Gold Nanoparticle DNA Damage by Photon Beam in a Magnetic Field: A Monte Carlo Study

Recent Advances in Nanomaterial-Mediated Cell Death for Cancer Therapy

Nanomedicine has shown great anticancer potential by disrupting redox homeostasis and increasing the levels of oxidative stress, but the therapeutic effect is limited by factors including the intrinsic self-protection mechanism of tumors. Cancer cell death can be induced by the exploration of different cell death mechanisms, such as apoptosis, pyroptosis, necroptosis, cuproptosis, and ferroptosis. The merging of nanotechnology with biomedicine has provided tremendous opportunities to construct cell death-based nanomedicine for innovative cancer therapy. Nanocarriers are not only used for the targeted delivery of cell death inducers, but also as therapeutic components to induce cell death to achieve efficient tumor treatment. This review focuses on seven cell death modalities mediated by nanomaterials, such as apoptosis, pyroptosis, necroptosis, ferroptosis, cuprotosis, immunogenic cell death, and autophagy. The mechanisms of these seven cell death modalities are described in detail, as well as the preparation of nanomaterials that induce them and the mechanisms, they used to exert their effects. Finally, this work describes the potential future development based on the current knowledge related to cell death induced by nanomaterials.

Exploring the Frontier of Biopolymer-Assisted Drug Delivery: Advancements, Clinical Applications, and Future Perspectives in Cancer Nanomedicine

The burgeoning global mortality rates attributed to cancer have precipitated a critical reassessment of conventional therapeutic modalities, most notably chemotherapy, due to their pronounced adverse effects. This reassessment has instigated a paradigmatic shift towards nanomedicine, with a particular emphasis on the potentialities of biopolymer-assisted drug delivery systems. Biopolymers, distinguished by their impeccable biocompatibility, versatility, and intrinsic biomimetic properties, are rapidly ascending as formidable vectors within the cancer theragnostic arena. This review endeavors to meticulously dissect the avant-garde methodologies central to biopolymer-based nanomedicine, exploring their synthesis, functional mechanisms, and subsequent clinical ramifications. A key focus of this analysis is the pioneering roles and efficacies of lipid-based, polysaccharide, and composite nano-carriers in enhancing drug delivery, notably amplifying the enhanced permeation and retention effect. This examination is further enriched by referencing flagship nano formulations that have received FDA endorsement, thereby underscoring the transformative potential and clinical viability of biopolymer-based nanomedicines. Furthermore, this discourse illuminates groundbreaking advancements in the realm of photodynamic therapy and elucidates the implications of advanced imaging techniques in live models. Conclusively, this review not only synthesizes current research trajectories but also delineates visionary pathways for the integration of cutting-edge biomaterials in cancer treatment. It charts a course for future explorations within the dynamic domain of biopolymer-nanomedicine, thereby contributing to a deeper understanding and enhanced application of these novel therapeutic strategies.

The Refined Application and Evolution of Nanotechnology in Enhancing Radiosensitivity During Radiotherapy: Transitioning from Gold Nanoparticles to Multifunctional Nanomaterials

Radiotherapy is a pivotal method for treating malignant tumors, and enhancing the therapeutic gain ratio of radiotherapy through physical techniques is the direction of modern precision radiotherapy. Due to the inherent physical properties of high-energy radiation, enhancing the therapeutic gain ratio of radiotherapy through radiophysical techniques inevitably encounters challenges. The combination of hyperthermia and radiotherapy can enhance the radiosensitivity of tumor cells, reduce their radioresistance, and holds significant clinical utility in radiotherapy. Multifunctional nanomaterials with excellent biocompatibility and safety have garnered widespread attention in tumor hyperthermia research, demonstrating promising potential. Utilizing nanotechnology as a sensitizing carrier in conjunction with radiotherapy, and high atomic number nanomaterials can also serve independently as radiosensitizing carriers. This synergy between tumor hyperthermia and radiotherapy may overcome many challenges currently limiting tumor radiotherapy, offering new opportunities for its further advancement. In recent years, the continuous progress in the synthesis and design of novel nanomaterials will propel the future development of medical imaging and cancer treatment. This article summarizes the radiosensitizing mechanisms and effects based on gold nanotechnology and provides an overview of the advancements of other nanoparticles (such as bismuth-based nanomaterials, magnetic nanomaterials, selenium nanomaterials, etc.) in the process of radiation therapy.

Review of nanomaterial advances for ionizing radiation dosimetry

There are a wide range of applications with ionizing radiation and a common theme throughout these is that accurate dosimetry is usually required, although many newer demands are provided by improved features in higher range, multi-spectral and particle type detected. Today, the array of dosimeters includes both offline and online tools, such as gel dosimeters, thermoluminescence (TL), scintillators, optically stimulated luminescence (OSL), radiochromic polymeric films, gels, ionization chambers, colorimetry, and electron spin resonance (ESR) measurement systems. Several future nanocomposite features and interpretation of their substantial behaviors are discussed that can lead to improvements in specific features, such as (1) lower sensitivity range, (2) less saturation at high range, (3) overall increased dynamic range, (4) superior linearity, (5) linear energy transfer and energy independence, (6) lower cost, (7) higher ease of use, and (8) improved tissue equivalence. Nanophase versions of TL and ESR dosimeters and scintillators each have potential for higher range of linearity, sometimes due to superior charge transfer to the trapping center. Both OSL and ESR detection of nanomaterials can have increased dose sensitivity because of their higher readout sensitivity with nanoscale sensing. New nanocrystalline scintillators, such as perovskite, have fundamentally important advantages in sensitivity and purposeful design for key new applications. Nanoparticle plasmon coupled sensors doped within a lower Zeff material have been an effective way to achieve enhanced sensitivity of many dosimetry systems while still achieving tissue equivalency. These nanomaterial processing techniques and unique combinations of them are key steps that lead to the advanced features. Each must be realized through industrial production and quality control with packaging into dosimetry systems that maximize stability and reproducibility. Ultimately, recommendations for future work in this field of radiation dosimetry were summarized throughout the review.

Dosimetric Impact on the Flattening Filter and Addition of Gold Nanoparticles in Radiotherapy: A Monte Carlo Study on Depth Dose Using the 6 and 10 MV FFF Photon Beams

PURPOSE

This phantom study investigated through Monte Carlo simulation how the dose enhancement varied with depth, when gold nanoparticles (NPs) were added using the flattening filter-free (FFF) photon beams in gold NP-enhanced radiotherapy.

METHOD

A phantom with materials varying from pure water to a mixture of water and gold NPs at different concentrations (3-40 mg/mL) were irradiated by the 6 and 10 MV flattening filter (FF) and FFF photon beams. Monte Carlo simulations were carried out to determine the depth doses along the central beam axis of the phantom up to a depth of 40 cm. The dose enhancement ratio (DER) and FFF enhancement ratio (FFFER) were calculated based on the Monte Carlo results.

RESULTS

The DER values were found decreased with an increase of depth and increase of NP concentration in the phantom. For the maximum NP concentration of 40 mg/mL, the DER values decreased 6.9, 12, 4.6 and 7.2% at a phantom depth from 2 to 40 cm, using the 6 MV FF, 6 MV FFF, 10 MV FF and 10 MV FFF photon beams, respectively. The maximum DER values for the 6 MV beams were 1.08 (FF) and 1.14 (FFF), while those for the 10 MV beams were 1.04 (FF) and 1.07 (FFF). When the FF was removed from the linear accelerator head, the FFFER showed a more significant increase of dose enhancement for the 6 MV beams (1.057) than the 10 MV (1.031).

CONCLUSION

From the DER and FFFER values based on the Monte Carlo results, it is concluded that the dose enhancement with depth was dependent on the NP and beam variables, namely, NP concentration, presence of FF in the beam and beam energy. Dose enhancement was more significant when using the lower photon beam energy (i.e., 6 MV), FFF photon beam and higher NP concentration in the study.

Evaluation of Dosimetric Effect of Bone Scatter on Nanoparticle-Enhanced Orthovoltage Radiotherapy: A Monte Carlo Phantom Study

In nanoparticle (NP)-enhanced orthovoltage radiotherapy, bone scatter affected dose enhancement at the skin lesion in areas such as the forehead, chest wall, and knee. Since each of these treatment sites have a bone, such as the frontal bone, rib, or patella, underneath the skin lesion and this bone is not considered in dose delivery calculations, uncertainty arises in the evaluation of dose enhancement with the addition of NPs in radiotherapy. To investigate the impact of neglecting the effect of bone scatter, Monte Carlo simulations based on heterogeneous phantoms were carried out to determine and compare the dose enhancement ratio (DER), when a bone was and was not present underneath the skin lesion. For skin lesions with added NPs, Monte Carlo simulations were used to calculate the DER values using different elemental NPs (gold, platinum, silver, iodine, as well as iron oxide), in varying NP concentrations (3−40 mg/mL), at two different photon beam energies (105 and 220 kVp). It was found that DER values at the skin lesion increased with the presence of bone when there was a higher atomic number of NPs, a higher NP concentration, and a lower photon beam energy. When comparing DER values with and without bone, using the same NP elements, NP concentration, and beam energy, differences were found in the range 0.04−3.55%, and a higher difference was found when the NP concentration increased. By considering the uncertainty in the DER calculation, the effect of bone scatter became significant to the dose enhancement (>2%) when the NP concentration was higher than 18 mg/mL. This resulted in an underestimation of dose enhancement at the skin lesion, when the bone underneath the tumour was neglected during orthovoltage radiotherapy.

Neuroprotective Effect of Gold Nanoparticles and Alpha-Lipoic Acid Mixture against Radiation-Induced Brain Damage in Rats

The current study aims to evaluate the possible neuroprotective impact of gold nanoparticles (AuNPs) and an alpha-lipoic acid (ALA) mixture against brain damage in irradiated rats. AuNPs were synthesized and characterized using different techniques. Then, a preliminary investigation was carried out to determine the neuroprotective dose of AuNPs, where three single doses (500, 1000, and 1500 µg/kg) were orally administrated to male Wistar rats, one hour before being exposed to a single dose of 7Gy gamma radiation. One day following irradiation, the estimation of oxidative stress biomarkers (malondialdehyde, MDA; glutathione peroxidase, GPX), DNA fragmentation, and histopathological alterations were performed in brain cortical and hippocampal tissues in both normal and irradiated rats. The chosen neuroprotective dose of AuNPs (1000 µg/kg) was processed with ALA (100 mg/kg) to prepare the AuNPs-ALA mixture. The acute neuroprotective effect of AuNPs-ALA in irradiated rats was determined against valproic acid as a neuroprotective centrally acting reference drug. All drugs were orally administered one hour before the 7Gy-gamma irradiation. One day following irradiation, animals were sacrificed and exposed to examinations such as those of the preliminary experiment. Administration of AuNPs, ALA, and AuNPs-ALA mixture before irradiation significantly attenuated the radiation-induced oxidative stress through amelioration of MDA content and GPX activity along with alleviating DNA fragmentation and histopathological changes in both cortical and hippocampal tissues. Notably, the AuNPs-ALA mixture showed superior effect compared to that of AuNPs or ALA alone, as it mitigated oxidative stress, DNA damage, and histopathological injury collectively. Administration of AuNPs-ALA resulted in normalized MDA content, increased GPX activity, restored DNA content in the cortex and hippocampus besides only mild histopathological changes. The present data suggest that the AuNPs-ALA mixture may be considered a potential candidate for alleviating radiation-associated brain toxicity.

Integration of an Independent Monitor Unit Check for High-Magnetic-Field MR-Guided Radiation Therapy System

Purpose

Commercial independent monitor unit (IMU) check systems for high-magnetic-field MR-guided radiation therapy (RT) systems are lacking. We investigated the feasibility of adopting an existing treatment planning system (TPS) as an IMU check for online adaptive radiotherapy using 1.5-Tesla MR-Linac.

Methods

The 7-MV flattening filter free (FFF) beam and multi-leaf collimator (MLC) models of a 1.5-T Elekta Unity MR-Linac within Monte Carlo-based Monaco TPS were used to generate an optimized beam model in Eclipse TPS. The MLC dosimetric leaf gap of the beam in Eclipse was determined by matching the dose distribution of Eclipse-generated intensity-modulated radiation therapy (IMRT) plans using the Analytical Anisotropic Algorithm (AAA) algorithm to Monaco plans. The plans were automatically adjusted for different source-to-axis distances (SADs) between the two systems. For IMU check, the treatment plans developed in Monaco were transferred to Eclipse to recalculate the dose using AAA. A plug-in within Eclipse was created to perform a 2D gamma analysis of the AAA and Monte Carlo dose distribution on a beam’s eye view parallel plane. Monaco dose distribution was shifted laterally by 2 mm during gamma analysis to account for the impact of magnetic field on electron trajectories. Eclipse doses for posterior beams were corrected for both the Unity couch and the posterior MR coil attenuation. Thirteen patients, each with 4–5 fractions for a variety of tumor sites (pancreas, rectum, and prostate), were tested.

Results

After thorough commissioning, the method was implemented as part of the standard clinical workflow. A total of 62 online plans, each with approximately 15 beams, were evaluated. The average per-beam gamma (3%/3 mm) pass rate for plans was 97.9% (range, 95.9% to 98.8%). The average pass rate per beam for all 932 beams used in these plans was 97.9% ± 1.9%, with the lowest per-beam gamma pass rate at 88.4%. The time for the process was within 3.2 ± 0.9 min.

Conclusion

The use of a second planning system provides an efficient way to perform IMU checks with clinically acceptable accuracy for online adaptive plans on Unity MR-Linac. This is essential for meeting the safety requirements for second checks as outlined in American Association of Physicists in Medicine Task Group (AAPM TG) reports 114 and 219.

Special Issue: Application of Nanomaterials in Biomedical Imaging and Cancer Therapy

Nanomaterials of different types-namely, inorganic-based, organic-based, carbon-based, and composite-based ones, with various structures such as nanoparticles, nanofibers, nanorods, nanoshells, and nanostars, all have demonstrated a wide range of medical biophysical and chemical properties [...].