1
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Barghouth PG, Melemenidis S, Montay-Gruel P, Ollivier J, Viswanathan V, Jorge PG, Soto LA, Lau BC, Sadeghi C, Edlabadkar A, Zhang R, Ru N, Baulch JE, Manjappa R, Wang J, Le Bouteiller M, Surucu M, Yu A, Bush K, Skinner L, Maxim PG, Loo BW, Limoli CL, Vozenin MC, Frock RL. FLASH-RT does not affect chromosome translocations and junction structures beyond that of CONV-RT dose-rates. Radiother Oncol 2023; 188:109906. [PMID: 37690668 PMCID: PMC10591966 DOI: 10.1016/j.radonc.2023.109906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND PURPOSE The impact of radiotherapy (RT) at ultra high vs conventional dose rate (FLASH vs CONV) on the generation and repair of DNA double strand breaks (DSBs) is an important question that remains to be investigated. Here, we tested the hypothesis as to whether FLASH-RT generates decreased chromosomal translocations compared to CONV-RT. MATERIALS AND METHODS We used two FLASH validated electron beams and high-throughput rejoin and genome-wide translocation sequencing (HTGTS-JoinT-seq), employing S. aureus and S. pyogenes Cas9 "bait" DNA double strand breaks (DSBs) in HEK239T cells, to measure differences in bait-proximal repair and their genome-wide translocations to "prey" DSBs generated after various irradiation doses, dose rates and oxygen tensions (normoxic, 21% O2; physiological, 4% O2; hypoxic, 2% and 0.5% O2). Electron irradiation was delivered using a FLASH capable Varian Trilogy and the eRT6/Oriatron at CONV (0.08-0.13 Gy/s) and FLASH (1x102-5x106 Gy/s) dose rates. Related experiments using clonogenic survival and γH2AX foci in the 293T and the U87 glioblastoma lines were also performed to discern FLASH-RT vs CONV-RT DSB effects. RESULTS Normoxic and physioxic irradiation of HEK293T cells increased translocations at the cost of decreasing bait-proximal repair but were indistinguishable between CONV-RT and FLASH-RT. Although no apparent increase in chromosome translocations was observed with hypoxia-induced apoptosis, the combined decrease in oxygen tension with IR dose-rate modulation did not reveal significant differences in the level of translocations nor in their junction structures. Furthermore, RT dose rate modality on U87 cells did not change γH2AX foci numbers at 1- and 24-hours post-irradiation nor did this affect 293T clonogenic survival. CONCLUSION Irrespective of oxygen tension, FLASH-RT produces translocations and junction structures at levels and proportions that are indistinguishable from CONV-RT.
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Affiliation(s)
- Paul G Barghouth
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Stavros Melemenidis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Pierre Montay-Gruel
- Laboratory of Radiation Oncology, Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Switzerland; Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Jonathan Ollivier
- Laboratory of Radiation Oncology, Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Vignesh Viswanathan
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Patrik G Jorge
- Institute of Radiation Physics/CHUV, Lausanne University Hospital, Switzerland
| | - Luis A Soto
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Brianna C Lau
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Cheyenne Sadeghi
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Anushka Edlabadkar
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Richard Zhang
- Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Ning Ru
- Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Janet E Baulch
- Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Rakesh Manjappa
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jinghui Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Marie Le Bouteiller
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Murat Surucu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Amy Yu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Karl Bush
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Lawrie Skinner
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Peter G Maxim
- Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Billy W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Charles L Limoli
- Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Marie-Catherine Vozenin
- Laboratory of Radiation Oncology, Department of Radiation Oncology, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Richard L Frock
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA.
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2
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Barghouth PG, Melemenidis S, Montay-Gruel P, Ollivier J, Viswanathan V, Jorge PG, Soto LA, Lau BC, Sadeghi C, Edlabadkar A, Manjappa R, Wang J, Le Bouteiller M, Surucu M, Yu A, Bush K, Skinner L, Maxim PG, Loo BW, Limoli CL, Vozenin MC, Frock RL. FLASH-RT does not affect chromosome translocations and junction structures beyond that of CONV-RT dose-rates. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.27.534408. [PMID: 37034651 PMCID: PMC10081175 DOI: 10.1101/2023.03.27.534408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The molecular and cellular mechanisms driving the enhanced therapeutic ratio of ultra-high dose-rate radiotherapy (FLASH-RT) over slower conventional (CONV-RT) radiotherapy dose-rate remain to be elucidated. However, attenuated DNA damage and transient oxygen depletion are among several proposed models. Here, we tested whether FLASH-RT under physioxic (4% O 2 ) and hypoxic conditions (≤2% O 2 ) reduces genome-wide translocations relative to CONV-RT and whether any differences identified revert under normoxic (21% O 2 ) conditions. We employed high-throughput rejoin and genome-wide translocation sequencing ( HTGTS-JoinT-seq ), using S. aureus and S. pyogenes Cas9 "bait" DNA double strand breaks (DSBs), to measure differences in bait-proximal repair and their genome-wide translocations to "prey" DSBs generated by electron beam CONV-RT (0.08-0.13Gy/s) and FLASH-RT (1×10 2 -5×10 6 Gy/s), under varying ionizing radiation (IR) doses and oxygen tensions. Normoxic and physioxic irradiation of HEK293T cells increased translocations at the cost of decreasing bait-proximal repair but were indistinguishable between CONV-RT and FLASH-RT. Although no apparent increase in chromosome translocations was observed with hypoxia-induced apoptosis, the combined decrease in oxygen tension with IR dose-rate modulation did not reveal significant differences in the level of translocations nor in their junction structures. Thus, Irrespective of oxygen tension, FLASH-RT produces translocations and junction structures at levels and proportions that are indistinguishable from CONV-RT.
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Affiliation(s)
- Paul G. Barghouth
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Stavros Melemenidis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Pierre Montay-Gruel
- Laboratory of Radiation Oncology, Department of Radiation Oncology. Lausanne University Hospital and University of Lausanne, Switzerland
- Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Jonathan Ollivier
- Laboratory of Radiation Oncology, Department of Radiation Oncology. Lausanne University Hospital and University of Lausanne, Switzerland
| | - Vignesh Viswanathan
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Patrik G. Jorge
- Institute of Radiation Physics/CHUV, Lausanne University Hospital, Switzerland
| | - Luis A. Soto
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Brianna C. Lau
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Cheyenne Sadeghi
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Anushka Edlabadkar
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Rakesh Manjappa
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Jinghui Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Marie Le Bouteiller
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Murat Surucu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Amy Yu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Karl Bush
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Lawrie Skinner
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Peter G. Maxim
- Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Billy W. Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Charles L. Limoli
- Department of Radiation Oncology, University of California, Irvine, CA 92697-2695, USA
| | - Marie-Catherine Vozenin
- Laboratory of Radiation Oncology, Department of Radiation Oncology. Lausanne University Hospital and University of Lausanne, Switzerland
| | - Richard L. Frock
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA
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Lv Y, Lv Y, Wang Z, Lan T, Feng X, Chen H, Zhu J, Ma X, Du J, Hou G, Liao W, Yuan K, Wu H. FLASH radiotherapy: A promising new method for radiotherapy. Oncol Lett 2022; 24:419. [PMID: 36284652 PMCID: PMC9580247 DOI: 10.3892/ol.2022.13539] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/10/2022] [Indexed: 11/06/2022] Open
Abstract
Among the treatments for malignant tumors, radiotherapy is of great significance both as a main treatment and as an adjuvant treatment. Radiation therapy damages cancer cells with ionizing radiation, leading to their death. However, radiation-induced toxicity limits the dose delivered to the tumor, thereby constraining the control effect of radiotherapy on tumor growth. In addition, the delayed toxicity caused by radiotherapy significantly harms the physical and mental health of patients. FLASH-RT, an emerging class of radiotherapy, causes a phenomenon known as the 'FLASH effect', which delivers radiotherapy at an ultra-high dose rate with lower toxicity to normal tissue than conventional radiotherapy to achieve local tumor control. Although its mechanism remains to be fully elucidated, this modality constitutes a potential new approach to treating malignant tumors. In the present review, the current research progress of FLASH-RT and its various particular effects are described, including the status of research on FLASH-RT and its influencing factors. The hypothetic mechanism of action of FLASH-RT is also summarized, providing insight into future tumor treatments.
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Affiliation(s)
- Yinghao Lv
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Yue Lv
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Zhen Wang
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
- Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P.R. China
| | - Tian Lan
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Xuping Feng
- Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P.R. China
| | - Hao Chen
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Jiang Zhu
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Xiao Ma
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Jinpeng Du
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Guimin Hou
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Wenwei Liao
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
| | - Kefei Yuan
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
- Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P.R. China
| | - Hong Wu
- Department of Liver Surgery and Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, West China Hospital, Chengdu, Sichuan 610000, P.R. China
- Laboratory of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P.R. China
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4
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Cooper CR, Jones D, Jones GDD, Petersson K. FLASH irradiation induces lower levels of DNA damage ex vivo, an effect modulated by oxygen tension, dose, and dose rate. Br J Radiol 2022; 95:20211150. [PMID: 35171701 PMCID: PMC10993968 DOI: 10.1259/bjr.20211150] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/07/2022] [Accepted: 01/31/2022] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE FLASH irradiation reportedly produces less normal tissue toxicity, while maintaining tumour response. To investigate oxygen's role in the 'FLASH effect', we assessed DNA damage levels following irradiation at different oxygen tensions, doses and dose rates. METHODS Samples of whole blood were irradiated (20 Gy) at various oxygen tensions (0.25-21%) with 6 MeV electrons at dose rates of either 2 kGy/s (FLASH) or 0.1 Gy/s (CONV), and subsequently with various doses (0-40 Gy) and intermediate dose rates (0.3-1000 Gy/s). DNA damage of peripheral blood lymphocytes (PBL) were assessed by the alkaline comet assay. RESULTS Following 20 Gy irradiation, lower levels of DNA damage were induced for FLASH, the difference being significant at 0.25% (p < 0.05) and 0.5% O2 (p < 0.01). The differential in DNA damage at 0.5% O2 was found to increase with total dose and dose rate, becoming significant for doses ≥20 Gy and dose rates ≥30 Gy/s. CONCLUSION This study shows, using the alkaline comet assay, that lower levels of DNA damage are induced following FLASH irradiation, an effect that is modulated by the oxygen tension, and increases with the total dose and dose rate of irradiation, indicating that an oxygen related mechanism, e.g. transient radiation-induced oxygen depletion, may contribute to the tissue sparing effect of FLASH irradiation. ADVANCES IN KNOWLEDGE This paper is first to directly show that FLASH-induced DNA damage is modulated by oxygen tension, total dose and dose rate, with FLASH inducing significantly lower levels of DNA damage for doses ≥20 Gy and dose rates ≥30 Gy/s, at 0.5% O2.
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Affiliation(s)
- Christian R Cooper
- Leicester Cancer Research Centre, University of Leicester,
Robert Kilpatrick Clinical Sciences Building, Leicester Royal
Infirmary, Leicester,
UK
| | - Donald Jones
- Leicester Cancer Research Centre, University of Leicester,
Robert Kilpatrick Clinical Sciences Building, Leicester Royal
Infirmary, Leicester,
UK
| | - George DD Jones
- Leicester Cancer Research Centre, University of Leicester,
Robert Kilpatrick Clinical Sciences Building, Leicester Royal
Infirmary, Leicester,
UK
| | - Kristoffer Petersson
- MRC Oxford Institute for Radiation Oncology, University of
Oxford, Old Road Campus Research Building,
Oxford, UK
- Department of Haematology, Oncology and Radiation Physics,
Skåne University Hospital Lund University,
Lund, Sweden
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5
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Pakela JM, Knopf A, Dong L, Rucinski A, Zou W. Management of Motion and Anatomical Variations in Charged Particle Therapy: Past, Present, and Into the Future. Front Oncol 2022; 12:806153. [PMID: 35356213 PMCID: PMC8959592 DOI: 10.3389/fonc.2022.806153] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/04/2022] [Indexed: 12/14/2022] Open
Abstract
The major aim of radiation therapy is to provide curative or palliative treatment to cancerous malignancies while minimizing damage to healthy tissues. Charged particle radiotherapy utilizing carbon ions or protons is uniquely suited for this task due to its ability to achieve highly conformal dose distributions around the tumor volume. For these treatment modalities, uncertainties in the localization of patient anatomy due to inter- and intra-fractional motion present a heightened risk of undesired dose delivery. A diverse range of mitigation strategies have been developed and clinically implemented in various disease sites to monitor and correct for patient motion, but much work remains. This review provides an overview of current clinical practices for inter and intra-fractional motion management in charged particle therapy, including motion control, current imaging and motion tracking modalities, as well as treatment planning and delivery techniques. We also cover progress to date on emerging technologies including particle-based radiography imaging, novel treatment delivery methods such as tumor tracking and FLASH, and artificial intelligence and discuss their potential impact towards improving or increasing the challenge of motion mitigation in charged particle therapy.
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Affiliation(s)
- Julia M. Pakela
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, United States
| | - Antje Knopf
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department I of Internal Medicine, Center for Integrated Oncology Cologne, University Hospital of Cologne, Cologne, Germany
| | - Lei Dong
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, United States
| | - Antoni Rucinski
- Institute of Nuclear Physics, Polish Academy of Sciences, Krakow, Poland
| | - Wei Zou
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, United States
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6
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Sarti A, De Maria P, Battistoni G, De Simoni M, Di Felice C, Dong Y, Fischetti M, Franciosini G, Marafini M, Marampon F, Mattei I, Mirabelli R, Muraro S, Pacilio M, Palumbo L, Rocca L, Rubeca D, Schiavi A, Sciubba A, Tombolini V, Toppi M, Traini G, Trigilio A, Patera V. Deep Seated Tumour Treatments With Electrons of High Energy Delivered at FLASH Rates: The Example of Prostate Cancer. Front Oncol 2022; 11:777852. [PMID: 35024354 PMCID: PMC8744000 DOI: 10.3389/fonc.2021.777852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/19/2021] [Indexed: 12/25/2022] Open
Abstract
Different therapies are adopted for the treatment of deep seated tumours in combination or as an alternative to surgical removal or chemotherapy: radiotherapy with photons (RT), particle therapy (PT) with protons or even heavier ions like 12C, are now available in clinical centres. In addition to these irradiation modalities, the use of Very High Energy Electron (VHEE) beams (100–200 MeV) has been suggested in the past, but the diffusion of that technique was delayed due to the needed space and budget, with respect to standard photon devices. These disadvantages were not paired by an increased therapeutic efficacy, at least when comparing to proton or carbon ion beams. In this contribution we investigate how recent developments in electron beam therapy could reshape the treatments of deep seated tumours. In this respect we carefully explored the application of VHEE beams to the prostate cancer, a well-known and studied example of deep seated tumour currently treated with high efficacy both using RT and PT. The VHEE Treatment Planning System was obtained by means of an accurate Monte Carlo (MC) simulation of the electrons interactions with the patient body. A simple model of the FLASH effect (healthy tissues sparing at ultra-high dose rates), has been introduced and the results have been compared with conventional RT. The study demonstrates that VHEE beams, even in absence of a significant FLASH effect and with a reduced energy range (70–130 MeV) with respect to implementations already explored in literature, could be a good alternative to standard RT, even in the framework of technological developments that are nowadays affordable.
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Affiliation(s)
- Alessio Sarti
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Patrizia De Maria
- Scuola post-laurea in Fisica Medica, Dipartimento di Scienze e Biotecnologie medico-chirurgiche, Sapienza Università di Roma, Roma, Italy
| | - Giuseppe Battistoni
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Milano, Milano, Italy
| | - Micol De Simoni
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy
| | - Cinzia Di Felice
- Unità di Fisica Sanitaria, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Roma, Italy
| | - Yunsheng Dong
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Milano, Milano, Italy
| | - Marta Fischetti
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Gaia Franciosini
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy
| | - Michela Marafini
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy
| | - Francesco Marampon
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo Patologiche, Sapienza Università di Roma, Roma, Italy
| | - Ilaria Mattei
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Milano, Milano, Italy
| | - Riccardo Mirabelli
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy
| | - Silvia Muraro
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Milano, Milano, Italy
| | - Massimiliano Pacilio
- Unità di Fisica Sanitaria, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Roma, Italy
| | - Luigi Palumbo
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Loredana Rocca
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy
| | - Damiana Rubeca
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy
| | - Angelo Schiavi
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Adalberto Sciubba
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione dei Laboratori di Frascati, Roma, Italy
| | - Vincenzo Tombolini
- Dipartimento di Scienze Radiologiche, Oncologiche e Anatomo Patologiche, Sapienza Università di Roma, Roma, Italy
| | - Marco Toppi
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione dei Laboratori di Frascati, Roma, Italy
| | - Giacomo Traini
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
| | - Antonio Trigilio
- Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy.,Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy
| | - Vincenzo Patera
- Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.,Istituto Nazionale di Fisica Nucleare (INFN) Sezione di Roma I, Roma, Italy
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7
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Li M, Zhang Q, Yang K. Role of MRI-Based Functional Imaging in Improving the Therapeutic Index of Radiotherapy in Cancer Treatment. Front Oncol 2021; 11:645177. [PMID: 34513659 PMCID: PMC8429950 DOI: 10.3389/fonc.2021.645177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/30/2021] [Indexed: 02/05/2023] Open
Abstract
Advances in radiation technology, such as intensity-modulated radiation therapy (IMRT), have largely enabled a biological dose escalation of the target volume (TV) and reduce the dose to adjacent tissues or organs at risk (OARs). However, the risk of radiation-induced injury increases as more radiation dose utilized during radiation therapy (RT), which predominantly limits further increases in TV dose distribution and reduces the local control rate. Thus, the accurate target delineation is crucial. Recently, technological improvements for precise target delineation have obtained more attention in the field of RT. The addition of functional imaging to RT can provide a more accurate anatomy of the tumor and normal tissues (such as location and size), along with biological information that aids to optimize the therapeutic index (TI) of RT. In this review, we discuss the application of some common MRI-based functional imaging techniques in clinical practice. In addition, we summarize the main challenges and prospects of these imaging technologies, expecting more inspiring developments and more productive research paths in the near future.
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Affiliation(s)
- Mei Li
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.,West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qin Zhang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Kaixuan Yang
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
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8
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Abstract
This article summarizes the role of PET imaging for detection, characterization, and theranostic/therapy planning for neuroendocrine tumors. Topics in this article span overall imaging accuracy with mostly 68Ga-DOTA-peptide imaging as well as basic principles of individualized dosimetry. There is also some discussion around further specialized approaches in dosimetry in theranostics. In addition, an overview of the literature on functional imaging in neuroendocrine tumors and the current understanding of imaging-derived clinical outcome prediction are presented.
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Affiliation(s)
- Rebecca K S Wong
- Radiation Medicine Program, Princess Margaret Cancer Center, University Health Network, 610 University Ave, Toronto, ON M5G 2M9, Canada; Department of Radiation Oncology Temerty Faculty of Medicine, University of Toronto, 149 College Street, Suite 504, Toronto, ON M5T 1P5, Canada
| | - Ur Metser
- Joint Department Medical Imaging, University Health Network, Mount Sinai Hospital & Women's College Hospital, University of Toronto, 610 University Ave, Suite 3-920, Toronto, ON M5G 2M9, Canada; Department of Medical Imaging, University of Toronto, 263 McCaul Street, 4th Floor, Toronto, ON M5T 1W7, Canada
| | - Patrick Veit-Haibach
- Joint Department Medical Imaging, University Health Network, Mount Sinai Hospital & Women's College Hospital, University of Toronto, 610 University Ave, Suite 3-920, Toronto, ON M5G 2M9, Canada; Department of Medical Imaging, University of Toronto, 263 McCaul Street, 4th Floor, Toronto, ON M5T 1W7, Canada.
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9
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Sanduleanu S, van der Wiel AM, Lieverse RI, Marcus D, Ibrahim A, Primakov S, Wu G, Theys J, Yaromina A, Dubois LJ, Lambin P. Hypoxia PET Imaging with [18F]-HX4-A Promising Next-Generation Tracer. Cancers (Basel) 2020; 12:cancers12051322. [PMID: 32455922 PMCID: PMC7280995 DOI: 10.3390/cancers12051322] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 02/04/2023] Open
Abstract
Hypoxia—a common feature of the majority of solid tumors—is a negative prognostic factor, as it is associated with invasion, metastasis and therapy resistance. To date, a variety of methods are available for the assessment of tumor hypoxia, including the use of positron emission tomography (PET). A plethora of hypoxia PET tracers, each with its own strengths and limitations, has been developed and successfully validated, thereby providing useful prognostic or predictive information. The current review focusses on [18F]-HX4, a promising next-generation hypoxia PET tracer. After a brief history of its development, we discuss and compare its characteristics with other hypoxia PET tracers and provide an update on its progression into the clinic. Lastly, we address the potential applications of assessing tumor hypoxia using [18F]-HX4, with a focus on improving patient-tailored therapies.
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Affiliation(s)
- Sebastian Sanduleanu
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
- Correspondence:
| | - Alexander M.A. van der Wiel
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
| | - Relinde I.Y. Lieverse
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
| | - Damiënne Marcus
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
| | - Abdalla Ibrahim
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
- Department of Radiology and Nuclear Medicine, GROW—School for Oncology and Developmental Biology, Maastricht University Medical Centre+, 6229 Maastricht, The Netherlands
- Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, Hospital Center Universitaire De Liege, 4030 Liege, Belgium
- Department of Nuclear Medicine and Comprehensive Diagnostic Center Aachen (CDCA), University Hospital RWTH Aachen University, 52074 Aachen, Germany
| | - Sergey Primakov
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
| | - Guangyao Wu
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
| | - Jan Theys
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
| | - Ala Yaromina
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
| | - Ludwig J. Dubois
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
| | - Philippe Lambin
- The D-Lab and The M-Lab, Department of Precision Medicine, GROW—School for Oncology, Maastricht University, 6211 Maastricht, The Netherlands; (A.M.A.v.d.W.); (R.I.Y.L.); (D.M.); (A.I.); (S.P.); (G.W.); (J.T.); (A.Y.); (L.J.D.); (P.L.)
- Department of Radiology and Nuclear Medicine, GROW—School for Oncology and Developmental Biology, Maastricht University Medical Centre+, 6229 Maastricht, The Netherlands
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