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
我是老大应助优美访文采纳,获得10
刚刚
忧郁秋尽发布了新的文献求助10
1秒前
金轩完成签到 ,获得积分10
2秒前
3秒前
nini完成签到,获得积分10
4秒前
彭于晏应助盼山采纳,获得10
5秒前
5秒前
Rain完成签到,获得积分20
5秒前
乐乐应助皓月千里采纳,获得10
6秒前
YDM发布了新的文献求助10
8秒前
Charming发布了新的文献求助10
10秒前
彭于晏应助缓慢的香芦采纳,获得10
12秒前
筱筱完成签到,获得积分10
12秒前
titamisulydia完成签到,获得积分10
13秒前
爆米花应助Elio采纳,获得10
14秒前
英姑应助忧郁秋尽采纳,获得10
15秒前
watermelon完成签到,获得积分10
16秒前
明理的蜗牛完成签到,获得积分10
17秒前
不倦应助小付采纳,获得10
18秒前
Tina完成签到 ,获得积分10
20秒前
JuJh完成签到,获得积分10
20秒前
望仔发布了新的文献求助10
21秒前
八段锦完成签到,获得积分10
23秒前
23秒前
田恬完成签到,获得积分10
24秒前
24秒前
25秒前
26秒前
英俊的铭应助zhu97采纳,获得10
28秒前
FashionBoy应助包容的忆灵采纳,获得30
28秒前
相龙发布了新的文献求助10
28秒前
初夏发布了新的文献求助10
29秒前
沸腾鱼健康完成签到,获得积分20
29秒前
29秒前
打打应助静远采纳,获得10
30秒前
包妹发布了新的文献求助10
30秒前
cicely发布了新的文献求助10
31秒前
fiee发布了新的文献求助10
32秒前
相龙完成签到,获得积分20
34秒前
34秒前
高分求助中
Evolution 3rd edition 1500
保险藏宝图 1000
Lire en communiste 1000
Mantiden: Faszinierende Lauerjäger Faszinierende Lauerjäger 700
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 700
Mathematics and Finite Element Discretizations of Incompressible Navier—Stokes Flows 500
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
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 3182363
求助须知:如何正确求助?哪些是违规求助? 2832717
关于积分的说明 7990455
捐赠科研通 2494715
什么是DOI,文献DOI怎么找? 1330971
科研通“疑难数据库(出版商)”最低求助积分说明 636197
邀请新用户注册赠送积分活动 603152