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Kim DW, Hong CS, Son J, Kim SY, Park YI, Chung M, Chung WK, Han MC, Kim J, Kim H, Kim JS. Dosimetric analysis of six whole-breast irradiation techniques in supine and prone positions. Sci Rep 2024; 14:14347. [PMID: 38907042 PMCID: PMC11192744 DOI: 10.1038/s41598-024-65461-y] [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: 11/27/2023] [Accepted: 06/20/2024] [Indexed: 06/23/2024] Open
Abstract
In breast cancer radiation therapy, minimizing radiation-related risks and toxicity is vital for improving life expectancy. Tailoring radiotherapy techniques and treatment positions can reduce radiation doses to normal organs and mitigate treatment-related toxicity. This study entailed a dosimetric comparison of six different external beam whole-breast irradiation techniques in both supine and prone positions. We selected fourteen breast cancer patients, generating six treatment plans in both positions per patient. We assessed target coverage and organs at risk (OAR) doses to evaluate the impact of treatment techniques and positions. Excess absolute risk was calculated to estimate potential secondary cancer risk in the contralateral breast, ipsilateral lung, and contralateral lung. Additionally, we analyzed the distance between the target volume and OARs (heart and ipsilateral lung) while considering the treatment position. The results indicate that prone positioning lowers lung exposure in X-ray radiotherapy. However, particle beam therapies (PBTs) significantly reduce the dose to the heart and ipsilateral lung regardless of the patient's position. Notably, negligible differences were observed between arc-delivery and static-delivery PBTs in terms of target conformity and OAR sparing. This study provides critical dosimetric evidence to facilitate informed decision-making regarding treatment techniques and positions.
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Affiliation(s)
- Dong Wook Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, South Korea, 03722
| | - Chae-Seon Hong
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, South Korea, 03722.
| | - Junyoung Son
- Department of Radiation Oncology, Yongin Severance Hospital, Yongin, South Korea
| | - Se Young Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Seoul, South Korea
| | - Ye-In Park
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, South Korea, 03722
| | - Mijoo Chung
- Department of Radiation Oncology, Changwon Hanmaeum Hospital, Hanyang University College of Medicine, Changwon, South Korea
| | - Weon Kuu Chung
- Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea
| | - Min Cheol Han
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, South Korea, 03722
| | - Jihun Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hojin Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, South Korea, 03722
| | - Jin Sung Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, South Korea, 03722.
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Lo CY, Tsai SW, Niu H, Chen FH, Hwang HC, Chao TC, Hsiao IT, Liaw JW. Gold-Nanoparticles-Enhanced Production of Reactive Oxygen Species in Cells at Spread-Out Bragg Peak under Proton Beam Radiation. ACS OMEGA 2023; 8:17922-17931. [PMID: 37251180 PMCID: PMC10210040 DOI: 10.1021/acsomega.3c01025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/26/2023] [Indexed: 05/31/2023]
Abstract
This study investigates the radiobiological effects of gold nanoparticles (GNPs) as radiosensitizers for proton beam therapy (PBT). Specifically, we explore the enhanced production of reactive oxygen species (ROS) in GNP-loaded tumor cells irradiated by a 230 MeV proton beam in a spread-out Bragg peak (SOBP) zone obtained by a passive scattering system. Our findings indicate that the radiosensitization enhancement factor is 1.24 at 30% cell survival fraction, 8 days after 6 Gy proton beam irradiation. Since protons deposit the majority of their energy at the SOBP region and interact with GNPs to induce more ejected electrons from the high-Z GNPs, these ejected electrons then react with water molecules to produce excessive ROS that can damage cellular organelles. Laser scanning confocal microscopy reveals the excessive ROS induced inside the GNP-loaded cells immediately after proton irradiation. Furthermore, the damage to cytoskeletons and mitochondrial dysfunction in GNP-loaded cells caused by the induced ROS becomes significantly severe, 48 h after proton irradiation. Our biological evidence suggests that the cytotoxicity of GNP-enhanced ROS production has the potential to increase the tumoricidal efficacy of PBT.
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Affiliation(s)
- Chang-Yun Lo
- Department
of Mechanical Engineering, Chang Gung University, Taoyuan 333, Taiwan
| | - Shiao-Wen Tsai
- Department
of Biomedical Engineering, Chang Gung University, Taoyuan 333, Taiwan
- Department
of Periodontics, Chang Gung Memorial Hospital, Taipei 105, Taiwan
| | - Huan Niu
- Accelerator
Laboratory, Nuclear Science and Technology Development Center, National Tsing Hua University, Hsinchu 300, Taiwan
| | - Fang-Hsin Chen
- Institute
of Nuclear Engineering and Science, National
Tsing Hua University, Hsinchu 300, Taiwan
- Department
of Radiation Oncology, Chang Gung Memorial
Hospital, Taoyuan 333, Taiwan
- Department
of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan 333, Taiwan
| | - Hsiao-Chien Hwang
- Proton
and Radiation Therapy Center, Linkou Chang
Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Tsi-Chian Chao
- Department
of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan 333, Taiwan
| | - Ing-Tsung Hsiao
- Department
of Medical Imaging and Radiological Science, Chang Gung University, Taoyuan 333, Taiwan
| | - Jiunn-Woei Liaw
- Department
of Mechanical Engineering, Chang Gung University, Taoyuan 333, Taiwan
- Proton
and Radiation Therapy Center, Linkou Chang
Gung Memorial Hospital, Taoyuan 333, Taiwan
- Department
of Mechanical Engineering, Ming Chi University
of Technology, New Taipei City 243, Taiwan
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Karaca S. The use of Hybrid Techniques in Whole-Breast Radiotherapy: A Systematic Review. Technol Cancer Res Treat 2022; 21:15330338221143937. [PMID: 36537067 PMCID: PMC9772967 DOI: 10.1177/15330338221143937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives The development of new techniques in radiotherapy (RT) provides a better planned target volume (PTV) dose distribution while further improving the protection of organs at risk (OARs). The study aims to present the dosimetric results of studies using hybrid techniques in whole-breast radiotherapy (WBRT). Methods: This systematic literature review was conducted by scanning the relevant literature in PubMed, Scopus, and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Among the parameters are dose values for PTV and OARs beam contribute ratios, the value of monitors, and treatment times for different RT techniques. Initially, 586 articles were identified; 196 duplicate articles were removed leaving 391 articles for screening. Three-hundred and thirty-seven irrelevant articles were excluded, leaving 54 studies assessed for eligibility. A total of 22 articles met the search criteria to evaluate dosimetric results of hybrid and other RT techniques in WBRT. Results: According to the dosimetric data of the studies, hybrid intensity-modulated RT (H-IMRT) and hybrid volumetric-modulated arc therapy (H-VMAT) techniques give dosimetrically advantageous results in WBRT compared to other RT techniques. Conclusion: Hybrid techniques using appropriate beams contribute value and show great promise in improving dosimetric results in WBRT. However, there is a need for new studies showing the long-term clinical results of hybrid RT.
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Affiliation(s)
- Sibel Karaca
- Faculty of Medicine, Department of Radiation Oncology, Akdeniz University, Antalya, Turkey,Sibel Karaca, Faculty of Medicine, Department of Radiation Oncology, Akdeniz University, Antalya, 07070, Turkey.
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Minafra L, Cammarata FP, Calvaruso M. The Role of Radiation in Cancer Treatment: New Insights towards Personalized Therapies. J Pers Med 2022; 12:jpm12020312. [PMID: 35207800 PMCID: PMC8878217 DOI: 10.3390/jpm12020312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/16/2022] Open
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