Normal Tissue Response of Combined Temporal and Spatial Fractionation in Proton Minibeam Radiation Therapy

质子疗法 核医学 放射治疗 辐照 红斑 分馏 束流扫描 生物医学工程 医学 化学 放射科 外科 物理 色谱法 核物理学
作者
Matthias Sammer,Annique C. Dombrowsky,Jannis Schauer,Kateryna Oleksenko,Sandra Bicher,Benjamin Schwarz,Sarah Rudigkeit,Nicole Matejka,Judith Reindl,Stefano Ermon,Andreas Blutke,Annette Feuchtinger,Stephanie E. Combs,G. Dollinger,Thomas E. Schmid
出处
期刊:International Journal of Radiation Oncology Biology Physics [Elsevier]
卷期号:109 (1): 76-83 被引量:13
标识
DOI:10.1016/j.ijrobp.2020.08.027
摘要

Purpose Proton minibeam radiation therapy, a spatial fractionation concept, widens the therapeutic window. By reducing normal tissue toxicities, it allows a temporally fractionated regime with high daily doses. However, an array shift between daily fractions can affect the tissue-sparing effect by decreasing the total peak-to-valley dose ratio. Therefore, combining temporal fractions with spatial fractionation raises questions about the impact of daily applied dose modulations, reirradiation accuracies, and total dose modulations. Methods and Materials Healthy mouse ear pinnae were irradiated with 4 daily fractions of 30 Gy mean dose, applying proton pencil minibeams (pMB) of Gaussian σ = 222 μm in 3 different schemes: a 16 pMB array with a center-to-center distance of 1.8 mm irradiated the same position in all sessions (FS1) or was shifted by 0.9 mm to never hit the previously irradiated tissue in each session (FS2), or a 64 pMB array with a center-to-center distance of 0.9 mm irradiated the same position in all sessions (FS3), resulting in the same total dose distribution as FS2. Reirradiation positioning and its accuracy were obtained from image guidance using the unique vessel structure of ears. Acute toxicities (swelling, erythema, and desquamation) were evaluated for 153 days after the first fraction. Late toxicities (fibrous tissue, inflammation) were analyzed on day 153. Results Reirradiation of highly dose-modulated arrays at a positioning accuracy of 110 ± 52 μm induced the least severe acute and late toxicities. A shift of the same array in FS2 led to significantly inducted acute toxicities, a higher otitis score, and a slight increase in fibrous tissue. FS3 led to the strongest increase in acute and late toxicities. Conclusions The highest normal-tissue sparing is achieved after accurate reirradiation of a highly dose modulated pMB array, although high positioning accuracies are challenging in a clinical environment. Nevertheless, the same integral dose applied in highly dose-modulated fractions is superior to low daily dose-modulated fractions. Proton minibeam radiation therapy, a spatial fractionation concept, widens the therapeutic window. By reducing normal tissue toxicities, it allows a temporally fractionated regime with high daily doses. However, an array shift between daily fractions can affect the tissue-sparing effect by decreasing the total peak-to-valley dose ratio. Therefore, combining temporal fractions with spatial fractionation raises questions about the impact of daily applied dose modulations, reirradiation accuracies, and total dose modulations. Healthy mouse ear pinnae were irradiated with 4 daily fractions of 30 Gy mean dose, applying proton pencil minibeams (pMB) of Gaussian σ = 222 μm in 3 different schemes: a 16 pMB array with a center-to-center distance of 1.8 mm irradiated the same position in all sessions (FS1) or was shifted by 0.9 mm to never hit the previously irradiated tissue in each session (FS2), or a 64 pMB array with a center-to-center distance of 0.9 mm irradiated the same position in all sessions (FS3), resulting in the same total dose distribution as FS2. Reirradiation positioning and its accuracy were obtained from image guidance using the unique vessel structure of ears. Acute toxicities (swelling, erythema, and desquamation) were evaluated for 153 days after the first fraction. Late toxicities (fibrous tissue, inflammation) were analyzed on day 153. Reirradiation of highly dose-modulated arrays at a positioning accuracy of 110 ± 52 μm induced the least severe acute and late toxicities. A shift of the same array in FS2 led to significantly inducted acute toxicities, a higher otitis score, and a slight increase in fibrous tissue. FS3 led to the strongest increase in acute and late toxicities. The highest normal-tissue sparing is achieved after accurate reirradiation of a highly dose modulated pMB array, although high positioning accuracies are challenging in a clinical environment. Nevertheless, the same integral dose applied in highly dose-modulated fractions is superior to low daily dose-modulated fractions.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
成就发箍发布了新的文献求助10
1秒前
2秒前
所所应助Yolo采纳,获得10
3秒前
太阳花发布了新的文献求助10
4秒前
菜狗完成签到 ,获得积分10
5秒前
一枚研究僧完成签到,获得积分10
10秒前
归海听云发布了新的文献求助10
12秒前
neyney完成签到,获得积分10
14秒前
尘雾完成签到 ,获得积分10
15秒前
16秒前
16秒前
小白完成签到 ,获得积分10
16秒前
酷波er应助郑小凝采纳,获得10
18秒前
诸山柳完成签到 ,获得积分10
19秒前
21秒前
xueee完成签到,获得积分10
21秒前
science发布了新的文献求助10
21秒前
李hk完成签到,获得积分10
21秒前
CipherSage应助afaf采纳,获得10
22秒前
清脆的飞丹完成签到,获得积分10
22秒前
可爱的函函应助山见山采纳,获得10
23秒前
企鹅嗷嗷完成签到 ,获得积分10
23秒前
归海听云完成签到,获得积分10
23秒前
杏仁核发布了新的文献求助10
25秒前
阿贝发布了新的文献求助10
26秒前
少年完成签到,获得积分10
26秒前
成就发箍完成签到,获得积分10
32秒前
开放铅笔完成签到 ,获得积分10
32秒前
南风旧巷完成签到,获得积分10
33秒前
所所应助寒冷半雪采纳,获得10
34秒前
Hello应助李秋秋采纳,获得10
34秒前
迷你的隶完成签到,获得积分10
35秒前
35秒前
39秒前
劲秉应助Messi采纳,获得10
39秒前
40秒前
研究牛牛完成签到,获得积分10
41秒前
长孙曼香发布了新的文献求助10
43秒前
丰知然举报quan求助涉嫌违规
43秒前
高分求助中
Spray / Wall-interaction Modelling by Dimensionless Data Analysis 2000
ALA生合成不全マウスでの糖代謝異常の分子機構解析 520
安全防范技术与工程 500
Mathematics and Finite Element Discretizations of Incompressible Navier—Stokes Flows 500
2-Acetyl-1-pyrroline: an important aroma component of cooked rice 500
A real-time energy management strategy based on fuzzy control and ECMS for PHEVs 400
2024 Medicinal Chemistry Reviews 400
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3190867
求助须知:如何正确求助?哪些是违规求助? 2840066
关于积分的说明 8026815
捐赠科研通 2503309
什么是DOI,文献DOI怎么找? 1336841
科研通“疑难数据库(出版商)”最低求助积分说明 637971
邀请新用户注册赠送积分活动 606296