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Timmermans L, De Brabander I, Van Damme N, Bleyen L, Martens P, Van Herck K, Thierens H, Bacher K, Depypere H. Tumour characteristics of screen-detected and interval cancers in the Flemish Breast Cancer Screening Programme: A mammographic breast density study. Maturitas 2022; 158:55-60. [DOI: 10.1016/j.maturitas.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/29/2021] [Accepted: 12/12/2021] [Indexed: 12/25/2022]
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Depuydt J, Viaene T, Blondeel P, Roche N, Van den Broecke R, Thierens H, Vral A. DNA double strand breaks induced by low dose mammography X-rays in breast tissue: A pilot study. Oncol Lett 2018; 16:3394-3400. [PMID: 30127940 DOI: 10.3892/ol.2018.9024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 04/26/2018] [Indexed: 12/18/2022] Open
Abstract
Breast tissue is very sensitive to ionizing radiation due to the presence of reproductive hormones, including estrogen. In the present pilot study, the efficiency of mammography X-rays to induce DNA double strand breaks (DSB) in mammary epithelial cells was investigated. For this, freshly resected healthy breast tissue was irradiated with 30 kV mammography X-rays in the dose range 0-500 mGy (2, 4, 10, 20, 40, 100 and 500 mGy). Breast specimens were also irradiated with identical doses of 60Co γ-rays as a radiation quality standard. With the γH2AX-foci assay, the number of DNA DSB induced by radiation were quantified in the mammary epithelial cells present in breast tissue. Results indicated that foci induced by 30 kV X-rays and γ-rays followed a biphasic linear dose-response. For 30 kV X-rays, the slope in the low dose region (0-20 mGy) was 8.71 times steeper compared with the slope in the higher dose region (20-500 mGy). Furthermore, compared with γ-rays, 30 kV X-rays were also more effective in inducing γH2AX-foci. This resulted in a relative biological effectiveness (RBE) value of 1.82 in the low dose range. In the higher dose range, an RBE close to 1 was obtained. In conclusion, the results indicated the existence of a low dose hypersensitive response for DSB induction in the dose range representative for mammography screening, which is probably caused by the bystander effect. This could affect the radiation risk calculations for women participating in mammography screening.
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Affiliation(s)
- Julie Depuydt
- Department of Basic Medical Sciences, University of Ghent, 9000 Ghent, Belgium
| | - Tanguy Viaene
- Department of Basic Medical Sciences, University of Ghent, 9000 Ghent, Belgium
| | | | - Nathalie Roche
- Plastic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | | | - Hubert Thierens
- Department of Basic Medical Sciences, University of Ghent, 9000 Ghent, Belgium
| | - Anne Vral
- Department of Basic Medical Sciences, University of Ghent, 9000 Ghent, Belgium
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Mbah C, De Ruyck K, De Schrijver S, De Sutter C, Schiettecatte K, Monten C, Paelinck L, De Neve W, Thierens H, West C, Amorim G, Thas O, Veldeman L. A new approach for modeling patient overall radiosensitivity and predicting multiple toxicity endpoints for breast cancer patients. Acta Oncol 2018; 57:604-612. [PMID: 29299946 DOI: 10.1080/0284186x.2017.1417633] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/03/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Evaluation of patient characteristics inducing toxicity in breast radiotherapy, using simultaneous modeling of multiple endpoints. METHODS AND MATERIALS In 269 early-stage breast cancer patients treated with whole-breast irradiation (WBI) after breast-conserving surgery, toxicity was scored, based on five dichotomized endpoints. Five logistic regression models were fitted, one for each endpoint and the effect sizes of all variables were estimated using maximum likelihood (MLE). The MLEs are improved with James-Stein estimates (JSEs). The method combines all the MLEs, obtained for the same variable but from different endpoints. Misclassification errors were computed using MLE- and JSE-based prediction models. For associations, p-values from the sum of squares of MLEs were compared with p-values from the Standardized Total Average Toxicity (STAT) Score. RESULTS With JSEs, 19 highest ranked variables were predictive of the five different endpoints. Important variables increasing radiation-induced toxicity were chemotherapy, age, SATB2 rs2881208 SNP and nodal irradiation. Treatment position (prone position) was most protective and ranked eighth. Overall, the misclassification errors were 45% and 34% for the MLE- and JSE-based models, respectively. p-Values from the sum of squares of MLEs and p-values from STAT score led to very similar conclusions, except for the variables nodal irradiation and treatment position, for which STAT p-values suggested an association with radiosensitivity, whereas p-values from the sum of squares indicated no association. Breast volume was ranked as the most significant variable in both strategies. DISCUSSION The James-Stein estimator was used for selecting variables that are predictive for multiple toxicity endpoints. With this estimator, 19 variables were predictive for all toxicities of which four were significantly associated with overall radiosensitivity. JSEs led to almost 25% reduction in the misclassification error rate compared to conventional MLEs. Finally, patient characteristics that are associated with radiosensitivity were identified without explicitly quantifying radiosensitivity.
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Affiliation(s)
- Chamberlain Mbah
- a Department of Radiotherapy and Experimental Cancer Research , Ghent University , Ghent , Belgium
- b Department of Mathematical Modelling, Statistics, and Bioinformatics, Faculty of Bioscience Engineering , University of Ghent , Ghent , Belgium
| | - Kim De Ruyck
- c Department of Basic Medical Sciences, Faculty of Health Sciences , University of Ghent , Ghent , Belgium
| | - Silke De Schrijver
- c Department of Basic Medical Sciences, Faculty of Health Sciences , University of Ghent , Ghent , Belgium
| | - Charlotte De Sutter
- a Department of Radiotherapy and Experimental Cancer Research , Ghent University , Ghent , Belgium
| | - Kimberly Schiettecatte
- a Department of Radiotherapy and Experimental Cancer Research , Ghent University , Ghent , Belgium
| | - Chris Monten
- a Department of Radiotherapy and Experimental Cancer Research , Ghent University , Ghent , Belgium
- d Department of Radiation Oncology , Ghent University Hospital , Ghent , Belgium
| | - Leen Paelinck
- d Department of Radiation Oncology , Ghent University Hospital , Ghent , Belgium
| | - Wilfried De Neve
- a Department of Radiotherapy and Experimental Cancer Research , Ghent University , Ghent , Belgium
- d Department of Radiation Oncology , Ghent University Hospital , Ghent , Belgium
| | - Hubert Thierens
- c Department of Basic Medical Sciences, Faculty of Health Sciences , University of Ghent , Ghent , Belgium
| | - Catharine West
- e Translational Radiobiology Group , Institute of Cancer Sciences Radiotherapy Related Research Christie Hospital NHS Trust , Manchester , UK
| | - Gustavo Amorim
- b Department of Mathematical Modelling, Statistics, and Bioinformatics, Faculty of Bioscience Engineering , University of Ghent , Ghent , Belgium
| | - Olivier Thas
- b Department of Mathematical Modelling, Statistics, and Bioinformatics, Faculty of Bioscience Engineering , University of Ghent , Ghent , Belgium
- f National Institute for Applied Statistics Research Australia (NIASRA), School of Mathematics and Applied Statistics , University of Wollongong , Wollongong , Australia
| | - Liv Veldeman
- d Department of Radiation Oncology , Ghent University Hospital , Ghent , Belgium
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Duprez F, De Witte L, Nuyts S, Deheneffe S, Van Gestel D, Voordeckers M, Thierens H, De Neve W, De Ruyck K. PO-0605: Factors associated with late dysphagia and xerostomia in (chemo)radiation for head and neck cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31041-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Azria D, Lapierre A, Gourgou S, De Ruysscher D, Colinge J, Lambin P, Brengues M, Ward T, Bentzen SM, Thierens H, Rancati T, Talbot CJ, Vega A, Kerns SL, Andreassen CN, Chang-Claude J, West CML, Gill CM, Rosenstein BS. Data-Based Radiation Oncology: Design of Clinical Trials in the Toxicity Biomarkers Era. Front Oncol 2017; 7:83. [PMID: 28497027 PMCID: PMC5406456 DOI: 10.3389/fonc.2017.00083] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/13/2017] [Indexed: 12/15/2022] Open
Abstract
The ability to stratify patients using a set of biomarkers, which predict that toxicity risk would allow for radiotherapy (RT) modulation and serve as a valuable tool for precision medicine and personalized RT. For patients presenting with tumors with a low risk of recurrence, modifying RT schedules to avoid toxicity would be clinically advantageous. Indeed, for the patient at low risk of developing radiation-associated toxicity, use of a hypofractionated protocol could be proposed leading to treatment time reduction and a cost-utility advantage. Conversely, for patients predicted to be at high risk for toxicity, either a more conformal form or a new technique of RT, or a multidisciplinary approach employing surgery could be included in the trial design to avoid or mitigate RT when the potential toxicity risk may be higher than the risk of disease recurrence. In addition, for patients at high risk of recurrence and low risk of toxicity, dose escalation, such as a greater boost dose, or irradiation field extensions could be considered to improve local control without severe toxicities, providing enhanced clinical benefit. In cases of high risk of toxicity, tumor control should be prioritized. In this review, toxicity biomarkers with sufficient evidence for clinical testing are presented. In addition, clinical trial designs and predictive models are described for different clinical situations.
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Affiliation(s)
- David Azria
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Ariane Lapierre
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Sophie Gourgou
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Dirk De Ruysscher
- Department of Radiation Oncology, Maastricht University Medical Centre, MAASTRO Clinic, Maastricht, Netherlands
- Radiation Oncology, KU Leuven, Leuven, Belgium
| | - Jacques Colinge
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Philippe Lambin
- Department of Radiation Oncology, Maastricht University Medical Centre, MAASTRO Clinic, Maastricht, Netherlands
| | - Muriel Brengues
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Tim Ward
- Patient Advocate, Manchester, UK
| | - Søren M. Bentzen
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Ana Vega
- Fundacion Publica Galega de Medicina Xenomica-SERGAS, Grupo de Medicina Xenomica-USC, IDIS, CIBERER, Santiago de Compostela, Spain
| | - Sarah L. Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Catharine M. L. West
- Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital NHS Trust, Manchester, UK
| | - Corey M. Gill
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barry S. Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Timmermans L, Bleyen L, Bacher K, Van Herck K, Lemmens K, Van Ongeval C, Van Steen A, Martens P, De Brabander I, Goossens M, Thierens H. Screen-detected versus interval cancers: Effect of imaging modality and breast density in the Flemish Breast Cancer Screening Programme. Eur Radiol 2017; 27:3810-3819. [PMID: 28289944 DOI: 10.1007/s00330-017-4757-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/22/2016] [Accepted: 01/19/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate if direct radiography (DR) performs better than screen-film mammography (SF) and computed radiography (CR) in dense breasts in a decentralized organised Breast Cancer Screening Programme. To this end, screen-detected versus interval cancers were studied in different BI-RADS density classes for these imaging modalities. METHODS The study cohort consisted of 351,532 women who participated in the Flemish Breast Cancer Screening Programme in 2009 and 2010. Information on screen-detected and interval cancers, breast density scores of radiologist second readers, and imaging modality was obtained by linkage of the databases of the Centre of Cancer Detection and the Belgian Cancer Registry. RESULTS Overall, 67% of occurring breast cancers are screen detected and 33% are interval cancers, with DR performing better than SF and CR. The interval cancer rate increases gradually with breast density, regardless of modality. In the high-density class, the interval cancer rate exceeds the cancer detection rate for SF and CR, but not for DR. CONCLUSIONS DR is superior to SF and CR with respect to cancer detection rates for high-density breasts. To reduce the high interval cancer rate in dense breasts, use of an additional imaging technique in screening can be taken into consideration. KEY POINTS • Interval cancer rate increases gradually with breast density, regardless of modality. • Cancer detection rate in high-density breasts is superior in DR. • IC rate exceeds CDR for SF and CR in high-density breasts. • DR performs better in high-density breasts for third readings and false-positives.
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Affiliation(s)
- Lore Timmermans
- Department of Basic Medical Sciences, QCC-Gent, Ghent University, Ghent, Belgium.
| | - Luc Bleyen
- Centrum voor Preventie en Vroegtijdige Opsporing van Kanker, Ghent University, Ghent, Belgium
| | - Klaus Bacher
- Department of Basic Medical Sciences, QCC-Gent, Ghent University, Ghent, Belgium
| | - Koen Van Herck
- Centrum voor Preventie en Vroegtijdige Opsporing van Kanker, Ghent University, Ghent, Belgium
| | - Kim Lemmens
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | | | - Andre Van Steen
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | | | | | | | - Hubert Thierens
- Department of Basic Medical Sciences, QCC-Gent, Ghent University, Ghent, Belgium
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Andreassen CN, Rosenstein BS, Kerns SL, Ostrer H, De Ruysscher D, Cesaretti JA, Barnett GC, Dunning AM, Dorling L, West CML, Burnet NG, Elliott R, Coles C, Hall E, Fachal L, Vega A, Gómez-Caamaño A, Talbot CJ, Symonds RP, De Ruyck K, Thierens H, Ost P, Chang-Claude J, Seibold P, Popanda O, Overgaard M, Dearnaley D, Sydes MR, Azria D, Koch CA, Parliament M, Blackshaw M, Sia M, Fuentes-Raspall MJ, Ramon Y Cajal T, Barnadas A, Vesprini D, Gutiérrez-Enríquez S, Mollà M, Díez O, Yarnold JR, Overgaard J, Bentzen SM, Alsner J. Individual patient data meta-analysis shows a significant association between the ATM rs1801516 SNP and toxicity after radiotherapy in 5456 breast and prostate cancer patients. Radiother Oncol 2016; 121:431-439. [PMID: 27443449 PMCID: PMC5559879 DOI: 10.1016/j.radonc.2016.06.017] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/18/2016] [Accepted: 06/29/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Several small studies have indicated that the ATM rs1801516 SNP is associated with risk of normal tissue toxicity after radiotherapy. However, the findings have not been consistent. In order to test this SNP in a well-powered study, an individual patient data meta-analysis was carried out by the International Radiogenomics Consortium. MATERIALS AND METHODS The analysis included 5456 patients from 17 different cohorts. 2759 patients were given radiotherapy for breast cancer and 2697 for prostate cancer. Eight toxicity scores (overall toxicity, acute toxicity, late toxicity, acute skin toxicity, acute rectal toxicity, telangiectasia, fibrosis and late rectal toxicity) were analyzed. Adjustments were made for treatment and patient related factors with potential impact on the risk of toxicity. RESULTS For all endpoints except late rectal toxicity, a significantly increased risk of toxicity was found for carriers of the minor (Asn) allele with odds ratios of approximately 1.5 for acute toxicity and 1.2 for late toxicity. The results were consistent with a co-dominant pattern of inheritance. CONCLUSION This study convincingly showed a significant association between the ATM rs1801516 Asn allele and increased risk of radiation-induced normal tissue toxicity.
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Affiliation(s)
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sarah L Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, USA; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Harry Ostrer
- Departments of Pathology and Pediatrics, Albert Einstein College of Medicine, New York, USA
| | - Dirk De Ruysscher
- Department of Radiotherapy (Maastro Clinic), Maastricht University Medical Center, The Netherlands
| | | | - Gillian C Barnett
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK; Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, UK
| | - Alison M Dunning
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK; Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, UK
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, UK
| | - Catharine M L West
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, UK
| | - Neil G Burnet
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Rebecca Elliott
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Charlotte Coles
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Emma Hall
- Clinical Trials & Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Laura Fachal
- Fundacion Publica Galega de Medicina Xenomica-SERGAS, Grupo de Medicina Xenomica-USC, IDIS, CIBERER, Santiago de Compostela, Spain
| | - Ana Vega
- Fundacion Publica Galega de Medicina Xenomica-SERGAS, Grupo de Medicina Xenomica-USC, IDIS, CIBERER, Santiago de Compostela, Spain
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | | | - R Paul Symonds
- Department of Cancer Studies, University of Leicester, UK
| | - Kim De Ruyck
- Department of Basic Medical Sciences, Ghent University, Belgium
| | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Belgium
| | - Piet Ost
- Department of Radiotherapy, Ghent University Hospital, Belgium
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; University Cancer Center Hamburg, University (UCCH), University Medical Center Hamburg-Eppendorf, Germany
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Odilia Popanda
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marie Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark
| | - David Dearnaley
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | | | - David Azria
- Department of Radiation Oncology and Medical Physics, Institut regional du Cancer Montpellier, France
| | - Christine Anne Koch
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Matthew Parliament
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | - Michael Blackshaw
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | - Michael Sia
- Department of Radiation Oncology, British Columbia Cancer Agency Abbotsford Clinic, Canada
| | | | - Teresa Ramon Y Cajal
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Agustin Barnadas
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Danny Vesprini
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Sara Gutiérrez-Enríquez
- Oncogenetics Group, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Spain
| | - Meritxell Mollà
- Department of Radiation Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Orland Díez
- Oncogenetics Group, Vall d'Hebron Institute of Oncology (VHIO), Area of Clinical and Molecular Genetics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - John R Yarnold
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark
| | - Søren M Bentzen
- Greenebaum Cancer Center and Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark
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Vandevoorde C, Depuydt J, Veldeman L, De Neve W, Sebastià N, Wieme G, Baert A, De Langhe S, Philippé J, Thierens H, Vral A. In vitro cellular radiosensitivity in relationship to late normal tissue reactions in breast cancer patients: a multi-endpoint case-control study. Int J Radiat Biol 2016; 92:823-836. [PMID: 27586010 DOI: 10.1080/09553002.2016.1230238] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE A minority of patients exhibits severe late normal tissue toxicity after radiotherapy (RT), possibly related to their inherent individual radiation sensitivity. This study aimed to evaluate four different candidate in vitro cellular radiosensitivity assays for prediction of late normal tissue reactions, in a retrospective matched case-control set-up of breast cancer patients. METHODS The study population consists of breast cancer patients expressing severe radiation toxicity (12 cases) and no or minimal reactions (12 controls), with a follow-up for at least 3 years. Late adverse reactions were evaluated by comparing standardized photographs pre- and post-RT resulting in an overall cosmetic score and by clinical examination using the LENT-SOMA scale. Four cellular assays on peripheral blood lymphocytes reported to be associated with normal tissue reactions were performed after in vitro irradiation of patient blood samples to compare case and control radiation responses: radiation-induced CD8+ late apoptosis, residual DNA double-strand breaks, G0 and G2 micronucleus assay. RESULTS A significant difference was observed for all cellular endpoints when matched cases and controls were compared both pairwise and grouped. However, it is important to point out that most case-control pairs showed a substantial overlap in standard deviations, which questions the predictive value of the individual assays. The apoptosis assay performed best, with less apoptosis seen in CD8+ lymphocytes of the cases (average: 14.45%) than in their matched controls (average: 30.64%) for 11 out of 12 patient pairs (p < .01). The number of residual DNA DSB was higher in cases (average: 9.92 foci/cell) compared to their matched control patients (average: 9.17 foci/cell) (p < .01). The average dose response curve of the G0 MN assay for cases lies above the average dose response curve of the controls. Finally, a pairwise comparison of the G2 MN results showed a higher MN yield for cases (average: 351 MN/1000BN) compared to controls (average: 219 MN/1000BN) in 9 out of 10 pairs (p < .01). CONCLUSION This matched case-control study in breast cancer patients, using different endpoints for in vitro cellular radiosensitivity related to DNA repair and apoptosis, suggests that patients' intrinsic radiosensitivity is involved in the development of late normal tissue reactions after RT. Larger prospective studies are warranted to validate the retrospective findings and to use in vitro cellular assays in the future to predict late normal tissue radiosensitivity and discriminate individuals with marked RT responses.
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Affiliation(s)
- Charlot Vandevoorde
- a Ghent University , Department of Basic Medical Sciences , Ghent , Belgium.,b National Research Foundation (NRF) , iThemba LABS , Somerset West , South Africa
| | - Julie Depuydt
- a Ghent University , Department of Basic Medical Sciences , Ghent , Belgium
| | - Liv Veldeman
- c Department of Radiotherapy , Ghent University Hospital , Ghent , Belgium
| | - Wilfried De Neve
- c Department of Radiotherapy , Ghent University Hospital , Ghent , Belgium
| | - Natividad Sebastià
- d Radiation Protection Service , IISLAFE , Valencia , Spain.,e Grupo de Investigación Biomédica en Imagen GIBI230 , IISLAFE , Valencia , Spain
| | - Greet Wieme
- a Ghent University , Department of Basic Medical Sciences , Ghent , Belgium.,f Department of Pediatrics and Medical Genetics , Ghent University , Ghent , Belgium
| | - Annelot Baert
- a Ghent University , Department of Basic Medical Sciences , Ghent , Belgium
| | - Sofie De Langhe
- a Ghent University , Department of Basic Medical Sciences , Ghent , Belgium
| | - Jan Philippé
- g Department of Clinical Chemistry, Microbiology and Immunology , Ghent University , Ghent , Belgium
| | - Hubert Thierens
- a Ghent University , Department of Basic Medical Sciences , Ghent , Belgium
| | - Anne Vral
- a Ghent University , Department of Basic Medical Sciences , Ghent , Belgium
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Abstract
Abstract
The Thetis research pool reactor (with a nominal power of 150 kW) of the Ghent University was operational from 1967 till December 2003. The first phase of the decommissioning of the reactor, the removal of the spent fuel from the site, took place in 2010. The cumulative dose received was only 404 man · μSv. During the second phase, the transition period between the removal of the spent fuel in 2010 and the start of the decommissioning phase in March 2013, 3-monthly internal inspections and inspections by Bel V, were performed. The third and final decommissioning phase started on March 18, 2013. The total dose received between March 2013 and August 2013 was 1561 man · μSv. The declassification from a Class I installation to a Class II installation was possible by the end of 2015. The activated concrete in the reactor pool will remain under regulatory control until the activation levels are lower than the limits for free release.
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Affiliation(s)
| | - C. Mommaert
- Bel V , Rue Walcourt, 148, B-1070 Brussels , Belgium
| | - H. Thierens
- Ghent University , Proeftuinstraat, 86, B-9000 Ghent , Belgium
| | - M. Monsieurs
- Ghent University , Proeftuinstraat, 86, B-9000 Ghent , Belgium
| | - I. Meirlaen
- Ghent University , Proeftuinstraat, 86, B-9000 Ghent , Belgium
| | - K. Strijckmans
- Ghent University , Krijgslaan, 281, B-9000 Ghent , Belgium
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Trompier F, Baumann M, Barrios L, Gregoire E, Abend M, Ainsbury E, Barnard S, Barquinero JF, Bautista JA, Brzozowska B, Perez-Calatayud J, De Angelis C, Domínguez I, Hadjidekova V, Kulka U, Mateos JC, Meschini R, Monteiro Gil O, Moquet J, Oestreicher U, Montoro Pastor A, Quintens R, Sebastià N, Sommer S, Stoyanov O, Thierens H, Terzoudi G, Villaescusa JI, Vral A, Wojcik A, Zafiropoulos D, Roy L. Investigation of the influence of calibration practices on cytogenetic laboratory performance for dose estimation. Int J Radiat Biol 2016; 93:118-126. [DOI: 10.1080/09553002.2016.1213455] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- François Trompier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-roses, France
| | - Marion Baumann
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-roses, France
| | | | - Eric Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-roses, France
| | - Michael Abend
- Bundeswehr Institut für Radiologie in verbindung mit der Universtität Ulm, Germany
| | - Elizabeth Ainsbury
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE), Chilton, UK
| | - Stephen Barnard
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE), Chilton, UK
| | | | | | - Beata Brzozowska
- Stockholm University, Department of Molecular Biosciences, Stockholm, Sweden
| | | | | | | | | | - Ulrike Kulka
- Bundesamt fuer Strahlenschutz, Department Radiation Protection and Health, Neuherberg, Germany
| | | | | | - Octávia Monteiro Gil
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | - Jayne Moquet
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE), Chilton, UK
| | - Ursula Oestreicher
- Bundesamt fuer Strahlenschutz, Department Radiation Protection and Health, Neuherberg, Germany
| | | | - Roel Quintens
- Belgian Nuclear Research Centre (SCK-CEN), Mol, Belgium
| | | | | | | | - Hubert Thierens
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Georgia Terzoudi
- National Centre for Scientific Research “Demokritos”, Health Physics, Radiobiology & Cytogenetics, Athens, Greece
| | | | - Anne Vral
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Andrzej Wojcik
- Stockholm University, Department of Molecular Biosciences, Stockholm, Sweden
| | | | - Laurence Roy
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-roses, France
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Kulka U, Abend M, Ainsbury E, Badie C, Barquinero JF, Barrios L, Beinke C, Bortolin E, Cucu A, De Amicis A, Domínguez I, Fattibene P, Frøvig, AM, Gregoire E, Guogyte K, Hadjidekova V, Jaworska A, Kriehuber R, Lindholm C, Lloyd D, Lumniczky K, Lyng F, Meschini R, Mörtl S, Della Monaca S, Monteiro Gil O, Montoro A, Moquet J, Moreno M, Oestreicher U, Palitti F, Pantelias G, Patrono C, Piqueret-Stephan L, Port M, Prieto MJ, Quintens R, Ricoul M, Romm H, Roy L, Sáfrány G, Sabatier L, Sebastià N, Sommer S, Terzoudi G, Testa A, Thierens H, Turai I, Trompier F, Valente M, Vaz P, Voisin P, Vral A, Woda C, Zafiropoulos D, Wojcik A. RENEB – Running the European Network of biological dosimetry and physical retrospective dosimetry. Int J Radiat Biol 2016; 93:2-14. [DOI: 10.1080/09553002.2016.1230239] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Ulrike Kulka
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | - Michael Abend
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | | | | | | | | | - Christina Beinke
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | | | | | | | | | | | | | - Eric Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | | | | | | | | | | | - David Lloyd
- affiliated to Public Health England, CRCE, Chilton, Didcot, Oxon, UK
| | - Katalin Lumniczky
- National Public Health Centre – National Research Directorate for Radiobiology and Radiohygiene, Budapest, Hungary
| | - Fiona Lyng
- Dublin Institute of Technology, Dublin, Ireland
| | | | - Simone Mörtl
- HelmholtzZentrum München, Oberschleissheim, Germany
| | | | - Octávia Monteiro Gil
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | - Alegria Montoro
- Hospital Universitario y Politécnico la Fe de la Comunidad Valenciana, Valencia, Spain
| | - Jayne Moquet
- Public Health England, CRCE, Chilton, Didcot, Oxon, UK
| | - Mercedes Moreno
- Servicio Madrileño de Salud – Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ursula Oestreicher
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | | | | | - Clarice Patrono
- Agenzia Nazionale per le Nuove Tecnologie, ĹEnergia e lo Sviluppo Economico Sostenibile, Rome, Italy
| | - Laure Piqueret-Stephan
- PROCyTOX, Commissariat à l’Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, and Université Paris-Saclay, Paris, France
| | - Matthias Port
- Bundeswehr Institute of Radiobiology affiliated to the University of Ulm, Munich, Germany
| | - María Jesus Prieto
- Servicio Madrileño de Salud – Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Michelle Ricoul
- PROCyTOX, Commissariat à l’Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, and Université Paris-Saclay, Paris, France
| | - Horst Romm
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | - Laurence Roy
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Géza Sáfrány
- National Public Health Centre – National Research Directorate for Radiobiology and Radiohygiene, Budapest, Hungary
| | - Laure Sabatier
- PROCyTOX, Commissariat à l’Energie Atomique et aux Energies Alternatives, Fontenay-aux-Roses, and Université Paris-Saclay, Paris, France
| | - Natividad Sebastià
- Hospital Universitario y Politécnico la Fe de la Comunidad Valenciana, Valencia, Spain
| | | | - Georgia Terzoudi
- National Centre for Scientific Research Demokritos, Athens, Greece
| | - Antonella Testa
- Agenzia Nazionale per le Nuove Tecnologie, ĹEnergia e lo Sviluppo Economico Sostenibile, Rome, Italy
| | - Hubert Thierens
- Universiteit Gent, Faculty of Medicine and Health Sciences, Gent, Belgium
| | - Istvan Turai
- affiliated to National Public Health Centre – National Research Directorate for Radiobiology and Radiohygiene, Budapest, Hungary
| | - François Trompier
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | | | - Pedro Vaz
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | - Philippe Voisin
- affiliated to Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Anne Vral
- Universiteit Gent, Faculty of Medicine and Health Sciences, Gent, Belgium
| | - Clemens Woda
- HelmholtzZentrum München, Oberschleissheim, Germany
| | | | - Andrzej Wojcik
- Stockholm University, Centre for Radiation Protection Research, Stockholm, Sweden
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12
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Ainsbury EA, Higueras M, Puig P, Einbeck J, Samaga D, Barquinero JF, Barrios L, Brzozowska B, Fattibene P, Gregoire E, Jaworska A, Lloyd D, Oestreicher U, Romm H, Rothkamm K, Roy L, Sommer S, Terzoudi G, Thierens H, Trompier F, Vral A, Woda C. Uncertainty of fast biological radiation dose assessment for emergency response scenarios. Int J Radiat Biol 2016; 93:127-135. [PMID: 27572921 DOI: 10.1080/09553002.2016.1227106] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Reliable dose estimation is an important factor in appropriate dosimetric triage categorization of exposed individuals to support radiation emergency response. MATERIALS AND METHODS Following work done under the EU FP7 MULTIBIODOSE and RENEB projects, formal methods for defining uncertainties on biological dose estimates are compared using simulated and real data from recent exercises. RESULTS The results demonstrate that a Bayesian method of uncertainty assessment is the most appropriate, even in the absence of detailed prior information. The relative accuracy and relevance of techniques for calculating uncertainty and combining assay results to produce single dose and uncertainty estimates is further discussed. CONCLUSIONS Finally, it is demonstrated that whatever uncertainty estimation method is employed, ignoring the uncertainty on fast dose assessments can have an important impact on rapid biodosimetric categorization.
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Affiliation(s)
- Elizabeth A Ainsbury
- a Public Health England Centre for Radiation , Chemical and Environmental Hazards (PHE) , Chilton , UK
| | - Manuel Higueras
- a Public Health England Centre for Radiation , Chemical and Environmental Hazards (PHE) , Chilton , UK.,b Universitat Autonoma de Barcelona , Barcelona , Spain
| | - Pedro Puig
- b Universitat Autonoma de Barcelona , Barcelona , Spain
| | - Jochen Einbeck
- c Department of Mathematical Sciences , Durham University , Durham , UK
| | - Daniel Samaga
- d Bundesamt für Strahlenschutz (BfS) , Munich , Germany
| | | | | | - Beata Brzozowska
- e Stockholm University , Centre for Radiation Protection Research, Department of Molecular Bioscience, The Wenner-Gren Institute , Stockholm , Sweden.,f University of Warsaw , Faculty of Physics, Department of Biomedical Physics , Warsaw , Poland
| | | | - Eric Gregoire
- h Institut de radioprotection et de sûreté nucléaire (IRSN) , Paris , France
| | - Alicja Jaworska
- i Norwegian Radiation Protection Authority (NRPA) , Østerås , Norway
| | - David Lloyd
- a Public Health England Centre for Radiation , Chemical and Environmental Hazards (PHE) , Chilton , UK
| | | | - Horst Romm
- d Bundesamt für Strahlenschutz (BfS) , Munich , Germany
| | - Kai Rothkamm
- a Public Health England Centre for Radiation , Chemical and Environmental Hazards (PHE) , Chilton , UK.,j University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Laurence Roy
- h Institut de radioprotection et de sûreté nucléaire (IRSN) , Paris , France
| | - Sylwester Sommer
- k Institute of Nuclear Chemistry and Technology (ICHTJ) , Warsaw , Poland
| | - Georgia Terzoudi
- l National Centre for Scientific Research Demokritos , Athens , Greece
| | | | - Francois Trompier
- h Institut de radioprotection et de sûreté nucléaire (IRSN) , Paris , France
| | - Anne Vral
- m Ghent University , Ghent , Belgium
| | - Clemens Woda
- n Helmholtz Zentrum München (HMGU) , Neuherberg , Germany
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13
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Vandevoorde C, Depuydt J, Veldeman L, De Neve W, Sebastià N, Wieme G, Baert A, De Langhe S, Philippé J, Vral A, Thierens H. O39. In vitro cellular radiosensitivity assays as predictor of radiotherapy related late toxicity in breast cancer patients. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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14
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Depuydt J, Baeyens A, Barnard S, Beinke C, Benedek A, Beukes P, Buraczewska I, Darroudi F, De Sanctis S, Dominguez I, Monteiro Gil O, Hadjidekova V, Kis E, Kulka U, Lista F, Lumniczky K, M’kacher R, Moquet J, Obreja D, Oestreicher U, Pajic J, Pastor N, Popova L, Regalbuto E, Ricoul M, Sabatier L, Slabbert J, Sommer S, Testa A, Thierens H, Wojcik A, Vral A. O42. Realizing the European Network of Biological Dosimetry ‘RENEB’: Results of 2 intercomparison exercises for the micronucleus assay. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Vandevoorde C, Thierens H, Vral A, Vandekerckhove B, Slabbert J. O38. Radiosensitivity of CD34+ hematopoietic stem and progenitor cells: A target for radiation-induced leukemia. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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16
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Beukes P, Depuydt J, Castelein E, Thierens H, Vral A, Slabbert J. O40. The cytogenetic response of human T-lymphocytes to low doses of p(66)/Be neutrons and heterogeneous exposures to 60Co γ-rays. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Depuydt J, Beukes P, Baert A, Vandersickel V, Thierens H, Slabbert J, Vral A. O44. The differences in induction and repair of DNA DSB induced by 30 kV X-rays, fast neutrons and γ-rays. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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18
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Depuydt J, Baeyens A, Barnard S, Beinke C, Benedek A, Beukes P, Buraczewska I, Darroudi F, De Sanctis S, Dominguez I, Monteiro Gil O, Hadjidekova V, Kis E, Kulka U, Lista F, Lumniczky K, M’kacher R, Moquet J, Obreja D, Oestreicher U, Pajic J, Pastor N, Popova L, Regalbuto E, Ricoul M, Sabatier L, Slabbert J, Sommer S, Testa A, Thierens H, Wojcik A, Vral A. RENEB intercomparison exercises analyzing micronuclei (Cytokinesis-block Micronucleus Assay). Int J Radiat Biol 2016; 93:36-47. [DOI: 10.1080/09553002.2016.1206231] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Julie Depuydt
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Ans Baeyens
- National Research Foundation (NRF) iThemba LABS, Somerset West, South Africa
| | - Stephen Barnard
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, UK
| | - Christina Beinke
- Bundeswehr Institut für Radiobiology, Universität Ulm, Munich, Germany
| | - Anett Benedek
- National Public Health Centre – National Research Directorate for Radiobiology and Radiohygiene, Budapest, Hungary
| | - Philip Beukes
- National Research Foundation (NRF) iThemba LABS, Somerset West, South Africa
| | | | | | | | | | - Octávia Monteiro Gil
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | | | - Enikő Kis
- National Public Health Centre – National Research Directorate for Radiobiology and Radiohygiene, Budapest, Hungary
| | - Ulrike Kulka
- Bundesamt für Strahlenschutz, Department Radiation Protection and Health, Oberschleissheim, Germany
| | - Florigio Lista
- Army Medical and Veterinary Research Center, Rome, Italy
| | - Katalin Lumniczky
- National Public Health Centre – National Research Directorate for Radiobiology and Radiohygiene, Budapest, Hungary
| | - Radhia M’kacher
- Laboratoire de Radiobiologie et Oncologie, Commissariat à l’Energy Atomique, France
| | - Jayne Moquet
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, UK
| | - Doina Obreja
- Institutul National de Sanatate Publica, Bucuresti, Romania
| | - Ursula Oestreicher
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Jelena Pajic
- Serbian Institute of Occupational Health “Dr Dragomir Karajovic”, Radiation Protection Center, Belgrado, Serbia
| | | | - Ljubomira Popova
- National Center for Radiobiology and Radiation Protection, Sofia, Bulgaria
| | | | - Michelle Ricoul
- Laboratoire de Radiobiologie et Oncologie, Commissariat à l’Energy Atomique, France
| | - Laure Sabatier
- Laboratoire de Radiobiologie et Oncologie, Commissariat à l’Energy Atomique, France
| | - Jacobus Slabbert
- National Research Foundation (NRF) iThemba LABS, Somerset West, South Africa
| | | | - Antonella Testa
- Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile, Rome, Italy
| | - Hubert Thierens
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Andrzej Wojcik
- Institute Molecular Biosciences, Stockholm University, Stockholm, Sweden
| | - Anne Vral
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
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Mbah C, Thierens H, Thas O, De Neve J, Chang-Claude J, Seibold P, Botma A, West C, De Ruyck K. Pitfalls in Prediction Modeling for Normal Tissue Toxicity in Radiation Therapy: An Illustration With the Individual Radiation Sensitivity and Mammary Carcinoma Risk Factor Investigation Cohorts. Int J Radiat Oncol Biol Phys 2016; 95:1466-1476. [PMID: 27479726 DOI: 10.1016/j.ijrobp.2016.03.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 02/07/2016] [Accepted: 03/24/2016] [Indexed: 01/21/2023]
Abstract
PURPOSE To identify the main causes underlying the failure of prediction models for radiation therapy toxicity to replicate. METHODS AND MATERIALS Data were used from two German cohorts, Individual Radiation Sensitivity (ISE) (n=418) and Mammary Carcinoma Risk Factor Investigation (MARIE) (n=409), of breast cancer patients with similar characteristics and radiation therapy treatments. The toxicity endpoint chosen was telangiectasia. The LASSO (least absolute shrinkage and selection operator) logistic regression method was used to build a predictive model for a dichotomized endpoint (Radiation Therapy Oncology Group/European Organization for the Research and Treatment of Cancer score 0, 1, or ≥2). Internal areas under the receiver operating characteristic curve (inAUCs) were calculated by a naïve approach whereby the training data (ISE) were also used for calculating the AUC. Cross-validation was also applied to calculate the AUC within the same cohort, a second type of inAUC. Internal AUCs from cross-validation were calculated within ISE and MARIE separately. Models trained on one dataset (ISE) were applied to a test dataset (MARIE) and AUCs calculated (exAUCs). RESULTS Internal AUCs from the naïve approach were generally larger than inAUCs from cross-validation owing to overfitting the training data. Internal AUCs from cross-validation were also generally larger than the exAUCs, reflecting heterogeneity in the predictors between cohorts. The best models with largest inAUCs from cross-validation within both cohorts had a number of common predictors: hypertension, normalized total boost, and presence of estrogen receptors. Surprisingly, the effect (coefficient in the prediction model) of hypertension on telangiectasia incidence was positive in ISE and negative in MARIE. Other predictors were also not common between the 2 cohorts, illustrating that overcoming overfitting does not solve the problem of replication failure of prediction models completely. CONCLUSIONS Overfitting and cohort heterogeneity are the 2 main causes of replication failure of prediction models across cohorts. Cross-validation and similar techniques (eg, bootstrapping) cope with overfitting, but the development of validated predictive models for radiation therapy toxicity requires strategies that deal with cohort heterogeneity.
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Affiliation(s)
- Chamberlain Mbah
- Department of Basic Medical Sciences, Faculty of Health Sciences, Ghent University, Ghent, Belgium; Department of Mathematical Modeling, Statistics, and Bioinformatics, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.
| | - Hubert Thierens
- Department of Basic Medical Sciences, Faculty of Health Sciences, Ghent University, Ghent, Belgium
| | - Olivier Thas
- Department of Mathematical Modeling, Statistics, and Bioinformatics, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium; National Institute for Applied Statistics Research Australia, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jan De Neve
- Department of Data Analysis, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Akke Botma
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Catharine West
- Translational Radiobiology Group, Institute of Cancer Sciences, Radiotherapy Related Research, Christie Hospital NHS Trust, University of Manchester, Manchester, United Kingdom
| | - Kim De Ruyck
- Department of Basic Medical Sciences, Faculty of Health Sciences, Ghent University, Ghent, Belgium
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Vandevoorde C, Vral A, Vandekerckhove B, Philippé J, Thierens H. Radiation Sensitivity of Human CD34+Cells Versus Peripheral Blood T Lymphocytes of Newborns and Adults: DNA Repair and Mutagenic Effects. Radiat Res 2016; 185:580-90. [DOI: 10.1667/rr14109.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rattay T, Johnson K, Lavers S, Azria D, Botma A, Chang-Claude J, Davidson S, De Ruysscher D, quez SGE, Lambin P, Rancati T, Rosenstein B, Talbot C, Thierens H, Valdagni R, Vega A, Webb A, Wenz F, West C, Burr T, Dunning A, Paul Symonds R. The REQUITE-AB study: Validating predictive models and biomarkers of radiotherapy toxicity to reduce side-effects and improve quality of life in breast cancer patients. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.02.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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22
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Valdagni R, Appanvel A, Botma A, Webb A, Azria D, Burr T, Chang-Claude J, Davidson S, Elliot RM, Gutierrez-Enríquez S, Johnson K, Lambin P, Rancati T, Rosenstein B, Ruysscher DD, Talbot C, Thierens H, Vega A, Wenz F, West C. The REQUITE Project: Validating predictive models and biomarkers of radiotherapy toxicity to reduce side-effects and improve quality of life in cancer survivors. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.2_suppl.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
85 Background: To present the REQUITE project (Validating Predictive Models and Biomarkers of Radiotherapy (RT) toxicity to reduce side-effects and improve quality-of-life in cancer survivors) and first results on the enrollment and acute toxicity (tox) of prostate cancer (Pca) patients (pts). Methods: The European Union funded REQUITE project involves centers in Europe and the USA. The main objectives of the project are to: carry out a multicentre, cohort study collecting blood samples, standardized epidemiology and treatment data, longitudinal side-effect and quality of life data (before and after treatment, years 1 and 2); produce a centralized database and biobank of DNA for 5,300 patients; validate clinical/dosimetric predictors of RT tox and incorporate biomarker data. The project focuses on cancers of the breast, lung and prostate. For PCa the primary endpoint is rectal bleeding at 2 years. Results: A centralized database was established for data collection, including storage of complete dosimetric information in DICOM RT format. Enrollment started in April 2014 and will end in August 2018. In the first 16 months 909 PCa pts were enrolled: 10% low risk, 33% intermediate and 57% high risk. 63% pts received exclusive RT (neoadjuvant hormone therapy in 62%) and 37% post-prostatectomy; 97% external beam RT (prescription doses: 60-85Gy, 2Gy equivalent, alpha/beta=3Gy), while 3% received brachytherapy. Data on acute tox at RT end (measured by CTCAE 4.03) are available for 496 pts. 79 G2-G3 GI tox were reported, with proctitis and diarrhea having the higher prevalence (45 and 30 events respectively). 74 pts exhibited G2-G3 GU tox, with 34 pts reporting multiple symptoms and frequency and urgency having the higher prevalence (43 and 30 events respectively, 25 pts both). Conclusions: REQUITE is proving the feasibility of a prospective standardized collection of epidemiological/clinical/dosimetric/toxicity data coupled to centralized storing of biological material. Meanwhile a large database is being created, which will be of value also for future research in the field of radioinduced side effects. REQUITE is funded by a European Union FP7 grant (601826).
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Affiliation(s)
| | | | - Akke Botma
- German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Adam Webb
- University of Leicester, Leicester, United Kingdom
| | - David Azria
- Institut Régional du Cancer Montpellier, Montpellier, France
| | - Tom Burr
- Source Bioscience, Nottingham, United Kingdom
| | | | - Susan Davidson
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | | | | | - Philippe Lambin
- Stichting Maastricht Radiation Oncology, Maastricht, Netherlands
| | - Tiziana Rancati
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Chris Talbot
- University of Leicester, Leicester, United Kingdom
| | | | - Ana Vega
- Fundación Pública Galega Medicina Xenómica, Santiago de Compostela, Spain
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Franck C, Vandevoorde C, Goethals I, Smeets P, Achten E, Verstraete K, Thierens H, Bacher K. The role of Size-Specific Dose Estimate (SSDE) in patient-specific organ dose and cancer risk estimation in paediatric chest and abdominopelvic CT examinations. Eur Radiol 2015; 26:2646-55. [PMID: 26670320 DOI: 10.1007/s00330-015-4091-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 10/21/2015] [Accepted: 10/27/2015] [Indexed: 12/11/2022]
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Beukes P, Depuydt J, Thierens H, Vral A, Slabbert J. A comparative study of the cytogenetic responses for homo- and heterogeneous exposures of human T-lymphocytes. Phys Med 2015. [DOI: 10.1016/j.ejmp.2015.07.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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De Crop A, Smeets P, Van Hoof T, Vergauwen M, Dewaele T, Van Borsel M, Achten E, Verstraete K, D'Herde K, Thierens H, Bacher K. Correlation of clinical and physical-technical image quality in chest CT: a human cadaver study applied on iterative reconstruction. BMC Med Imaging 2015; 15:32. [PMID: 26286596 PMCID: PMC4541737 DOI: 10.1186/s12880-015-0075-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 08/10/2015] [Indexed: 12/14/2022] Open
Abstract
Background The first aim of this study was to evaluate the correlation between clinical and physical-technical image quality applied to different strengths of iterative reconstruction in chest CT images using Thiel cadaver acquisitions and Catphan images. The second aim was to determine the potential dose reduction of iterative reconstruction compared to conventional filtered back projection based on different clinical and physical-technical image quality parameters. Methods Clinical image quality was assessed using three Thiel embalmed human cadavers. A Catphan phantom was used to assess physical-technical image quality parameters such as noise, contrast-detail and contrast-to-noise ratio (CNR). Both Catphan and chest Thiel CT images were acquired on a multislice CT scanner at 120 kVp and 0.9 pitch. Six different refmAs settings were applied (12, 30, 60, 90, 120 and 150refmAs) and each scan was reconstructed using filtered back projection (FBP) and iterative reconstruction (SAFIRE) algorithms (1,3 and 5 strengths) using a sharp kernel, resulting in 24 image series. Four radiologists assessed the clinical image quality, using a visual grading analysis (VGA) technique based on the European Quality Criteria for Chest CT. Results Correlation coefficients between clinical and physical-technical image quality varied from 0.88 to 0.92, depending on the selected physical-technical parameter. Depending on the strength of SAFIRE, the potential dose reduction based on noise, CNR and the inverse image quality figure (IQFinv) varied from 14.0 to 67.8 %, 16.0 to 71.5 % and 22.7 to 50.6 % respectively. Potential dose reduction based on clinical image quality varied from 27 to 37.4 %, depending on the strength of SAFIRE. Conclusion Our results demonstrate that noise assessments in a uniform phantom overestimate the potential dose reduction for the SAFIRE IR algorithm. Since the IQFinv based dose reduction is quite consistent with the clinical based dose reduction, an optimised contrast-detail phantom could improve the use of contrast-detail analysis for image quality assessment in chest CT imaging. In conclusion, one should be cautious to evaluate the performance of CT equipment taking into account only physical-technical parameters as noise and CNR, as this might give an incomplete representation of the actual clinical image quality performance.
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Affiliation(s)
- An De Crop
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, B-9000, Ghent, Belgium.
| | - Peter Smeets
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.
| | - Tom Van Hoof
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, B-9000, Ghent, Belgium.
| | - Merel Vergauwen
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.
| | - Tom Dewaele
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.
| | - Mathias Van Borsel
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.
| | - Eric Achten
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.
| | - Koenraad Verstraete
- Department of Radiology, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium.
| | - Katharina D'Herde
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, B-9000, Ghent, Belgium.
| | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, B-9000, Ghent, Belgium.
| | - Klaus Bacher
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, B-9000, Ghent, Belgium.
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Vandevoorde C, Gomolka M, Roessler U, Samaga D, Lindholm C, Fernet M, Hall J, Pernot E, El-Saghire H, Baatout S, Kesminiene A, Thierens H. EPI-CT: in vitro assessment of the applicability of the γ-H2AX-foci assay as cellular biomarker for exposure in a multicentre study of children in diagnostic radiology. Int J Radiat Biol 2015; 91:653-63. [PMID: 25968559 DOI: 10.3109/09553002.2015.1047987] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To conduct a feasibility study on the application of the γ-H2AX foci assay as an exposure biomarker in a prospective multicentre paediatric radiology setting. MATERIALS AND METHODS A set of in vitro experiments was performed to evaluate technical hurdles related to biological sample collection in a paediatric radiology setting (small blood sample volume), processing and storing of blood samples (effect of storing blood at 4°C), the reliability of foci scoring for low-doses (merge γ-H2AX/53BP1 scoring), as well as the impact of contrast agent administration as potential confounding factor. Given the exploratory nature of this study and the ethical constraints related to paediatric blood sampling, blood samples from adult volunteers were used for these experiments. In order to test the feasibility of pooling the γ-H2AX data when different centres are involved in an international multicentre study, two intercomparison studies in the low-dose range (10-500 mGy) were performed. RESULTS Determination of the number of X-ray induced γ-H2AX foci is feasible with one 2 ml blood sample pre- and post-computed tomography (CT) scan. Lymphocyte isolation and fixation on slides is necessary within 5 h of blood sampling to guarantee reliable results. The possible enhancement effect of contrast medium on the induction of DNA DSB in a patient study can be ruled out if radiation doses and the contrast agent concentration are within diagnostic ranges. The intercomparison studies using in vitro irradiated blood samples showed that the participating laboratories, executing successfully the γ-H2AX foci assay in lymphocytes, were able to rank blind samples in order of lowest to highest radiation dose based on mean foci/cell counts. The dose response of all intercomparison data shows that a dose point of 10 mGy could be distinguished from the sham-irradiated control (p = 0.006). CONCLUSIONS The results demonstrate that it is feasible to apply the γ-H2AX foci assay as a cellular biomarker of exposure in a multicentre prospective study in paediatric CT imaging after validating it in an in vivo international pilot study on paediatric patients.
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Affiliation(s)
| | - Maria Gomolka
- b Federal Office for Radiation Protection , BfS , Germany
| | - Ute Roessler
- b Federal Office for Radiation Protection , BfS , Germany
| | - Daniel Samaga
- b Federal Office for Radiation Protection , BfS , Germany
| | | | | | - Janet Hall
- e Centre de Recherche en Cancérologie de Lyon - UMR Inserm 1052 - CNRS 5286 , France
| | - Eileen Pernot
- f Centre for Research in Environmental Epidemiology , CREAL , Spain
- g Universitat Pompeu Fabra (UPF) , Barcelona , Spain
- h CIBER Epidemiología y salud P ublica (CIBERESP) , Barcelona , Spain
| | | | - Sarah Baatout
- i Radiobiology Unit, Belgian Nuclear Research Centre, SCK-CEN , Belgium
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Talbot C, Azria D, Brookes A, Burr T, ChangClaude J, Davidson S, De uysscher D, Dunning A, Elliott R, Gutiérrez Enríquez S, Lambin P, Rancati T, Rosenstein B, Seibold P, Symonds R, Thierens H, Valdagni R, Vega A, Wenz F, Yuille M, West C. SP-0169: Validating predictive models and biomarkers for radiotherapy toxicity: the REQUITE project. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40167-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Barnard S, Ainsbury EA, Al-hafidh J, Hadjidekova V, Hristova R, Lindholm C, Monteiro Gil O, Moquet J, Moreno M, Rößler U, Thierens H, Vandevoorde C, Vral A, Wojewódzka M, Rothkamm K. The first gamma-H2AX biodosimetry intercomparison exercise of the developing European biodosimetry network RENEB. Radiat Prot Dosimetry 2015; 164:265-270. [PMID: 25118318 DOI: 10.1093/rpd/ncu259] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 07/18/2014] [Indexed: 06/03/2023]
Abstract
In the event of a mass casualty radiation incident, the gamma-H2AX foci assay could be a useful tool to estimate radiation doses received by individuals. The rapid processing time of blood samples of just a few hours and the potential for batch processing, enabling high throughput, make the assay ideal for early triage categorisation to separate the 'worried well' from the low and critically exposed by quantifying radiation-induced foci in peripheral blood lymphocytes. Within the RENEB framework, 8 European laboratories have taken part in the first European gamma-H2AX biodosimetry exercise, which consisted of a telescoring comparison of 200 circulated foci images taken from 8 samples, and a comparison of 10 fresh blood lymphocyte samples that were shipped overnight to participating labs 4 or 24 h post-exposure. Despite large variations between laboratories in the dose-response relationship for foci induction, the obtained results indicate that the network should be able to use the gamma-H2AX assay for rapidly identifying the most severely exposed individuals within a cohort who could then be prioritised for accurate chromosome dosimetry.
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Affiliation(s)
- S Barnard
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, UK
| | - E A Ainsbury
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, UK
| | - J Al-hafidh
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, UK
| | - V Hadjidekova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - R Hristova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - C Lindholm
- Radiation and Nuclear Safety Authority (STUK), Helsinki, Finland
| | - O Monteiro Gil
- Instituto Superior Técnico, Universidade de Lisboa, CTN, Grupo de Protecção e Segurança Radiológica, Bobadela-LRS, Portugal
| | - J Moquet
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, UK
| | - M Moreno
- Servicio Madrileño de Salud, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - U Rößler
- Bundesamt für Strahlenschutz, Oberschleissheim, Germany
| | - H Thierens
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - C Vandevoorde
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - A Vral
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - M Wojewódzka
- Institute of Nuclear Chemistry and Technology, Center for Radiobiology and Biological Dosimetry, Warsaw, Poland
| | - K Rothkamm
- Public Health England, Centre for Radiation Chemical and Environmental Hazards, Chilton, UK
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Kulka U, Ainsbury L, Atkinson M, Barnard S, Smith R, Barquinero JF, Barrios L, Bassinet C, Beinke C, Cucu A, Darroudi F, Fattibene P, Bortolin E, Monaca SD, Gil O, Gregoire E, Hadjidekova V, Haghdoost S, Hatzi V, Hempel W, Herranz R, Jaworska A, Lindholm C, Lumniczky K, M'kacher R, Mörtl S, Montoro A, Moquet J, Moreno M, Noditi M, Ogbazghi A, Oestreicher U, Palitti F, Pantelias G, Popescu I, Prieto MJ, Roch-Lefevre S, Roessler U, Romm H, Rothkamm K, Sabatier L, Sebastià N, Sommer S, Terzoudi G, Testa A, Thierens H, Trompier F, Turai I, Vandevoorde C, Vaz P, Voisin P, Vral A, Ugletveit F, Wieser A, Woda C, Wojcik A. Realising the European network of biodosimetry: RENEB-status quo. Radiat Prot Dosimetry 2015; 164:42-5. [PMID: 25205835 PMCID: PMC4401036 DOI: 10.1093/rpd/ncu266] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Creating a sustainable network in biological and retrospective dosimetry that involves a large number of experienced laboratories throughout the European Union (EU) will significantly improve the accident and emergency response capabilities in case of a large-scale radiological emergency. A well-organised cooperative action involving EU laboratories will offer the best chance for fast and trustworthy dose assessments that are urgently needed in an emergency situation. To this end, the EC supports the establishment of a European network in biological dosimetry (RENEB). The RENEB project started in January 2012 involving cooperation of 23 organisations from 16 European countries. The purpose of RENEB is to increase the biodosimetry capacities in case of large-scale radiological emergency scenarios. The progress of the project since its inception is presented, comprising the consolidation process of the network with its operational platform, intercomparison exercises, training activities, proceedings in quality assurance and horizon scanning for new methods and partners. Additionally, the benefit of the network for the radiation research community as a whole is addressed.
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Affiliation(s)
- U Kulka
- Bundesamt für Strahlenschutz, Salzgitter, Germany
| | | | - M Atkinson
- Helmholtz Centre Munich, Neuherberg, Germany
| | | | - R Smith
- Public Health England, Chilton, UK
| | - J F Barquinero
- Universitat Autonoma de Barcelona, Cerdanyola del Valles, Spain
| | - L Barrios
- Universitat Autonoma de Barcelona, Cerdanyola del Valles, Spain
| | - C Bassinet
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - C Beinke
- Bundeswehr Institut für Radiobiologie/Universität Ulm, Ulm, Germany
| | - A Cucu
- National Institute of Public Health Romania, Bucharest, Romania
| | - F Darroudi
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - E Bortolin
- Istituto Superiore di Sanità, Rome, Italy
| | | | - O Gil
- Instituto Superior Técnico, Universidade de Lisboa, Bobadela LRS, Portugal
| | - E Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - V Hadjidekova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | | | - V Hatzi
- National Centre for Scientific Research Demokritos, Athens, Greece
| | - W Hempel
- Commissariat à l'Énergie Atomique, Fontenay-aux-Roses, France
| | - R Herranz
- Servicio Madrileño de Salud, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A Jaworska
- Norwegian Radiation Protection Authority, Osteraas, Norway
| | - C Lindholm
- Radiation and Nuclear Safety Authority, Research and Environmental Surveillance, Helsinki, Finland
| | - K Lumniczky
- National Research Institute for Radiobiology and Radiohygiene, Budapest, Hungary
| | - R M'kacher
- Commissariat à l'Énergie Atomique, Fontenay-aux-Roses, France
| | - S Mörtl
- Helmholtz Centre Munich, Neuherberg, Germany
| | - A Montoro
- Fundación para la Investigation del Hospital Universitario la Fe de la Comunidad Valenciana, Valencia, Spain
| | - J Moquet
- Public Health England, Chilton, UK
| | - M Moreno
- Servicio Madrileño de Salud, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - M Noditi
- National Institute of Public Health Romania, Bucharest, Romania
| | - A Ogbazghi
- Commissariat à l'Énergie Atomique, Fontenay-aux-Roses, France
| | | | - F Palitti
- University of Tuscia, Viterbo, Italy
| | - G Pantelias
- National Centre for Scientific Research Demokritos, Athens, Greece
| | - I Popescu
- National Institute of Public Health Romania, Bucharest, Romania
| | - M J Prieto
- Servicio Madrileño de Salud, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - S Roch-Lefevre
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - U Roessler
- Bundesamt für Strahlenschutz, Salzgitter, Germany
| | - H Romm
- Bundesamt für Strahlenschutz, Salzgitter, Germany
| | | | - L Sabatier
- Commissariat à l'Énergie Atomique, Fontenay-aux-Roses, France
| | - N Sebastià
- Fundación para la Investigation del Hospital Universitario la Fe de la Comunidad Valenciana, Valencia, Spain
| | - S Sommer
- Instytut Chemii i Techniki Jadrowej, Warsaw, Poland
| | - G Terzoudi
- National Centre for Scientific Research Demokritos, Athens, Greece
| | - A Testa
- Agenzia Nazionale per le Nuove Tecnologie, L'Energia e lo Sviluppo Economico Sostenibile, Rome, Italy
| | - H Thierens
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - F Trompier
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - I Turai
- National Research Institute for Radiobiology and Radiohygiene, Budapest, Hungary
| | - C Vandevoorde
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - P Vaz
- Instituto Superior Técnico, Universidade de Lisboa, Bobadela LRS, Portugal
| | - P Voisin
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - A Vral
- Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - F Ugletveit
- Norwegian Radiation Protection Authority, Osteraas, Norway
| | - A Wieser
- Helmholtz Centre Munich, Neuherberg, Germany
| | - C Woda
- Helmholtz Centre Munich, Neuherberg, Germany
| | - A Wojcik
- Stockholm University, Stockholm, Sweden
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Voets A, Oberije C, Nalbantov G, Stassen A, Hendrickx A, Vandecasteele K, De Ruyck K, Thierens H, Lievens Y, Herskind C, Smeets H, Lambin P. OC-0085: Mitochondrial DNA variation as a biomarker for the development of radiation-induced lung toxicity. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40085-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jaworska A, Ainsbury EA, Fattibene P, Lindholm C, Oestreicher U, Rothkamm K, Romm H, Thierens H, Trompier F, Voisin P, Vral A, Woda C, Wojcik A. Operational guidance for radiation emergency response organisations in Europe for using biodosimetric tools developed in EU MULTIBIODOSE project. Radiat Prot Dosimetry 2015; 164:165-169. [PMID: 25274532 DOI: 10.1093/rpd/ncu294] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In the event of a large-scale radiological emergency, the triage of individuals according to their degree of exposure forms an important initial step of the accident management. Although clinical signs and symptoms of a serious exposure may be used for radiological triage, they are not necessarily radiation specific and can lead to a false diagnosis. Biodosimetry is a method based on the analysis of radiation-induced changes in cells of the human body or in portable electronic devices and enables the unequivocal identification of exposed people who should receive medical treatment. The MULTIBIODOSE (MBD) consortium developed and validated several biodosimetric assays and adapted and tested them as tools for biological dose assessment in a mass-casualty event. Different biodosimetric assays were validated against the 'gold standard' of biological dosimetry-the dicentric assay. The assays were harmonised in such a way that, in an emergency situation, they can be run in parallel in a network of European laboratories. The aim of this guidance is to give a concise overview of the developed biodosimetric tools as well as how and when they can be used in an emergency situation.
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Affiliation(s)
- Alicja Jaworska
- Department of Monitoring and Research, Norwegian Radiation Protection Authority, Oesteraas, Norway
| | - Elizabeth A Ainsbury
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, Oxon, UK
| | - Paola Fattibene
- Department Technology and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Carita Lindholm
- Department of Environmental Radiation Surveillance, Radiation and Nuclear Safety Authority, Helsinki, Finland
| | - Ursula Oestreicher
- Department Radiation Protection and Health, Bundesamt fuer Strahlenschutz, Oberschleissheim, Germany
| | - Kai Rothkamm
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, Oxon, UK
| | - Horst Romm
- Department Radiation Protection and Health, Bundesamt fuer Strahlenschutz, Oberschleissheim, Germany
| | - Hubert Thierens
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - Francois Trompier
- Department of Radiobiology and Epidemiology, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-roses, France
| | - Philippe Voisin
- Department of Radiobiology and Epidemiology, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-roses, France
| | - Anne Vral
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Universiteit Gent, Gent, Belgium
| | - Clemens Woda
- Institute of Radiation Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Andrzej Wojcik
- Centre for Radiation Protection Research, MBW Department, Stockholm University, Stockholm, Sweden
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Eloot L, Thierens H, Taeymans Y, Drieghe B, De Pooter J, Van Peteghem S, Buytaert D, Gijs T, Lapere R, Bacher K. Novel X-ray imaging technology enables significant patient dose reduction in interventional cardiology while maintaining diagnostic image quality. Catheter Cardiovasc Interv 2015; 86:E205-12. [PMID: 25754018 PMCID: PMC6680340 DOI: 10.1002/ccd.25913] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 02/26/2015] [Indexed: 12/31/2022]
Abstract
Objectives The purpose of this study was to quantify the reduction in patient radiation dose during coronary angiography (CA) by a new X‐ray technology, and to assess its impact on diagnostic image quality. Background Recently, a novel X‐ray imaging technology has become available for interventional cardiology, using advanced image processing and an optimized acquisition chain for radiation dose reduction. Methods 70 adult patients were randomly assigned to a reference X‐ray system or the novel X‐ray system. Patient demographics were registered and exposure parameters were recorded for each radiation event. Clinical image quality was assessed for both patient groups. Results With the same angiographic technique and a comparable patient population, the new imaging technology was associated with a 75% reduction in total kerma‐area product (KAP) value (decrease from 47 Gycm2 to 12 Gycm2, P < 0.001). Clinical image quality showed an equivalent detail and contrast for both imaging systems. On the other hand, the subjective appreciation of noise was more apparent in images of the new image processing system, acquired at lower doses, compared to the reference system. However, the higher noise content did not affect the overall image quality score, which was adequate for diagnosis in both systems. Conclusions For the first time, we present a new X‐ray imaging technology, combining advanced noise reduction algorithms and an optimized acquisition chain, which reduces patient radiation dose in CA drastically (75%), while maintaining diagnostic image quality. Use of this technology may further improve the radiation safety of cardiac angiography and interventions. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Liesbeth Eloot
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Yves Taeymans
- Heart Centre, Ghent University Hospital, Ghent, Belgium
| | - Benny Drieghe
- Heart Centre, Ghent University Hospital, Ghent, Belgium
| | - Jan De Pooter
- Heart Centre, Ghent University Hospital, Ghent, Belgium
| | | | - Dimitri Buytaert
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Thomas Gijs
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Régine Lapere
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Klaus Bacher
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
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West C, Azria D, Chang-Claude J, Davidson S, Lambin P, Rosenstein B, De Ruysscher D, Talbot C, Thierens H, Valdagni R, Vega A, Yuille M. The REQUITE project: validating predictive models and biomarkers of radiotherapy toxicity to reduce side-effects and improve quality of life in cancer survivors. Clin Oncol (R Coll Radiol) 2014; 26:739-42. [PMID: 25267305 DOI: 10.1016/j.clon.2014.09.008] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 09/04/2014] [Indexed: 12/25/2022]
Affiliation(s)
- C West
- University of Manchester, Manchester, UK.
| | - D Azria
- University of Montpellier, Montpellier, France
| | - J Chang-Claude
- German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - S Davidson
- The Christie NHS Foundation Trust, Manchester, UK
| | - P Lambin
- University of Maastricht (Maastro-GROW), Maastricht, The Netherlands
| | - B Rosenstein
- Mount Sinai School of Medicine, New York, NY, USA
| | | | - C Talbot
- University of Leicester, Leicester, UK
| | | | - R Valdagni
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Vega
- Fundación Pública Galega Medicina Xenómica, Santiago de Compostela, Spain
| | - M Yuille
- University of Manchester, Manchester, UK
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Vandevoorde C, Franck C, Bacher K, Breysem L, Smet MH, Ernst C, De Backer A, Van De Moortele K, Smeets P, Thierens H. γ-H2AX foci as in vivo effect biomarker in children emphasize the importance to minimize x-ray doses in paediatric CT imaging. Eur Radiol 2014; 25:800-11. [PMID: 25354556 PMCID: PMC4328121 DOI: 10.1007/s00330-014-3463-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 09/16/2014] [Accepted: 10/01/2014] [Indexed: 11/26/2022]
Abstract
Objectives Investigation of DNA damage induced by CT x-rays in paediatric patients versus patient dose in a multicentre setting. Methods From 51 paediatric patients (median age, 3.8 years) who underwent an abdomen or chest CT examination in one of the five participating radiology departments, blood samples were taken before and shortly after the examination. DNA damage was estimated by scoring γ-H2AX foci in peripheral blood T lymphocytes. Patient-specific organ and tissue doses were calculated with a validated Monte Carlo program. Individual lifetime attributable risks (LAR) for cancer incidence and mortality were estimated according to the BEIR VII risk models. Results Despite the low CT doses, a median increase of 0.13 γ-H2AX foci/cell was observed. Plotting the induced γ-H2AX foci versus blood dose indicated a low-dose hypersensitivity, supported also by an in vitro dose–response study. Differences in dose levels between radiology centres were reflected in differences in DNA damage. LAR of cancer mortality for the paediatric chest CT and abdomen CT cohort was 0.08 and 0.13 ‰ respectively. Conclusion CT x-rays induce DNA damage in paediatric patients even at low doses and the level of DNA damage is reduced by application of more effective CT dose reduction techniques and paediatric protocols. Key Points • CT induces a small, significant number of double-strand DNA breaks in children. • More effective CT dose reduction results in less DNA damage. • Risk estimates based on the LNT hypothesis may represent underestimates.
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Affiliation(s)
- C Vandevoorde
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, 9000, Gent, Belgium,
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De Langhe S, Mulliez T, Veldeman L, Remouchamps V, van Greveling A, Gilsoul M, De Schepper E, De Ruyck K, De Neve W, Thierens H. Factors modifying the risk for developing acute skin toxicity after whole-breast intensity modulated radiotherapy. BMC Cancer 2014; 14:711. [PMID: 25252713 PMCID: PMC4192342 DOI: 10.1186/1471-2407-14-711] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 09/18/2014] [Indexed: 11/29/2022] Open
Abstract
Background After breast-conserving radiation therapy most patients experience acute skin toxicity to some degree. This may impair patients’ quality of life, cause pain and discomfort. In this study, we investigated treatment and patient-related factors, including genetic polymorphisms, that can modify the risk for severe radiation-induced skin toxicity in breast cancer patients. Methods We studied 377 patients treated at Ghent University Hospital and at ST.-Elisabeth Clinic and Maternity in Namur, with adjuvant intensity modulated radiotherapy (IMRT) after breast-conserving surgery for breast cancer. Women were treated in a prone or supine position with normofractionated (25 × 2 Gy) or hypofractionated (15 × 2.67 Gy) IMRT alone or in combination with other adjuvant therapies. Patient- and treatment-related factors and genetic markers in regulatory regions of radioresponsive genes and in LIG3, MLH1 and XRCC3 genes were considered as variables. Acute dermatitis was scored using the CTCAEv3.0 scoring system. Desquamation was scored separately on a 3-point scale (0-none, 1-dry, 2-moist). Results Two-hundred and twenty patients (58%) developed G2+ dermatitis whereas moist desquamation occurred in 56 patients (15%). Normofractionation (both p < 0.001), high body mass index (BMI) (p = 0.003 and p < 0.001), bra cup size ≥ D (p = 0.001 and p = 0.043) and concurrent hormone therapy (p = 0.001 and p = 0.037) were significantly associated with occurrence of acute dermatitis and moist desquamation, respectively. Additional factors associated with an increased risk of acute dermatitis were the genetic variation in MLH1 rs1800734 (p=0.008), smoking during RT (p = 0.010) and supine IMRT (p = 0.004). Patients receiving trastuzumab showed decreased risk of acute dermatitis (p < 0.001). Conclusions The normofractionation schedule, supine IMRT, concomitant hormone treatment and patient related factors (high BMI, large breast, smoking during treatment and the genetic variation in MLH1 rs1800734) were associated with increased acute skin toxicity in patients receiving radiation therapy after breast-conserving surgery. Trastuzumab seemed to be protective.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, 9000 Ghent, Belgium.
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De Ruyck K, Duprez F, Ferdinande L, Mbah C, Rios-Velazquez E, Hoebers F, Praet M, Deron P, Bonte K, Speel EJ, Libbrecht L, De Neve W, Lambin P, Thierens H. A let-7 microRNA polymorphism in the KRAS 3'-UTR is prognostic in oropharyngeal cancer. Cancer Epidemiol 2014; 38:591-8. [PMID: 25127693 DOI: 10.1016/j.canep.2014.07.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/16/2014] [Accepted: 07/23/2014] [Indexed: 01/05/2023]
Abstract
INTRODUCTION This study aimed to investigate the effect of genetic polymorphisms in miRNA sequences, miRNA target genes and miRNA processing genes as additional biomarkers to HPV for prognosis in oropharyngeal squamous cell carcinoma (OPSCC) patients. Secondarily, the prevalence of HPV-associated OPSCC in a European cohort was mapped. METHODS OPSCC patients (n=122) were genotyped for ten genetic polymorphisms in pre-miRNAs (pre-mir-146a, pre-mir-196a2), in miRNA biosynthesis genes (Drosha, XPO5) and in miRNA target genes (KRAS, SMC1B). HPV status was assessed by p16 immunohistochemistry (IHC) and high-risk HPV in situ hybridization (ISH) or by p16 IHC and PCR followed by enzyme-immunoassay (EIA). Overall and disease specific survival were analysed using Kaplan-Meier plots (log-rank test). Cox proportional hazard model was used to calculate hazard ratios (HR). RESULTS The overall HPV prevalence rate in our Belgian/Dutch cohort was 27.9%. Patients with HPV(+) tumours had a better 5-years overall survival (78% vs. 46%, p=0.001) and a better 5-years disease specific survival (90% vs. 70%, p=0.016) compared to patients with HPV(-) tumours. In multivariate Cox analysis including clinical, treatment and genetic parameters, HPV negativity (HR=3.89, p=0.005), advanced T-stage (HR=1.81, p=0.050), advanced N-stage (HR=5.86, p=0.001) and >10 pack-years of smoking (HR=3.45, p=0.012) were significantly associated with reduced overall survival. The variant G-allele of the KRAS-LCS6 polymorphism was significantly associated with a better overall survival (HR=0.40, p=0.031). CONCLUSIONS Our results demonstrate that OPSCC patients with the KRAS-LCS6 variant have a better outcome and suggest that this variant may be used as a prognostic biomarker for OPSCC.
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Affiliation(s)
- Kim De Ruyck
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, B-9000 Gent, Belgium.
| | - Fréderic Duprez
- Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium
| | - Liesbeth Ferdinande
- Department of Pathology, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium
| | - Chamberlain Mbah
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, B-9000 Gent, Belgium
| | - Emmanuel Rios-Velazquez
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Doctor Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Frank Hoebers
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Doctor Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Marleen Praet
- Department of Pathology, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium
| | - Philippe Deron
- Department of Head and Neck Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium
| | - Katrien Bonte
- Department of Head and Neck Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium
| | - Ernst-Jan Speel
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Doctor Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Louis Libbrecht
- Department of Pathology, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium
| | - Wilfried De Neve
- Department of Radiotherapy, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium
| | - Philippe Lambin
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Doctor Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Proeftuinstraat 86, B-9000 Gent, Belgium
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Rosenstein BS, West CM, Bentzen SM, Alsner J, Andreassen CN, Azria D, Barnett GC, Baumann M, Burnet N, Chang-Claude J, Chuang EY, Coles CE, Dekker A, De Ruyck K, De Ruysscher D, Drumea K, Dunning AM, Easton D, Eeles R, Fachal L, Gutiérrez-Enríquez S, Haustermans K, Henríquez-Hernández LA, Imai T, Jones GDD, Kerns SL, Liao Z, Onel K, Ostrer H, Parliament M, Pharoah PDP, Rebbeck TR, Talbot CJ, Thierens H, Vega A, Witte JS, Wong P, Zenhausern F. Radiogenomics: radiobiology enters the era of big data and team science. Int J Radiat Oncol Biol Phys 2014; 89:709-13. [PMID: 24969789 PMCID: PMC5119272 DOI: 10.1016/j.ijrobp.2014.03.009] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 02/19/2014] [Accepted: 03/06/2014] [Indexed: 11/16/2022]
Affiliation(s)
- Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York; Departments of Genetics and Genomic Sciences, Dermatology, and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Radiation Oncology, New York University School of Medicine, New York, New York.
| | - Catharine M West
- Translational Radiobiology Group, Institute of Cancer Sciences, The University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - Søren M Bentzen
- Division of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | | | - David Azria
- Department of Radiation Oncology, Institute of Cancer of Montpellier (INSERM), Center for Cancer Research, Montpellier, France
| | - Gillian C Barnett
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Michael Baumann
- Department of Radiation Oncology and OncoRay National Center for Radiation Research in Oncology, Technische Universität Dresden, and Helmholtz-Zentrum Dresden-Rossendorf Dresden, Germany
| | - Neil Burnet
- University of Cambridge Department of Oncology, Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge, UK
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric Y Chuang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | | | - Andre Dekker
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kim De Ruyck
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Dirk De Ruysscher
- Radiation Oncology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Belgium
| | - Karen Drumea
- Department of Oncology, Rambam Health Care Campus, Haifa, Israel
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Douglas Easton
- Department of Public Health and Primary Care and Department of Oncology, University of Cambridge, Cambridge, UK
| | - Rosalind Eeles
- Division of Cancer Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Laura Fachal
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain
| | - Sara Gutiérrez-Enríquez
- Oncogenetics Group, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Karin Haustermans
- Radiation Oncology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Belgium
| | | | - Takashi Imai
- Advanced Radiation Biology Research Program, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - George D D Jones
- Department Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - Sarah L Kerns
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Zhongxing Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kenan Onel
- Department of Pediatrics, The University of Chicago, Chicago, Illinois
| | - Harry Ostrer
- Departments of Pathology, Genetics and Pediatrics, Albert Einstein College of Medicine at Yeshiva University, New York, New York
| | - Matthew Parliament
- Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Timothy R Rebbeck
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, and Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Ana Vega
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain
| | - John S Witte
- Department of Epidemiology and Biostatistics, Institute for Human Genetics, University of California, San Francisco, California
| | - Philip Wong
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Frederic Zenhausern
- Department of Basic Medical Sciences, Center for Applied Nanobioscience and Medicine, College of Medicine Phoenix, University of Arizona, Phoenix, Arizona
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De Langhe S, De Meerleer G, De Ruyck K, Ost P, Fonteyne V, De Neve W, Thierens H. Integrated models for the prediction of late genitourinary complaints after high-dose intensity modulated radiotherapy for prostate cancer: Making informed decisions. Radiother Oncol 2014; 112:95-9. [DOI: 10.1016/j.radonc.2014.04.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 03/31/2014] [Accepted: 04/03/2014] [Indexed: 11/28/2022]
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Ainsbury EA, Barnard S, Barrios L, Fattibene P, de Gelder V, Gregoire E, Lindholm C, Lloyd D, Nergaard I, Rothkamm K, Romm H, Scherthan H, Thierens H, Vandevoorde C, Woda C, Wojcik A. Multibiodose radiation emergency triage categorization software. Health Phys 2014; 107:83-89. [PMID: 24849907 DOI: 10.1097/hp.0000000000000049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this note, the authors describe the MULTIBIODOSE software, which has been created as part of the MULTIBIODOSE project. The software enables doses estimated by networks of laboratories, using up to five retrospective (biological and physical) assays, to be combined to give a single estimate of triage category for each individual potentially exposed to ionizing radiation in a large scale radiation accident or incident. The MULTIBIODOSE software has been created in Java. The usage of the software is based on the MULTIBIODOSE Guidance: the program creates a link to a single SQLite database for each incident, and the database is administered by the lead laboratory. The software has been tested with Java runtime environment 6 and 7 on a number of different Windows, Mac, and Linux systems, using data from a recent intercomparison exercise. The Java program MULTIBIODOSE_1.0.jar is freely available to download from http://www.multibiodose.eu/software or by contacting the software administrator: MULTIBIODOSE-software@gmx.com.
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Affiliation(s)
- Elizabeth A Ainsbury
- *Public Health England Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxford OX11 0RQ; †Universitat Autònoma de Barcelona, Spain; ‡Istituto Superiore di Sanità, Italy; §Universiteit Gent, Belgium; **Institut de radioprotection et de sûreté nucléaire, France; ††Radiation and Nuclear Safety Authority, Finland; ‡‡Bundesamt fuer Strahlenschutz, Germany; §§Inst. für Radiobiologie der Bundeswehr in Verb. mit der Univ. Ulm, Germany; ***Helmholtz Zentrum München, Germany; †††Stockholm University, Sweden
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Thierens H, Vral A, Vandevoorde C, Vandersickel V, de Gelder V, Romm H, Oestreicher U, Rothkamm K, Barnard S, Ainsbury E, Sommer S, Beinke C, Wojcik A. Is a semi-automated approach indicated in the application of the automated micronucleus assay for triage purposes? Radiat Prot Dosimetry 2014; 159:87-94. [PMID: 24743767 DOI: 10.1093/rpd/ncu130] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Within the EU MULTIBIODOSE project, the automated micronucleus (MN) assay was optimised for population triage in large-scale radiological emergencies. For MN scoring, two approaches were applied using the Metafer4 platform (MetaSystems, Germany): fully automated scoring and semi-automated scoring with visual inspection of the gallery of MN-positive objects. Dose-response curves were established for acute and protracted whole-body and partial-body exposures. A database of background MN yields was set up, allowing determination of the dose detection threshold in both scoring modes. An analysis of the overdispersion of the MN frequency distribution σ(2)/µ obtained by semi-automated scoring showed that the value of this parameter represents a reliability check of the calculated equivalent total body dose in case the accident overexposure is a partial-body exposure. The elaborated methodology was validated in an accident training exercise. Overall, the semi-automated scoring procedure represents important added value to the automated MN assay.
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Affiliation(s)
- H Thierens
- Department of Basic Medical Sciences, Ghent University, Building 5B3, De Pintelaan 185, Gent B-9000, Belgium
| | - A Vral
- Department of Basic Medical Sciences, Ghent University, Building 5B3, De Pintelaan 185, Gent B-9000, Belgium
| | - C Vandevoorde
- Department of Basic Medical Sciences, Ghent University, Building 5B3, De Pintelaan 185, Gent B-9000, Belgium
| | - V Vandersickel
- Department of Basic Medical Sciences, Ghent University, Building 5B3, De Pintelaan 185, Gent B-9000, Belgium
| | - V de Gelder
- Department of Basic Medical Sciences, Ghent University, Building 5B3, De Pintelaan 185, Gent B-9000, Belgium
| | - H Romm
- Bundesamt fuer Strahlenschutz, Salzgitter, Germany
| | | | | | | | | | - S Sommer
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - C Beinke
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - A Wojcik
- Stockholm University, Stockholm, Sweden
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Romm H, Ainsbury E, Barnard S, Barrios L, Barquinero JF, Beinke C, Deperas M, Gregoire E, Koivistoinen A, Lindholm C, Moquet J, Oestreicher U, Puig R, Rothkamm K, Sommer S, Thierens H, Vandersickel V, Vral A, Wojcik A. Validation of semi-automatic scoring of dicentric chromosomes after simulation of three different irradiation scenarios. Health Phys 2014; 106:764-771. [PMID: 24776911 DOI: 10.1097/hp.0000000000000077] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Large scale radiological emergencies require high throughput techniques of biological dosimetry for population triage in order to identify individuals indicated for medical treatment. The dicentric assay is the "gold standard" technique for the performance of biological dosimetry, but it is very time consuming and needs well trained scorers. To increase the throughput of blood samples, semi-automation of dicentric scoring was investigated in the framework of the MULTIBIODOSE EU FP7 project, and dose effect curves were established in six biodosimetry laboratories. To validate these dose effect curves, blood samples from 33 healthy donors (>10 donors/scenario) were irradiated in vitro with ⁶⁰Co gamma rays simulating three different exposure scenarios: acute whole body, partial body, and protracted exposure, with three different doses for each scenario. All the blood samples were irradiated at Ghent University, Belgium, and then shipped blind coded to the participating laboratories. The blood samples were set up by each lab using their own standard protocols, and metaphase slides were prepared to validate the calibration curves established by semi-automatic dicentric scoring. In order to achieve this, 300 metaphases per sample were captured, and the doses were estimated using the newly formed dose effect curves. After acute uniform exposure, all laboratories were able to distinguish between 0 Gy, 0.5 Gy, 2.0, and 4.0 Gy (p < 0.001), and, in most cases, the dose estimates were within a range of ± 0.5 Gy of the given dose. After protracted exposure, all laboratories were able to distinguish between 1.0 Gy, 2.0 Gy, and 4.0 Gy (p < 0.001), and here also a large number of the dose estimates were within ± 0.5 Gy of the irradiation dose. After simulated partial body exposure, all laboratories were able to distinguish between 2.0 Gy, 4.0 Gy, and 6.0 Gy (p < 0.001). Overdispersion of the dicentric distribution enabled the detection of the partial body samples; however, this result was clearly dose-dependent. For partial body exposures, only a few dose estimates were in the range of ± 0.5 Gy of the given dose, but an improvement could be achieved with higher cell numbers. The new method of semi-automation of the dicentric assay was introduced successfully in a network of six laboratories. It is therefore concluded that this method can be used as a high-throughput screening tool in a large-scale radiation accident.
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Affiliation(s)
- H Romm
- *Bundesamt fuer Strahlenschutz (Germany); †Public Health England (United Kingdom); ‡Universitat Autonoma de Barcelona (Spain); §Institut de Radioprotection et de Sûreté Nucleaire (France); **Bundeswehr Institute of Radiobiology affiliated to the University of Ulm (Germany); ††Stockholm University (Sweden); ‡‡Radiation and Nuclear Safety Authority (Finland); §§Institute of Nuclear Chemistry and Technology (Poland); ***University of Ghent (Belgium)
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Romm H, Ainsbury E, Bajinskis A, Barnard S, Barquinero JF, Barrios L, Beinke C, Puig-Casanovas R, Deperas-Kaminska M, Gregoire E, Oestreicher U, Lindholm C, Moquet J, Rothkamm K, Sommer S, Thierens H, Vral A, Vandersickel V, Wojcik A. Web-based scoring of the dicentric assay, a collaborative biodosimetric scoring strategy for population triage in large scale radiation accidents. Radiat Environ Biophys 2014; 53:241-254. [PMID: 24557539 DOI: 10.1007/s00411-014-0519-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 01/28/2014] [Indexed: 06/03/2023]
Abstract
In the case of a large scale radiation accident high throughput methods of biological dosimetry for population triage are needed to identify individuals requiring clinical treatment. The dicentric assay performed in web-based scoring mode may be a very suitable technique. Within the MULTIBIODOSE EU FP7 project a network is being established of 8 laboratories with expertise in dose estimations based on the dicentric assay. Here, the manual dicentric assay was tested in a web-based scoring mode. More than 23,000 high resolution images of metaphase spreads (only first mitosis) were captured by four laboratories and established as image galleries on the internet (cloud). The galleries included images of a complete dose effect curve (0-5.0 Gy) and three types of irradiation scenarios simulating acute whole body, partial body and protracted exposure. The blood samples had been irradiated in vitro with gamma rays at the University of Ghent, Belgium. Two laboratories provided image galleries from Fluorescence plus Giemsa stained slides (3 h colcemid) and the image galleries from the other two laboratories contained images from Giemsa stained preparations (24 h colcemid). Each of the 8 participating laboratories analysed 3 dose points of the dose effect curve (scoring 100 cells for each point) and 3 unknown dose points (50 cells) for each of the 3 simulated irradiation scenarios. At first all analyses were performed in a QuickScan Mode without scoring individual chromosomes, followed by conventional scoring (only complete cells, 46 centromeres). The calibration curves obtained using these two scoring methods were very similar, with no significant difference in the linear-quadratic curve coefficients. Analysis of variance showed a significant effect of dose on the yield of dicentrics, but no significant effect of the laboratories, different methods of slide preparation or different incubation times used for colcemid. The results obtained to date within the MULTIBIODOSE project by a network of 8 collaborating laboratories throughout Europe are very promising. The dicentric assay in the web based scoring mode as a high throughput scoring strategy is a useful application for biodosimetry in the case of a large scale radiation accident.
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Affiliation(s)
- H Romm
- Bundesamt fuer Strahlenschutz, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany,
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Rancati T, Talbot C, Azria D, Brookes A, Burr T, Chang-Claude J, Davidson S, Ruysscher DD, Dunning A, Elliot RM, Gutierrez-Enríquez S, Lambin P, Rosenstein B, Symonds RP, Thierens H, Valdagni R, Vega A, Wenz F, Yuille M, West C. The REQUITE project: Validating predictive models and biomarkers of radiotherapy toxicity to reduce side effects. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.4_suppl.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
276 Background: Recently the first replicated genetic associations for adverse reactions to radiotherapy (RT) have been reported. These will help to build predictive statistical models for optimising RT delivery or interventions to alleviate the side effects. It is now timely to start a project that aims to validate known predictors of adverse reactions and develop the statistical models to become clinically useful. REQUITE is a European Union funded FP7 project that aims to do this. Methods: REQUITE’s objectives: (1.) Perform a multi-centre, cohort study collecting: blood samples, epidemiology and treatment data, longitudinal side-effect and QOL data (before and after treatment, yrs 1 and 2). (2.) Produce a centralised biobank of DNA from 5,300 patients and a centralised data management system. (3.) Validate published biomarkers of radiosensitivity. (4.) Validate clinical predictors of RT toxicity in breast, prostate, and lung cancer and incorporate biomarker data. (5.) Design interventional trials to reduce long-term side effects. (6.) Provide a resource for dissemination and exploitation to the RT community. Results: REQUITE is funded for 60 mos and organised into 7 work packages. Overall management and scientific oversight is run by Manchester. The central activity of the project is a multi-centre, observational study. Enrolment will proceed for 2 yrs in 9 clinical centres, with 2 yrs follow-up. The primary endpoints are change in breast appearance; rectal bleeding (prostate); pneumonitis (lung). Blood samples will be collected before radiotherapy. Tracking, biobanking, DNA preparation and validation of biomarkers (genetic markers and apoptosis assays) as predictive factors will be carried out in WP3-4. Some clinical factors have suggested predictive value for RT side-effects, but there is no consensus. Validation of published models in existing cohorts will be performed, leading to replicated models that can be validated using the REQUITE cohorts. Conclusions: The predictive models will be used to design clinical interventional trials and produce protocols that seek to lower RT side-effects in those individuals at high risk of developing them without affecting tumour control. Dissemination will follow.
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Affiliation(s)
- Tiziana Rancati
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - David Azria
- University of Montpellier, Montpellier, France
| | | | - Tom Burr
- Source Bioscience, Nottingham, United Kingdom
| | | | - Susan Davidson
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | | | | | | | - Philippe Lambin
- Stichting Maastricht Radiation Oncology, Maastricht, Netherlands
| | | | | | | | | | - Ana Vega
- Fundación Pública Galega Medicina Xenómica,, Santiago de Compostela, Spain
| | | | - Martin Yuille
- University of Manchester, Manchester, United Kingdom
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El-Saghire H, Vandevoorde C, Ost P, Monsieurs P, Michaux A, De Meerleer G, Baatout S, Thierens H. Intensity modulated radiotherapy induces pro-inflammatory and pro-survival responses in prostate cancer patients. Int J Oncol 2014; 44:1073-83. [PMID: 24435511 PMCID: PMC3977809 DOI: 10.3892/ijo.2014.2260] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 11/11/2013] [Indexed: 12/21/2022] Open
Abstract
Intensity modulated radiotherapy (IMRT) is one of the modern conformal radiotherapies that is widely used within the context of cancer patient treatment. It uses multiple radiation beams targeted to the tumor, however, large volumes of the body receive low doses of irradiation. Using γ-H2AX and global genome expression analysis, we studied the biological responses induced by low doses of ionizing radiation in prostate cancer patients following IMRT. By means of different bioinformatics analyses, we report that IMRT induced an inflammatory response via the induction of viral, adaptive, and innate immune signaling. In response to growth factors and immune-stimulatory signaling, positive regulation in the progression of cell cycle and DNA replication were induced. This denotes pro-inflammatory and pro-survival responses. Furthermore, double strand DNA breaks were induced in every patient 30 min after the treatment and remaining DNA repair and damage signaling continued after 18-24 h. Nine genes belonging to inflammatory responses (TLR3, SH2D1A and IL18), cell cycle progression (ORC4, SMC2 and CCDC99) and DNA damage and repair (RAD17, SMC6 and MRE11A) were confirmed by quantitative RT-PCR. This study emphasizes that the risk assessment of health effects from the out-of-field low doses during IMRT should be of concern, as these may increase the risk of secondary cancers and/or systemic inflammation.
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Affiliation(s)
- Houssein El-Saghire
- Radiobiology Unit, Molecular and Cellular Biology, Belgian Nuclear Research Centre (SCK·CEN), Mol, Belgium
| | | | - Piet Ost
- Department of Radiation Oncology, Ghent University Hospital, Gent, Belgium
| | - Pieter Monsieurs
- Radiobiology Unit, Molecular and Cellular Biology, Belgian Nuclear Research Centre (SCK·CEN), Mol, Belgium
| | - Arlette Michaux
- Radiobiology Unit, Molecular and Cellular Biology, Belgian Nuclear Research Centre (SCK·CEN), Mol, Belgium
| | - Gert De Meerleer
- Department of Radiation Oncology, Ghent University Hospital, Gent, Belgium
| | - Sarah Baatout
- Radiobiology Unit, Molecular and Cellular Biology, Belgian Nuclear Research Centre (SCK·CEN), Mol, Belgium
| | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Gent, Belgium
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Ainsbury EA, Al-Hafidh J, Bajinskis A, Barnard S, Barquinero JF, Beinke C, de Gelder V, Gregoire E, Jaworska A, Lindholm C, Lloyd D, Moquet J, Nylund R, Oestreicher U, Roch-Lefévre S, Rothkamm K, Romm H, Scherthan H, Sommer S, Thierens H, Vandevoorde C, Vral A, Wojcik A. Inter- and intra-laboratory comparison of a multibiodosimetric approach to triage in a simulated, large scale radiation emergency. Int J Radiat Biol 2013; 90:193-202. [DOI: 10.3109/09553002.2014.868616] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Romm H, Barnard S, Boulay-Greene H, De Amicis A, De Sanctis S, Franco M, Herodin F, Jones A, Kulka U, Lista F, Martigne P, Moquet J, Oestreicher U, Rothkamm K, Thierens H, Valente M, Vandersickel V, Vral A, Braselmann H, Meineke V, Abend M, Beinke C. Laboratory Intercomparison of the Cytokinesis-Block Micronucleus Assay. Radiat Res 2013; 180:120-8. [DOI: 10.1667/rr3234.1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Romm H, Ainsbury E, Barnard S, Barrios L, Barquinero J, Beinke C, Deperas M, Gregoire E, Koivistoinen A, Lindholm C, Moquet J, Oestreicher U, Puig R, Rothkamm K, Sommer S, Thierens H, Vandersickel V, Vral A, Wojcik A. Automatic scoring of dicentric chromosomes as a tool in large scale radiation accidents. Mutation Research/Genetic Toxicology and Environmental Mutagenesis 2013; 756:174-83. [DOI: 10.1016/j.mrgentox.2013.05.013] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 05/07/2013] [Indexed: 11/27/2022]
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Rothkamm K, Beinke C, Romm H, Badie C, Balagurunathan Y, Barnard S, Bernard N, Boulay-Greene H, Brengues M, De Amicis A, De Sanctis S, Greither R, Herodin F, Jones A, Kabacik S, Knie T, Kulka U, Lista F, Martigne P, Missel A, Moquet J, Oestreicher U, Peinnequin A, Poyot T, Roessler U, Scherthan H, Terbrueggen B, Thierens H, Valente M, Vral A, Zenhausern F, Meineke V, Braselmann H, Abend M. Comparison of established and emerging biodosimetry assays. Radiat Res 2013; 180:111-9. [PMID: 23862692 DOI: 10.1667/rr3231.1] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Rapid biodosimetry tools are required to assist with triage in the case of a large-scale radiation incident. Here, we aimed to determine the dose-assessment accuracy of the well-established dicentric chromosome assay (DCA) and cytokinesis-block micronucleus assay (CBMN) in comparison to the emerging γ-H2AX foci and gene expression assays for triage mode biodosimetry and radiation injury assessment. Coded blood samples exposed to 10 X-ray doses (240 kVp, 1 Gy/min) of up to 6.4 Gy were sent to participants for dose estimation. Report times were documented for each laboratory and assay. The mean absolute difference (MAD) of estimated doses relative to the true doses was calculated. We also merged doses into binary dose categories of clinical relevance and examined accuracy, sensitivity and specificity of the assays. Dose estimates were reported by the first laboratories within 0.3-0.4 days of receipt of samples for the γ-H2AX and gene expression assays compared to 2.4 and 4 days for the DCA and CBMN assays, respectively. Irrespective of the assay we found a 2.5-4-fold variation of interlaboratory accuracy per assay and lowest MAD values for the DCA assay (0.16 Gy) followed by CBMN (0.34 Gy), gene expression (0.34 Gy) and γ-H2AX (0.45 Gy) foci assay. Binary categories of dose estimates could be discriminated with equal efficiency for all assays, but at doses ≥1.5 Gy a 10% decrease in efficiency was observed for the foci assay, which was still comparable to the CBMN assay. In conclusion, the DCA has been confirmed as the gold standard biodosimetry method, but in situations where speed and throughput are more important than ultimate accuracy, the emerging rapid molecular assays have the potential to become useful triage tools.
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Affiliation(s)
- K Rothkamm
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon OX11 0RQ, United Kingdom
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Eloot L, Bacher K, Steenbeke F, Drieghe B, Gheeraert P, Taeymans Y, Thierens H. Three-dimensional rotational X-ray acquisition technique is reducing patients' cancer risk in coronary angiography. Catheter Cardiovasc Interv 2013; 82:E419-27. [PMID: 23420705 DOI: 10.1002/ccd.24879] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 01/16/2013] [Accepted: 02/11/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The purpose of this study was to assess patient-specific organ doses and cancer risk with 3D-rotational acquisitions versus the current standard of multiple single-plane coronary angiography (CA). BACKGROUND Catheter-based CA remains one of the most commonly performed diagnostic invasive procedures delivering a relatively high radiation dose to the patient. With the introduction of flat-panel technology, three-dimensional rotational angiography became an alternative for the conventional two-dimensional angiography. However, limited information is available on the difference in patient radiation exposure with both acquisition techniques. METHODS Eighty adult patients (45 males, age 38-93 years) were randomly assigned to the rotational or standard angiography group. Exposure parameters were registered and skin dose distribution was measured during the procedure. Patient-specific organ doses and related cancer risks were assessed with dedicated software. RESULTS Rotational angiograms were associated with 33% lower KAP-values (decrease from 49.99 Gycm(2) to 33.37 Gycm(2), P < 0.001). A significant (P < 0.001) lower peak skin dose was measured with rotational acquisitions (80 mGy, median) versus planar imaging (172 mGy, median). Moreover, the skin dose was smoothed over the whole chest of the patient. Contrast medium consumption decreased from 104 mL to 73 mL (P < 0.001) with the use of 3D-imaging. The reduction in radiation exposure resulted in a corresponding decrease of organ doses. The latter contributed to an overall cancer risk reduction of 21% for males and 50% for females. CONCLUSIONS The current study demonstrates that in CA radiation risk reduction is feasible by using a rotational acquisition technique.
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Affiliation(s)
- Liesbeth Eloot
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
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50
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Werbrouck J, Ost P, Fonteyne V, De Meerleer G, De Neve W, Bogaert E, Beels L, Bacher K, Vral A, Thierens H. Early biomarkers related to secondary primary cancer risk in radiotherapy treated prostate cancer patients: IMRT versus IMAT. Radiother Oncol 2013; 107:377-81. [PMID: 23791364 DOI: 10.1016/j.radonc.2013.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/03/2013] [Accepted: 05/06/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate whether rotational techniques (Volumetric Modulated Arc Therapy - VMAT) are associated with a higher risk for secondary primary malignancies compared to step-and-shoot Intensity Modulated Radiation Therapy (ss-IMRT). To this end, radiation therapy (RT) induced DNA double-strand-breaks and the resulting chromosomal damage were assessed in peripheral blood T-lymphocytes of prostate cancer (PCa) patients applying γH2AX foci and G0 micronucleus (MN) assays. METHODS AND MATERIALS The study comprised 33PCa patients. A blood sample was taken before start of therapy and after the 1st and 3rd RT fraction to determine respectively the RT-induced γH2AX foci and MN. The equivalent total body dose (D(ETB)) was calculated based on treatment planning data. RESULTS A linear dose response was obtained for γH2AX foci yields versus D(ETB) while MN showed a linear-quadratic dose response. Patients treated with large volume (LV) VMAT show a significantly higher level of induced γH2AX foci and MN compared to IMRT and small volume (SV) VMAT (p<0.01). Assuming a linear-quadratic relationship, a satisfactory correlation was found between both endpoints (R(2) 0.86). CONCLUSIONS Biomarker responses were governed by dose and irradiated volume of normal tissues. No significant differences between IMRT and rotational therapy inherent to the technique itself were observed.
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Affiliation(s)
- Joke Werbrouck
- Department of Basic Medical Sciences, Ghent University, Gent, Belgium
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