in RT practice. This paper aims to summarise the advances in IGRT in HNC treatment and provide clinics with recommendations for an IGRT strategy for HNC in the clinic.
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Affiliation(s)
- Maeve Kearney
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College, Dublin 2, Ireland
| | - Mary Coffey
- Applied Radiation Therapy Trinity, Discipline of Radiation Therapy, Trinity College, Dublin 2, Ireland
| | - Aidan Leong
- Department of Radiation Therapy, University of Otago, Wellington, New Zealand.,Bowen Icon Cancer Centre, Wellington, New Zealand
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22
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Pereira PMR, Edwards KJ, Mandleywala K, Carter LM, Escorcia FE, Campesato LF, Cornejo M, Abma L, Mohsen AA, Iacobuzio-Donahue CA, Merghoub T, Lewis JS. iNOS Regulates the Therapeutic Response of Pancreatic Cancer Cells to Radiotherapy. Cancer Res 2020; 80:1681-1692. [PMID: 32086240 PMCID: PMC7165066 DOI: 10.1158/0008-5472.can-19-2991] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/30/2019] [Accepted: 02/17/2020] [Indexed: 02/06/2023]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is highly resistant to radiotherapy, chemotherapy, or a combination of these modalities, and surgery remains the only curative intervention for localized disease. Although cancer-associated fibroblasts (CAF) are abundant in PDAC tumors, the effects of radiotherapy on CAFs and the response of PDAC cells to radiotherapy are unknown. Using patient samples and orthotopic PDAC biological models, we showed that radiotherapy increased inducible nitric oxide synthase (iNOS) in the tumor tissues. Mechanistic in vitro studies showed that, although undetectable in radiotherapy-activated tumor cells, iNOS expression and nitric oxide (NO) secretion were significantly increased in CAFs secretome following radiotherapy. Culture of PDAC cells with conditioned media from radiotherapy-activated CAFs increased iNOS/NO signaling in tumor cells through NF-κB, which, in turn, elevated the release of inflammatory cytokines by the tumor cells. Increased NO after radiotherapy in PDAC contributed to an acidic microenvironment that was detectable using the radiolabeled pH (low) insertion peptide (pHLIP). In murine orthotopic PDAC models, pancreatic tumor growth was delayed when iNOS inhibition was combined with radiotherapy. These data show the important role that iNOS/NO signaling plays in the effectiveness of radiotherapy to treat PDAC tumors. SIGNIFICANCE: A radiolabeled pH-targeted peptide can be used as a PET imaging tool to assess therapy response within PDAC and blocking iNOS/NO signaling may improve radiotherapy outcomes.
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Affiliation(s)
- Patricia M R Pereira
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kimberly J Edwards
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Komal Mandleywala
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lukas M Carter
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Freddy E Escorcia
- Molecular Imaging Program, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Luis Felipe Campesato
- Swim Across America and Ludwig Collaborative Laboratory, Immunology Program, Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mike Cornejo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lolkje Abma
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Abu-Akeel Mohsen
- Swim Across America and Ludwig Collaborative Laboratory, Immunology Program, Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christine A Iacobuzio-Donahue
- The David M. Rubenstein Center for Pancreatic Cancer Research, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Taha Merghoub
- Swim Across America and Ludwig Collaborative Laboratory, Immunology Program, Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Pharmacology, Weill Cornell Medical College, New York, New York
- Department of Radiology, Weill Cornell Medical College, New York, New York
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
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23
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Cobi AC, Gray L, Mittmann ER, Link SB, Hanumara NC, Lyatskaya Y, Roche E, Slocum AH, Zygmanski P. Design of a Reconfigurable Quality Assurance Phantom for Verifying the Spatial Accuracy of Radiosurgery Treatments for Multiple Brain Metastases. J Med Device 2019. [DOI: 10.1115/1.4044402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Radiation therapy frequently involves highly customized and complex treatments, employing sophisticated equipment, that require extensive patient-specific validation to verify the accuracy of the treatment plan as part of the clinical quality assurance (QA) process. This paper introduces a novel, reconfigurable QA phantom developed for the spatial validation of radiosurgery treatments of multiple brain metastases (MBM). This phantom works in conjunction with existing electronic portal imaging detector (EPID) technology to rapidly verify MBM treatment plans with submillimeter accuracy. The device provides a 12 × 12 × 12 cm3 active volume and multiple, independently configurable markers, in the form of 3 mm diameter radiopaque spheres, which serve as surrogates for brain lesions. The device is lightweight, portable, can be setup by a single operator, and is adaptable for use with external beam radiotherapy (EBRT) techniques and stereotactic linear accelerators (LINACs). This paper presents the device design and fabrication, along with initial testing and validation results both in the laboratory, using a coordinate measuring machine (CMM) and under simulated clinical conditions, using a radiosurgery treatment plan with 15 lesions. The device has been shown to place markers in space with a 0.45 mm root-mean-square error, which is satisfactory for initial clinical use. The device is undergoing further testing under simulated clinical conditions and improvements to reduce marker positional error.
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Affiliation(s)
- Alban C. Cobi
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Luke Gray
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Elizabeth R. Mittmann
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Steven B. Link
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Nevan C. Hanumara
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Yulia Lyatskaya
- Department of Radiation Oncology, BWH/DFCI/HMS, Boston, MA 02115
| | - Ellen Roche
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Alexander H. Slocum
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139
| | - Piotr Zygmanski
- Department of Radiation Oncology, BWH/DFCI/HMS, Boston, MA 02115
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24
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Alvarez-Lorenzo C, Concheiro A. Smart Drug Release from Medical Devices. J Pharmacol Exp Ther 2019; 370:544-554. [DOI: 10.1124/jpet.119.257220] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/01/2019] [Indexed: 12/23/2022] Open
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25
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Man Z, Chen T, Zhu Z, Zhang H, Ao L, Xi L, Zhou J, Tang Z. High expression of TRIM36 is associated with radiosensitivity in gastric cancer. Oncol Lett 2019; 17:4401-4408. [PMID: 30944633 PMCID: PMC6444413 DOI: 10.3892/ol.2019.10122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 02/11/2019] [Indexed: 12/20/2022] Open
Abstract
Radiotherapy is one of the main adjuvant treatments for gastric cancer (GC) that can effectively reduce local recurrence and improve survival rates. However, radiotherapy may result in cytotoxicity and not benefit all patients. This highlights the requirement for identifying potential radiosensitivity genes in GC. The current study investigated the association between tripartite motif containing 36 (TRIM36) status and the prognosis of patients with GC receiving radiotherapy. A total of 371 patients with GC were selected from The Cancer Genome Atlas and randomly divided into test and the validation groups. The results revealed that TRIM36 expression was not associated with the overall survival (OS) rate. Patients who received radiotherapy with high TRIM36 expression had an improved OS rate compared with patients who did not receive radiotherapy in the test group, as demonstrated by univariate analysis [hazard ratio (HR), 0.062; 95% confidence interval (CI), 0.008–0.462; P=0.007] and multivariate analysis (HR, 0.095; 95% CI, 0.012–0.748; P=0.025). In the validation group, patients with high TRIM36 expression had decreased mortality risk when they received radiotherapy compared with patients who did not receive radiotherapy, as determined by univariate analysis (HR, 0.190; 95% CI, 0.067–0.540; P=0.002) and multivariate analysis (HR, 0.075; 95% CI, 0.020–0.276; P<0.001). However, for patients with low expression, no significant difference was identified in the overall survival rates between the radiotherapy and non-radiotherapy groups. Chi-squared analysis revealed that the expression status of TRIM36 was an independent factor and was not associated with clinicopathological factors. The results indicated that patients with high TRIM36 expression receiving radiotherapy exhibited an improved OS rate. TRIM36 may therefore be an important factor affecting the clinical prognosis of patients with GC receiving radiotherapy and may be considered as a potential radiosensitivity gene signature.
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Affiliation(s)
- Zhongsong Man
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Tao Chen
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Zhongwei Zhu
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Haitao Zhang
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Lei Ao
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Liting Xi
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Jin Zhou
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Zaixiang Tang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
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Lorenz E, Scholz-Kreisel P, Baaken D, Pokora R, Blettner M. Radiotherapy for childhood cancer and subsequent thyroid cancer risk: a systematic review. Eur J Epidemiol 2018; 33:1139-1162. [PMID: 30511135 DOI: 10.1007/s10654-018-0467-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 11/20/2018] [Indexed: 12/18/2022]
Abstract
Most of the pooled analyses and reviews reported an association between radiotherapy for childhood cancer and an increased thyroid cancer risk. Up to now this article presents the first systematic literature review on this association combined with a critical assessment of the methodological quality of the included articles. PubMed and Web of Science databases were searched for relevant articles until May 2016. We included peer-reviewed cohort and case-control studies that investigated an association between radiotherapy for childhood cancer and the occurrence of subsequent thyroid cancer. A systematic overview is presented for the included studies. We identified 17 retrospective cohort studies, and four nested case-control studies, representing 100,818 subjects. The age range at first cancer diagnosis was 0-25.2 years. Considerable variability was found regarding study sizes, study design, treatment strategies, dose information, and follow-up periods. 20 of the 21 identified studies showed increased thyroid cancer risks associated with childhood radiation exposure. The large majority showed an increased relative risk or odds ratio confirming the association between radiotherapy and thyroid cancer although the variation in results was large. Additionally to a pooled analysis that has been published recently, we systematically included 17 further studies, which allowed us to cover information from countries that were not covered by large-scale childhood cancer survivor studies. The methodological limitations of existing studies and inconsistencies in findings across studies yielded a large study heterogeneity, which made a detailed comparison of study results difficult. There is a need to strengthen standardisation for reporting.
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Affiliation(s)
- Eva Lorenz
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, 55101, Mainz, Germany. .,Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Straße 74, 20359, Hamburg, Germany.
| | - Peter Scholz-Kreisel
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, 55101, Mainz, Germany
| | - Dan Baaken
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, 55101, Mainz, Germany
| | - Roman Pokora
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, 55101, Mainz, Germany
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, 55101, Mainz, Germany
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Design and Evaluation of a MEMS Magnetic Field Sensor-Based Respiratory Monitoring and Training System for Radiotherapy. SENSORS 2018; 18:s18092742. [PMID: 30134526 PMCID: PMC6163714 DOI: 10.3390/s18092742] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/16/2018] [Accepted: 08/18/2018] [Indexed: 12/25/2022]
Abstract
The patient’s respiratory pattern and reproducibility are important factors affecting the accuracy of radiotherapy for lung cancer or liver cancer cases. Therefore, respiration training is required to induce respiration regularity before radiotherapy. However, the need for specialized personnel, space, and time-consuming training represent limitations. To solve these problems, we have developed a respiratory monitoring and training system based on a micro-electro-mechanical-system (MEMS) magnetic sensor. This system consists of a small attaching magnet, a sensor, and a breathing pattern output device. In this study, we evaluated the performance of the signal measurement in the developed system based on the various respiratory cycles, the amplitudes, and the position angles of the magnet and the sensor. The system can provide a more accurate breathing signal graph with lower measurement error and higher spatial resolution than conventional sensor methods by using additional magnet. In addition, it is possible the patient to monitor and train breathing himself by making it easy to carry and use without restriction of time and space.
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Construction of dose response curves up to 6 Gy for Micronucleus and Dicentric Chromosome Aberration Assay with 6 MV X-ray Beam. RADIAT MEAS 2018. [DOI: 10.1016/j.radmeas.2018.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Buontempo F, Orsini E, Zironi I, Isolan L, Cappellini A, Rapino S, Tartari A, Mostacci D, Cucchi G, Martelli AM, Sumini M, Castellani G. Enhancing radiosensitivity of melanoma cells through very high dose rate pulses released by a plasma focus device. PLoS One 2018; 13:e0199312. [PMID: 29958291 PMCID: PMC6025851 DOI: 10.1371/journal.pone.0199312] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 06/05/2018] [Indexed: 12/19/2022] Open
Abstract
Radiation therapy is a useful and standard tumor treatment strategy. Despite recent advances in delivery of ionizing radiation, survival rates for some cancer patients are still low because of recurrence and radioresistance. This is why many novel approaches have been explored to improve radiotherapy outcome. Some strategies are focused on enhancement of accuracy in ionizing radiation delivery and on the generation of greater radiation beams, for example with a higher dose rate. In the present study we proposed an in vitro research of the biological effects of very high dose rate beam on SK-Mel28 and A375, two radioresistant human melanoma cell lines. The beam was delivered by a pulsed plasma device, a "Mather type" Plasma Focus for medical applications. We hypothesized that this pulsed X-rays generator is significantly more effective to impair melanoma cells survival compared to conventional X-ray tube. Very high dose rate treatments were able to reduce clonogenic efficiency of SK-Mel28 and A375 more than the X-ray tube and to induce a greater, less easy-to-repair DNA double-strand breaks. Very little is known about biological consequences of such dose rate. Our characterization is preliminary but is the first step toward future clinical considerations.
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Affiliation(s)
- Francesca Buontempo
- University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna, Italy
| | - Ester Orsini
- University of Bologna, Department of Biomedical and Neuromotor Sciences, Bologna, Italy
| | - Isabella Zironi
- University of Bologna, Department of Physics and Astronomy, Bologna, Italy
- University of Bologna, Department of Chemistry “G. Ciamician”, Bologna, Italy
- Interdepartmental Centre “L. Galvani” (CIG) for integrated studies of bioinformatics, biophysics and biocomplexity, Bologna, Italy
| | - Lorenzo Isolan
- European Institute of Oncology and Monzino Cardiac Center Foundation (IEO-CCM), Milano, Italy
- University of Bologna, Department of Industrial Engineering, Bologna, Italy
| | - Alessandra Cappellini
- University of Cassino and Southern Lazio, Department of Human Social and Health Sciences, Cassino, Italy
| | - Stefania Rapino
- Interdepartmental Centre “L. Galvani” (CIG) for integrated studies of bioinformatics, biophysics and biocomplexity, Bologna, Italy
- National Institute for Nuclear Physics (INFN), Bologna, Italy
| | - Agostino Tartari
- European Institute of Oncology and Monzino Cardiac Center Foundation (IEO-CCM), Milano, Italy
| | - Domiziano Mostacci
- European Institute of Oncology and Monzino Cardiac Center Foundation (IEO-CCM), Milano, Italy
| | - Giorgio Cucchi
- European Institute of Oncology and Monzino Cardiac Center Foundation (IEO-CCM), Milano, Italy
| | | | - Marco Sumini
- University of Bologna, Department of Chemistry “G. Ciamician”, Bologna, Italy
- European Institute of Oncology and Monzino Cardiac Center Foundation (IEO-CCM), Milano, Italy
| | - Gastone Castellani
- University of Bologna, Department of Physics and Astronomy, Bologna, Italy
- University of Bologna, Department of Chemistry “G. Ciamician”, Bologna, Italy
- Interdepartmental Centre “L. Galvani” (CIG) for integrated studies of bioinformatics, biophysics and biocomplexity, Bologna, Italy
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Abstract
PURPOSE OF REVIEW The aim of this article is to examine significant advances in our understanding of the late respiratory effects of cancer treatment, including surgery, radiotherapy, chemotherapy, biological therapies and haematopoietic stem cell transplant, and to provide a framework for assessing such patients. RECENT FINDINGS Oncology therapies have advanced considerably over recent years but pulmonary toxicity remains a concern. Advances have been made in our understanding of the risk factors, including genetic ones that lead to toxicity from radiotherapy and chemotherapy and risk stratification models are being developed to aid treatment planning. Targeted biological treatments are continuously being developed and consequently the Pneumotox database of pulmonary toxicity continues to be an essential resource. Early detection of bronchiolitis obliterans in haematopoietic stem cell transplant patients has been found to be critical, with some positive results from intervention trials. SUMMARY Pulmonary toxicity is a common unwanted consequence of life enhancing or saving cancer treatments which remain difficult to treat. Developments in these fields are mainly in the areas of prevention, early detection and monitoring of unwanted side effects. We discuss some of these developments within this review.
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Singh G, Oinam AS, Kamal R, Handa B, Kumar V, Rai B. Voxel based BED and EQD 2 Evaluation of the Radiotherapy Treatment Plan. J Med Phys 2018; 43:155-161. [PMID: 30305772 PMCID: PMC6172864 DOI: 10.4103/jmp.jmp_29_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Three-dimensional (3D) treatment planning of patient undergoing radiotherapy uses complex and meticulous computational algorithms. These algorithms use 3D voxel data of the patient to calculate the radiation dose distribution and display it over the CT image dataset for treatment plan evaluation. Aims and Objective: The purpose of the present study is the development and implementation of radiobiological evaluation of the radiotherapy treatment plan incorporating the tissue-specific radiobiological parameters. Material and Method: An indigenous program was written in MATLAB® software (version 2011b of Mathworks Inc.) to extract the patient treatment plan data from DICOM-RT files which are exported from the treatment planning system. CT-, Structures- and Dose-Cube matrices are reconstructed from the exported patient plan data. BED and EQD2 based dose volume histograms (DVHs), colorwash and iso-effective dose curves were generated from the physical Dose-Cube using the linear-quadratic (LQ) formalism and tissue-specific radiobiological parameters (α/β). Results and Conclusion: BED-and EQD2-colorwash and iso-effective curves along with BED and EQD2 dose volume histograms provide superior radiobiological information as compared to those of physical doses. This study provides supplementary recipes of radiobiological doses along with the physical doses which are useful for the evaluation of complex radiotherapy treatment plan of the patients.
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Affiliation(s)
- Gaganpreet Singh
- Centre for Medical Physics, Panjab University, Chandigarh, India
| | - Arun S Oinam
- Department of Radiotherapy, PGIMER, Chandigarh, India
| | - Rose Kamal
- Centre for Medical Physics, Panjab University, Chandigarh, India
| | - Bhumika Handa
- Centre for Medical Physics, Panjab University, Chandigarh, India
| | - Vivek Kumar
- Centre for Medical Physics, Panjab University, Chandigarh, India
| | - Bhavana Rai
- Department of Radiotherapy, PGIMER, Chandigarh, India
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Tommelein J, De Vlieghere E, Verset L, Melsens E, Leenders J, Descamps B, Debucquoy A, Vanhove C, Pauwels P, Gespach CP, Vral A, De Boeck A, Haustermans K, de Tullio P, Ceelen W, Demetter P, Boterberg T, Bracke M, De Wever O. Radiotherapy-Activated Cancer-Associated Fibroblasts Promote Tumor Progression through Paracrine IGF1R Activation. Cancer Res 2017; 78:659-670. [PMID: 29217764 DOI: 10.1158/0008-5472.can-17-0524] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 07/26/2017] [Accepted: 11/21/2017] [Indexed: 01/01/2023]
Abstract
Preoperative radiotherapy (RT) is a mainstay in the management of rectal cancer, a tumor characterized by desmoplastic stroma containing cancer-associated fibroblasts (CAF). Although CAFs are abundantly present, the effects of RT to CAF and its impact on cancer cells are unknown. We evaluated the damage responses of CAF to RT and investigated changes in colorectal cancer cell growth, transcriptome, metabolome, and kinome in response to paracrine signals emerging from irradiated CAF. RT to CAF induced DNA damage, p53 activation, cell-cycle arrest, and secretion of paracrine mediators, including insulin-like growth factor-1 (IGF1). Subsequently, RT-activated CAFs promoted survival of colorectal cancer cells, as well as a metabolic switch favoring glutamine consumption through IGF1 receptor (IGF1R) activation. RT followed by IGF1R neutralization in orthotopic colorectal cancer models reduced the number of mice with organ metastases. Activation of the downstream IGF1R mediator mTOR was significantly higher in matched (intrapatient) samples and in unmatched (interpatient) samples from rectal cancer patients after neoadjuvant chemoradiotherapy. Taken together, our data support the notion that paracrine IGF1/IGF1R signaling initiated by RT-activated CAF worsens colorectal cancer progression, establishing a preclinical rationale to target this activation loop to further improve clinical responses and patient survival.Significance: These findings reveal that paracrine IGF1/IGF1R signaling promotes colorectal cancer progression, establishing a preclinical rationale to target this activation loop. Cancer Res; 78(3); 659-70. ©2017 AACR.
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Affiliation(s)
- Joke Tommelein
- Laboratory of Experimental Cancer Research, Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Elly De Vlieghere
- Laboratory of Experimental Cancer Research, Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Laurine Verset
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Elodie Melsens
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Surgery, Ghent University Hospital, Ghent, Belgium
| | - Justine Leenders
- Center for Interdisciplinary Research on Medicines (CIRM), Université de Liège, Liège, Belgium
| | - Benedicte Descamps
- Department of Electronics and Information System, iMinds-IBiTech-MEDISIP, Ghent University, Ghent, Belgium
| | - Annelies Debucquoy
- Department of Oncology, Experimental Radiotherapy, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Christian Vanhove
- Department of Electronics and Information System, iMinds-IBiTech-MEDISIP, Ghent University, Ghent, Belgium
| | - Patrick Pauwels
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium
| | - Christian P Gespach
- Institut National de la Santé et de la Recherche Médicale, INSERM U938, Molecular and Clinical Oncology, Université Paris VI Pierre et Marie Curie, Paris, France
| | - Anne Vral
- Department of Basic Medical Sciences, Physiology Group, Ghent University, Ghent, Belgium
| | - Astrid De Boeck
- Arnie Charbonneau Cancer Centre, University of Calgary, Calgary, Alberta, Canada
| | - Karin Haustermans
- Department of Oncology, Experimental Radiotherapy, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Pascal de Tullio
- Center for Interdisciplinary Research on Medicines (CIRM), Université de Liège, Liège, Belgium
| | - Wim Ceelen
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
- Department of Surgery, Ghent University Hospital, Ghent, Belgium
| | - Pieter Demetter
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Tom Boterberg
- Laboratory of Experimental Cancer Research, Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Marc Bracke
- Laboratory of Experimental Cancer Research, Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Olivier De Wever
- Laboratory of Experimental Cancer Research, Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium.
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
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Naderi MS, Razzaghi M, Esmaeeli Djavid G, Hajebrahimi Z. A Comparative Study of 660 nm Low-Level Laser and Light Emitted Diode in Proliferative Effects of Fibroblast Cells. J Lasers Med Sci 2017; 8:S46-S50. [PMID: 29071035 DOI: 10.15171/jlms.2017.s9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: In recent years, low-power lasers have been widely used in medicine. With the introduction of affordable light emitted diode (LED), clinical application of LED light has become more and more popular. However, some researchers believe that due to lack of coherence of the LED light, it can be different in terms of biological effects, in comparison with laser. In this study, the biological effects of low-level laser (LLL) to those of LED light are compared and discussed. Methods: Human skin fibroblast cell line Hu02 was irradiated with LLL and LED light with a wavelength of 660 nm, power output of 35 mW and in continuous mode and the control group was not irradiated. The biological effects were compared through analysis of cell proliferation, production of reactive oxygen species (ROS) within the cell and rate of cell division. Results: Our findings showed that production of ROS within the cell was linearly increased both in the LED and laser light irradiated cells. However, laser light is more incremental in comparison to LED light. The MTT results showed that laser light at low energy density (less than 5 J/cm2) increased the rate of cell proliferation after 24 hours. Although, the rate of cell division was increased in energy density of 1 J/cm2 compared to the control group, this increase was not statistically significant. Discussion: The findings indicated that the coherence properties of laser light provided more energy for the cells, and in a constant energy density, laser light created more oxidative stresses in comparison with LED light.
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Affiliation(s)
| | - Mohammadreza Razzaghi
- Laser Application in Medical Sciences Research Center, Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zahra Hajebrahimi
- Aerospace Research Institute, Ministry of Science Research and Technology, Tehran, Iran
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Tatinati S, Shafiq G, Veluvolu KC, Khong AWH. Predictive local receptive fields based respiratory motion tracking for motion-adaptive radiotherapy. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:2859-2862. [PMID: 29060494 DOI: 10.1109/embc.2017.8037453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Extracranial robotic radiotherapy employs external markers and a correlation model to trace the tumor motion caused by the respiration. The real-time tracking of tumor motion however requires a prediction model to compensate the latencies induced by the software (image data acquisition and processing) and hardware (mechanical and kinematic) limitations of the treatment system. A new prediction algorithm based on local receptive fields extreme learning machines (pLRF-ELM) is proposed for respiratory motion prediction. All the existing respiratory motion prediction methods model the non-stationary respiratory motion traces directly to predict the future values. Unlike these existing methods, the pLRF-ELM performs prediction by modeling the higher-level features obtained by mapping the raw respiratory motion into the random feature space of ELM instead of directly modeling the raw respiratory motion. The developed method is evaluated using the dataset acquired from 31 patients for two horizons in-line with the latencies of treatment systems like CyberKnife. Results showed that pLRF-ELM is superior to that of existing prediction methods. Results further highlight that the abstracted higher-level features are suitable to approximate the nonlinear and non-stationary characteristics of respiratory motion for accurate prediction.
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Jensen CA, Acosta Roa AM, Lund JÅ, Frengen J. Intrafractional baseline drift during free breathing breast cancer radiation therapy. Acta Oncol 2017; 56:867-873. [PMID: 28464748 DOI: 10.1080/0284186x.2017.1288924] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Intrafraction motion in breast cancer radiation therapy (BCRT) has not yet been thoroughly described in the literature. It has been observed that baseline drift occurs as part of the intrafraction motion. This study aims to measure baseline drift and its incidence in free-breathing BCRT patients using an in-house developed laser system for tracking the position of the sternum. MATERIALS AND METHODS Baseline drift was monitored in 20 right-sided breast cancer patients receiving free breathing 3D-conformal RT by using an in-house developed laser system which measures one-dimensional distance in the AP direction. A total of 357 patient respiratory traces from treatment sessions were logged and analysed. Baseline drift was compared to patient positioning error measured from in-field portal imaging. RESULTS The mean overall baseline drift at end of treatment sessions was -1.3 mm for the patient population. Relatively small baseline drift was observed during the first fraction; however it was clearly detected already at the second fraction. Over 90% of the baseline drift occurs during the first 3 min of each treatment session. The baseline drift rate for the population was -0.5 ± 0.2 mm/min in the posterior direction the first minute after localization. Only 4% of the treatment sessions had a 5 mm or larger baseline drift at 5 min, all towards the posterior direction. Mean baseline drift in the posterior direction in free breathing BCRT was observed in 18 of 20 patients over all treatment sessions. CONCLUSIONS This study shows that there is a substantial baseline drift in free breathing BCRT patients. No clear baseline drift was observed during the first treatment session; however, baseline drift was markedly present at the rest of the sessions. Intrafraction motion due to baseline drift should be accounted for in margin calculations.
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Affiliation(s)
| | | | - Jo-Åsmund Lund
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jomar Frengen
- Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Djavid GE, Goliaie B, Nikoofar A. Analysis of Radiomodulatory Effect of Low-Level Laser Irradiation by Clonogenic Survival Assay. Photomed Laser Surg 2017; 33:452-9. [PMID: 26332916 DOI: 10.1089/pho.2015.3893] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the radiomoulatory effects of low-level laser irradiation (LLLI) in normal and cancer cells exposed to ionizing X-ray radiation on clonogenic survival assay. BACKGROUND DATA LLLI does have radioprotective effects on normal tissue. LLLI can reduce the incidence of mucocutaneous complications of ionizing radiation. Few in vitro studies reported adaptive responses for LLLI to ionizing radiation in normal and cancer cells, particularly with respect to clonogenic cell survival assay. METHODS Normal NIH 3T3 cells and cancer HeLa cells were irradiated with 685 and 830 nm LLLI at different energy densities prior to ionizing X-ray radiation. The survival fraction was determined after ionizing radiation (0, 2, 4, and 6 Gy). The values of the linear (α) and quadratic (β) parameters were calculated based on the clonogenic survival curves. RESULTS Clonogenic radiation survival assay showed that the application of LLLI at 685 nm prior to ionizing radiation could significantly inhibit clonogenic growth of HeLa cells compared with unirradiated HeLa cells. LLLI could also significantly increase the α parameter of the linear quadratic (LQ) model. In contrast, application of LLLI at 830 nm could significantly protect NIH 3T3 cells against radiation and decreased α parameter. CONCLUSIONS This study suggests that various physical parameters of LLLI can be diverse adaptive responses to ionizing radiation on normal and cancer cells.
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Affiliation(s)
- Gholamreza Esmaeeli Djavid
- 1 Laboratory of Biophysics and Molecular Biology, Institute of Biochemistry and Biophysics (IBB), University of Tehran , Tehran, Iran
| | - Bahram Goliaie
- 1 Laboratory of Biophysics and Molecular Biology, Institute of Biochemistry and Biophysics (IBB), University of Tehran , Tehran, Iran
| | - Alireza Nikoofar
- 2 Radiotherapy Department, Firoozgar Hospital, Iran University of Medical Sciences . Tehran, Iran
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Arnold CR, Kloss F, Singh S, Vasiljevic D, Stigler R, Auberger T, Wenzel V, Klima G, Lukas P, Lepperdinger G, Gassner R. A domestic porcine model for studying the effects of radiation on head and neck cancers. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:536-543. [PMID: 28130028 DOI: 10.1016/j.oooo.2016.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/11/2016] [Accepted: 11/25/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Radiation therapy (RT) of the head and neck region is often accompanied by serious side effects. Research in this area is needed to improve treatment outcomes and ameliorate therapy tolerance. Laboratory rodents are barely matching today's clinical standards in RT research. Yet domestic swine (Sus scrofa domestica) have previously proved suitable for various advanced tests in clinical research and training. We therefore investigated whether S. scrofa domestica is also appropriate for irradiation of the mandible. STUDY DESIGN A common scheme for irradiation treatment of S. scrofa domestica mandibles in a split-mouth design was acquired by applying computed tomography (CT) scanning under sedation. Basing on close anatomic resemblance, a standard treatment plan comprising 2 opposed irradiation fields could be accomplished. RESULTS RT was carried out in a clinical environment with 2 × 9 Gy. The resulting operating procedure facilitated complication-free sedation, transport, positioning, CT scanning, and effective irradiation. CONCLUSION Based on common standards applied for RT in humans, domestic pigs can be employed to progress RT clinical research. Due to their human-like anatomy, physiology, size, and weight, the swine model is expedient for advancing experimental RT of the head and neck area.
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Affiliation(s)
- Christoph R Arnold
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Innsbruck, Austria.
| | - Frank Kloss
- Department of Maxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
| | | | - Danijela Vasiljevic
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Innsbruck, Austria
| | - Robert Stigler
- Department of Maxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Thomas Auberger
- Department of Radiotherapy-Radiooncology, Hospital Traunstein, Traunstein, Germany
| | - Volker Wenzel
- Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria
| | - Günter Klima
- Division of Histology and Embryology, Innsbruck Medical University, Innsbruck, Austria
| | - Peter Lukas
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Innsbruck, Austria
| | - Günter Lepperdinger
- Institute for Biomedical Aging Research, Innsbruck, Austria; Department of Cell Biology, University Salzburg, Salzburg, Austria
| | - Robert Gassner
- Department of Maxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
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Li LS, Reddy S, Lin ZH, Liu S, Park H, Chun SG, Bornmann WG, Thibodeaux J, Yan J, Chakrabarti G, Xie XJ, Sumer BD, Boothman DA, Yordy JS. NQO1-Mediated Tumor-Selective Lethality and Radiosensitization for Head and Neck Cancer. Mol Cancer Ther 2016; 15:1757-67. [PMID: 27196777 PMCID: PMC5123441 DOI: 10.1158/1535-7163.mct-15-0765] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 03/14/2016] [Indexed: 01/30/2023]
Abstract
UNLABELLED Ionizing radiation (IR) is a key therapeutic regimen for many head and neck cancers (HNC). However, the 5-year overall survival rate for locally advanced HNCs is approximately 50% and better therapeutic efficacy is needed. NAD(P)H quinone oxidoreductase 1 (NQO1) is overexpressed in many cancers, and β-lapachone (β-lap), a unique NQO1 bioactivatable drug, exploits this enzyme to release massive reactive oxygen species (ROS) that synergize with IR to kill by programmed necrosis. β-Lap represents a novel therapeutic opportunity in HNC leading to tumor-selective lethality that will enhance the efficacy of IR. Immunohistochemical staining and Western blot assays were used to assess the expression levels of NQO1 in HNC cells and tumors. Forty-five percent of endogenous HNCs expressed elevated NQO1 levels. In addition, multiple HNC cell lines and tumors demonstrated elevated levels of NQO1 expression and activity and were tested for anticancer lethality and radiosensitization by β-lap using long-term survival assays. The combination of nontoxic β-lap doses and IR significantly enhanced NQO1-dependent tumor cell lethality, increased ROS, TUNEL-positive cells, DNA damage, NAD(+), and ATP consumption, and resulted in significant antitumor efficacy and prolonged survival in two xenograft murine HNC models, demonstrating β-lap radiosensitization of HNCs through a NQO1-dependent mechanism. This translational study offers a potential biomarker-driven strategy using NQO1 expression to select tumors susceptible to β-lap-induced radiosensitization. Mol Cancer Ther; 15(7); 1757-67. ©2016 AACR.
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Affiliation(s)
- Long-Shan Li
- Department of Radiation Oncology, University of Texas at Southwestern Medical Center, Dallas, Texas. Harold C. Simmons NCI Designated Comprehensive Cancer Center, University of Texas at Southwestern Medical Center, Dallas, Texas
| | - Srilakshmi Reddy
- Department of Radiation Oncology, University of Texas at Southwestern Medical Center, Dallas, Texas. Harold C. Simmons NCI Designated Comprehensive Cancer Center, University of Texas at Southwestern Medical Center, Dallas, Texas
| | - Zhen-Hua Lin
- Department of Pathology, Yanbian University Medical College, Yanji, Jilin, China
| | - Shuangping Liu
- Department of Pathology, Yanbian University Medical College, Yanji, Jilin, China
| | - Hyunsil Park
- Department of Radiation Oncology, University of Texas at Southwestern Medical Center, Dallas, Texas. Harold C. Simmons NCI Designated Comprehensive Cancer Center, University of Texas at Southwestern Medical Center, Dallas, Texas
| | - Stephen G Chun
- Department of Radiation Oncology, MD Anderson Comprehensive Cancer Center, Houston, Texas
| | - William G Bornmann
- Department of Experimental Therapeutics, MD Anderson Comprehensive Cancer Center, Houston, Texas
| | - Joel Thibodeaux
- Department of Pathology, University of Texas at Southwestern Medical Center, Dallas, Texas
| | - Jingsheng Yan
- Department of Clinical Sciences, University of Texas at Southwestern Medical Center, Dallas, Texas
| | - Gaurab Chakrabarti
- Department of Radiation Oncology, University of Texas at Southwestern Medical Center, Dallas, Texas. Harold C. Simmons NCI Designated Comprehensive Cancer Center, University of Texas at Southwestern Medical Center, Dallas, Texas
| | - Xian-Jin Xie
- Department of Clinical Sciences, University of Texas at Southwestern Medical Center, Dallas, Texas
| | - Baran D Sumer
- Harold C. Simmons NCI Designated Comprehensive Cancer Center, University of Texas at Southwestern Medical Center, Dallas, Texas. Department of Otolaryngology, Head and Neck Surgery, University of Texas at Southwestern Medical Center, Dallas, Texas
| | - David A Boothman
- Department of Radiation Oncology, University of Texas at Southwestern Medical Center, Dallas, Texas. Harold C. Simmons NCI Designated Comprehensive Cancer Center, University of Texas at Southwestern Medical Center, Dallas, Texas. Department of Pharmacology, University of Texas at Southwestern Medical Center, Dallas, Texas
| | - John S Yordy
- Valley Radiation Therapy Center, Palmer, Alaska.
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Brain dose-sparing radiotherapy techniques for localized intracranial germinoma: Case report and literature review of modern irradiation. Cancer Radiother 2016; 20:210-6. [DOI: 10.1016/j.canrad.2016.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 02/05/2016] [Accepted: 02/13/2016] [Indexed: 12/26/2022]
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Cellular Pathways in Response to Ionizing Radiation and Their Targetability for Tumor Radiosensitization. Int J Mol Sci 2016; 17:ijms17010102. [PMID: 26784176 PMCID: PMC4730344 DOI: 10.3390/ijms17010102] [Citation(s) in RCA: 268] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/22/2015] [Accepted: 12/25/2015] [Indexed: 12/20/2022] Open
Abstract
During the last few decades, improvements in the planning and application of radiotherapy in combination with surgery and chemotherapy resulted in increased survival rates of tumor patients. However, the success of radiotherapy is impaired by two reasons: firstly, the radioresistance of tumor cells and, secondly, the radiation-induced damage of normal tissue cells located in the field of ionizing radiation. These limitations demand the development of drugs for either radiosensitization of tumor cells or radioprotection of normal tissue cells. In order to identify potential targets, a detailed understanding of the cellular pathways involved in radiation response is an absolute requirement. This review describes the most important pathways of radioresponse and several key target proteins for radiosensitization.
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Au KM, Hyder SN, Wagner K, Shi C, Kim YS, Caster JM, Tian X, Min Y, Wang AZ. Direct Observation of Early-Stage High-Dose Radiotherapy-Induced Vascular Injury via Basement Membrane-Targeting Nanoparticles. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2015; 11:6404-10. [PMID: 26577747 PMCID: PMC4813349 DOI: 10.1002/smll.201501902] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/02/2015] [Indexed: 05/26/2023]
Abstract
Collagen IV-targeting peptide-conjugated basement membrane-targeting nanoparticles are successfully engineered to identify early-stage blood vessel injury induced by high-dose radiotherapy.
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Affiliation(s)
- Kin Man Au
- Laboratory of Nano- and Translational Medicine, Lineberger Comprehensive Cancer Center, Carolina Center for Cancer Nanotechnology Excellence, Carolina Institute of Nanomedicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Sayed Nabeel Hyder
- Laboratory of Nano- and Translational Medicine, Lineberger Comprehensive Cancer Center, Carolina Center for Cancer Nanotechnology Excellence, Carolina Institute of Nanomedicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Kyle Wagner
- Laboratory of Nano- and Translational Medicine, Lineberger Comprehensive Cancer Center, Carolina Center for Cancer Nanotechnology Excellence, Carolina Institute of Nanomedicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Caihong Shi
- Laboratory of Nano- and Translational Medicine, Lineberger Comprehensive Cancer Center, Carolina Center for Cancer Nanotechnology Excellence, Carolina Institute of Nanomedicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe, Shenyang, Liaoning, 110016, China
| | - Young Seok Kim
- Laboratory of Nano- and Translational Medicine, Lineberger Comprehensive Cancer Center, Carolina Center for Cancer Nanotechnology Excellence, Carolina Institute of Nanomedicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul 138-736, Korea
| | - Joseph M Caster
- Laboratory of Nano- and Translational Medicine, Lineberger Comprehensive Cancer Center, Carolina Center for Cancer Nanotechnology Excellence, Carolina Institute of Nanomedicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Xi Tian
- Laboratory of Nano- and Translational Medicine, Lineberger Comprehensive Cancer Center, Carolina Center for Cancer Nanotechnology Excellence, Carolina Institute of Nanomedicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Yuanzeng Min
- Laboratory of Nano- and Translational Medicine, Lineberger Comprehensive Cancer Center, Carolina Center for Cancer Nanotechnology Excellence, Carolina Institute of Nanomedicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Andrew Z. Wang
- Laboratory of Nano- and Translational Medicine, Lineberger Comprehensive Cancer Center, Carolina Center for Cancer Nanotechnology Excellence, Carolina Institute of Nanomedicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. Department of Radiation Oncology, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Chung EJ, McKay-Corkum G, Chung S, White A, Scroggins BT, Mitchell JB, Mulligan-Kehoe MJ, Citrin D. Truncated Plasminogen Activator Inhibitor-1 Protein Protects From Pulmonary Fibrosis Mediated by Irradiation in a Murine Model. Int J Radiat Oncol Biol Phys 2015; 94:1163-72. [PMID: 26883561 DOI: 10.1016/j.ijrobp.2015.11.044] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 11/05/2015] [Accepted: 11/30/2015] [Indexed: 12/13/2022]
Abstract
PURPOSE To determine whether the delivery of recombinant truncated plasminogen activator inhibitor-1 (PAI-1) protein (rPAI-1(23)) would protect from the development of radiation-induced lung injury. METHODS AND MATERIALS C57Bl/6 mice received intraperitoneal injections of rPAI-1(23) (5.4 μg/kg/d) or vehicle for 18 weeks, beginning 2 days before irradiation (IR) (5 daily fractions of 6 Gy). Cohorts of mice were followed for survival (n=8 per treatment) and tissue collection (n=3 per treatment and time point). Fibrosis in lung was assessed with Masson-Trichrome staining and measurement of hydroxyproline content. Senescence was assessed with staining for β-galactosidase activity in lung and primary pneumocytes. RESULTS Hydroxyproline content in irradiated lung was significantly reduced in mice that received rPAI-1(23) compared with mice that received vehicle (IR+vehicle: 84.97 μg/lung; IR+rPAI-1(23): 56.2 μg/lung, P=.001). C57Bl/6 mice exposed to IR+vehicle had dense foci of subpleural fibrosis at 19 weeks, whereas the lungs of mice exposed to IR+rPAI-1(23) were largely devoid of fibrotic foci. Cellular senescence was significantly decreased by rPAI-1(23) treatment in primary pneumocyte cultures and in lung at multiple time points after IR. CONCLUSIONS These studies identify that rPAI-1(23) is capable of preventing radiation-induced fibrosis in murine lungs. These antifibrotic effects are associated with increased fibrin metabolism, enhanced matrix metalloproteinase-3 expression, and reduced senescence in type 2 pneumocytes. Thus, rPAI-1(23) is a novel therapeutic option for radiation-induced fibrosis.
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Affiliation(s)
- Eun Joo Chung
- Radiation Oncology, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland
| | - Grace McKay-Corkum
- Radiation Oncology, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland
| | - Su Chung
- Radiation Oncology, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland
| | - Ayla White
- Radiation Oncology, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland
| | - Bradley T Scroggins
- Radiation Oncology, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland
| | - James B Mitchell
- Radiation Biology Branches, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland
| | | | - Deborah Citrin
- Radiation Oncology, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland.
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Kumar RV, Bhasker S. Is the fast-paced technological advancement in radiation treatment equipment good for Indian Scenario? No. J Cancer Policy 2015. [DOI: 10.1016/j.jcpo.2014.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Angus SD, Piotrowska MJ. A matter of timing: identifying significant multi-dose radiotherapy improvements by numerical simulation and genetic algorithm search. PLoS One 2014; 9:e114098. [PMID: 25460164 PMCID: PMC4252029 DOI: 10.1371/journal.pone.0114098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/01/2014] [Indexed: 12/25/2022] Open
Abstract
Multi-dose radiotherapy protocols (fraction dose and timing) currently used in the clinic are the product of human selection based on habit, received wisdom, physician experience and intra-day patient timetabling. However, due to combinatorial considerations, the potential treatment protocol space for a given total dose or treatment length is enormous, even for relatively coarse search; well beyond the capacity of traditional in-vitro methods. In constrast, high fidelity numerical simulation of tumor development is well suited to the challenge. Building on our previous single-dose numerical simulation model of EMT6/Ro spheroids, a multi-dose irradiation response module is added and calibrated to the effective dose arising from 18 independent multi-dose treatment programs available in the experimental literature. With the developed model a constrained, non-linear, search for better performing cadidate protocols is conducted within the vicinity of two benchmarks by genetic algorithm (GA) techniques. After evaluating less than 0.01% of the potential benchmark protocol space, candidate protocols were identified by the GA which conferred an average of 9.4% (max benefit 16.5%) and 7.1% (13.3%) improvement (reduction) on tumour cell count compared to the two benchmarks, respectively. Noticing that a convergent phenomenon of the top performing protocols was their temporal synchronicity, a further series of numerical experiments was conducted with periodic time-gap protocols (10 h to 23 h), leading to the discovery that the performance of the GA search candidates could be replicated by 17-18 h periodic candidates. Further dynamic irradiation-response cell-phase analysis revealed that such periodicity cohered with latent EMT6/Ro cell-phase temporal patterning. Taken together, this study provides powerful evidence towards the hypothesis that even simple inter-fraction timing variations for a given fractional dose program may present a facile, and highly cost-effecitive means of significantly improving clinical efficacy.
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Affiliation(s)
- Simon D. Angus
- Department of Economics, Monash University, Melbourne, Victoria, Australia
| | - Monika Joanna Piotrowska
- Faculty of Mathematics Informatics and Mechanics, Institute of Applied Mathematics and Mechanics, University of Warsaw, Warsaw, Mazowieckie, Poland
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Baskar R, Dai J, Wenlong N, Yeo R, Yeoh KW. Biological response of cancer cells to radiation treatment. Front Mol Biosci 2014; 1:24. [PMID: 25988165 PMCID: PMC4429645 DOI: 10.3389/fmolb.2014.00024] [Citation(s) in RCA: 337] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 10/31/2014] [Indexed: 12/15/2022] Open
Abstract
Cancer is a class of diseases characterized by uncontrolled cell growth and has the ability to spread or metastasize throughout the body. In recent years, remarkable progress has been made toward the understanding of proposed hallmarks of cancer development, care, and treatment modalities. Radiation therapy or radiotherapy is an important and integral component of cancer management, mostly conferring a survival benefit. Radiation therapy destroys cancer by depositing high-energy radiation on the cancer tissues. Over the years, radiation therapy has been driven by constant technological advances and approximately 50% of all patients with localized malignant tumors are treated with radiation at some point in the course of their disease. In radiation oncology, research and development in the last three decades has led to considerable improvement in our understanding of the differential responses of normal and cancer cells. The biological effectiveness of radiation depends on the linear energy transfer (LET), total dose, number of fractions and radiosensitivity of the targeted cells or tissues. Radiation can either directly or indirectly (by producing free radicals) damages the genome of the cell. This has been challenged in recent years by a newly identified phenomenon known as radiation induced bystander effect (RIBE). In RIBE, the non-irradiated cells adjacent to or located far from the irradiated cells/tissues demonstrate similar responses to that of the directly irradiated cells. Understanding the cancer cell responses during the fractions or after the course of irradiation will lead to improvements in therapeutic efficacy and potentially, benefitting a significant proportion of cancer patients. In this review, the clinical implications of radiation induced direct and bystander effects on the cancer cell are discussed.
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Affiliation(s)
- Rajamanickam Baskar
- Division of Cellular and Molecular Research, Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Jiawen Dai
- Division of Cellular and Molecular Research, Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Nei Wenlong
- Division of Cellular and Molecular Research, Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Richard Yeo
- Division of Cellular and Molecular Research, Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Kheng-Wei Yeoh
- Division of Cellular and Molecular Research, Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
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Cui L, Tse K, Zahedi P, Harding SM, Zafarana G, Jaffray DA, Bristow RG, Allen C. Hypoxia and cellular localization influence the radiosensitizing effect of gold nanoparticles (AuNPs) in breast cancer cells. Radiat Res 2014; 182:475-88. [PMID: 25361396 DOI: 10.1667/rr13642.1] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Hypoxia exists in all solid tumors and leads to clinical radioresistance and adverse prognosis. We hypothesized that hypoxia and cellular localization of gold nanoparticles (AuNPs) could be modifiers of AuNP-mediated radiosensitization. The possible mechanistic effect of AuNPs on cell cycle distribution and DNA double-strand break (DSB) repair postirradiation were also studied. Clonogenic survival data revealed that internalized and extracellular AuNPs at 0.5 mg/mL resulted in dose enhancement factors of 1.39 ± 0.07 and 1.09 ± 0.01, respectively. Radiosensitization by AuNPs was greatest in cells under oxia, followed by chronic and then acute hypoxia. The presence of AuNPs inhibited postirradiation DNA DSB repair, but did not lead to cell cycle synchronization. The relative radiosensitivity of chronic hypoxic cells is attributed to defective DSB repair (homologous recombination) due to decreased (RAD51)-associated protein expression. Our results support the need for further study of AuNPs for clinical development in cancer therapy since their efficacy is not limited in chronic hypoxic cells.
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Affiliation(s)
- Lei Cui
- a Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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Sbai A, Thariat J, Tachfouti N, Pan Q, Lagrange JL. [Intraprostatic calcifications as natural fiducial markers in image-guided radiotherapy for prostate cancer]. Cancer Radiother 2014; 18:740-4. [PMID: 25451671 DOI: 10.1016/j.canrad.2014.07.161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 04/07/2014] [Accepted: 07/03/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To establish whether intraprostatic calcifications can serve as natural fiducials for image-guided radiotherapy (IGRT), replacing the implantation of intraprostatic fiducial markers. PATIENTS AND METHODS Patients with prostate cancer, having intraprostatic calcifications visible on CT scan were selected and underwent intensity-modulated radiotherapy/3D conformal radiotherapy with IGRT in the department of radiotherapy of Henri-Mondor Hospital. All cone-beam computed tomographies (CBCT) were repositioned on intraprostatic calcifications. For each acquired image, displacements of intraprostatic calcifications were calculated with reference to position on planning CT in three directions: lateral, longitudinal and vertical. RESULTS Between 2011 and 2013, nine patients had 183 CBCT. For each image, three displacements and space coordinates were calculated using a single reference (intraprostatic calcification). Mean lateral, longitudinal and vertical movements were 0.26±5.7 mm, -1±4.6 mm and 0.42±3.5 mm, respectively. CONCLUSION Studies exploring prostatic movements with fiducial markers as reference and ours with natural fiducials yield similar results. Our data confirm previous studies that have suggested that intraprostatic calcifications can be used as natural fiducials with potential reduction of iatrogenic risks and costs associated with the implantation of fiducial markers.
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Affiliation(s)
- A Sbai
- Centre régional d'oncologie Hassan-II, BP 2013, oued Nachef, Oujda, Maroc.
| | - J Thariat
- Département de radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice cedex 2, France; Université Nice-Sophia-Antipolis, 33, avenue Valombrose, 06189 Nice cedex 2, France
| | - N Tachfouti
- Laboratoire d'épidémiologie, recherche clinique et de santé communautaire, CHU Hassan-II, Fès, Maroc
| | - Q Pan
- Service de radiothérapie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - J-L Lagrange
- Service de radiothérapie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France; Université Paris Est Créteil, avenue du Général-de-Gaulle, 94010 Créteil cedex, France
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Cannistraci A, Di Pace AL, De Maria R, Bonci D. MicroRNA as new tools for prostate cancer risk assessment and therapeutic intervention: results from clinical data set and patients' samples. BIOMED RESEARCH INTERNATIONAL 2014; 2014:146170. [PMID: 25309903 PMCID: PMC4182080 DOI: 10.1155/2014/146170] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 08/18/2014] [Accepted: 08/21/2014] [Indexed: 12/11/2022]
Abstract
Prostate cancer (PCa) is one of the leading causes of cancer-related death in men. Despite considerable advances in prostate cancer early detection and clinical management, validation of new biomarkers able to predict the natural history of tumor progression is still necessary in order to reduce overtreatment and to guide therapeutic decisions. MicroRNAs are endogenous noncoding RNAs which offer a fast fine-tuning and energy-saving mechanism for posttranscriptional control of protein expression. Growing evidence indicate that these RNAs are able to regulate basic cell functions and their aberrant expression has been significantly correlated with cancer development. Therefore, detection of microRNAs in tumor tissues and body fluids represents a new tool for early diagnosis and patient prognosis prediction. In this review, we summarize current knowledge about microRNA deregulation in prostate cancer mainly focusing on the different clinical aspects of the disease. We also highlight the potential roles of microRNAs in PCa management, while also discussing several current challenges and needed future research.
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Affiliation(s)
- Alessio Cannistraci
- Departement of Hematology, Oncology and Molecular Medicine, Istituto Superiore Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Anna Laura Di Pace
- Departement of Hematology, Oncology and Molecular Medicine, Istituto Superiore Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Ruggero De Maria
- Regina Elena National Cancer Institute, Via Fermo Ognibene, 00144 Rome, Italy
| | - Désirée Bonci
- Departement of Hematology, Oncology and Molecular Medicine, Istituto Superiore Sanità, Viale Regina Elena 299, 00161 Rome, Italy
- Regina Elena National Cancer Institute, Via Fermo Ognibene, 00144 Rome, Italy
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Pandya JA, Srikant N, Boaz K, Manaktala N, Kapila SN, Yinti SR. Post-radiation changes in oral tissues - An analysis of cancer irradiation cases. South Asian J Cancer 2014; 3:159-62. [PMID: 25136522 PMCID: PMC4134606 DOI: 10.4103/2278-330x.136785] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction: Radiation, commonly employed as neoadjuvant, primary, and adjuvant therapy for head and neck cancer causes numerous epithelial and stromal changes, prominent among which is fibrosis with its early and late consequences. Very little is known about the true nature of the fibrosed tissue and the type of fibers accumulated. Radiotherapy affects the supporting tumor stroma often resulting in a worsening grade of tumor post-radiation. Aim: To study epithelial, neoplastic, stromal, and glandular changes in oral cavity induced by radiation therapy for oral squamous cell carcinoma (OSCC) using special stains. Materials and Methods: The study included 27 samples of recurrent OSCC following completion of radiotherapy (recurrence within an average span of 11 months), and 26 non-irradiated cases of OSCC. Patients with a history of combined radiotherapy and chemotherapy were not included in the study. The epithelial changes assessed included epithelial atrophy, apoptosis, necrosis, dysplasia, and neoplasia. The connective tissue was evaluated for amount of fibrosis, quality of fibers (using picrosirius red staining), fibrinous exudate, necrosis, pattern of invasion, vessel wall thickening, and salivary gland changes. The aforementioned changes were assessed using light and polarizing microscopy and tabulated. Statistical Analysis: Epithelial and connective tissue parameters were compared between the irradiated and non-irradiated cases using chi square and t-tests. Results: Epithelial and connective tissue parameters were found to be increased in irradiated patients. Pattern of invasion by tumor cells varied from strands and cords between the two groups studied. The effect of radiation was seen to reflect on the maturity of fibers and the regularity of their distribution.
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Affiliation(s)
- Jay Ashokkumar Pandya
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka, India
| | - N Srikant
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka, India
| | - Karen Boaz
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka, India
| | - Nidhi Manaktala
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka, India
| | - Supriya Nikita Kapila
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka, India
| | - Shanmukha Raviteja Yinti
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Manipal University, Karnataka, India
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