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
今我来思完成签到 ,获得积分10
1秒前
3秒前
萧然完成签到,获得积分10
4秒前
hanghang发布了新的文献求助10
7秒前
酷波er应助ybwei2008_163采纳,获得10
16秒前
yuan完成签到,获得积分20
21秒前
杨杨杨完成签到,获得积分10
25秒前
25秒前
A12138完成签到 ,获得积分10
25秒前
等待的代容完成签到,获得积分10
28秒前
ybwei2008_163发布了新的文献求助10
32秒前
稀松完成签到,获得积分0
35秒前
38秒前
小梦完成签到,获得积分10
40秒前
生而追梦不止完成签到,获得积分10
44秒前
Gary完成签到 ,获得积分10
44秒前
50秒前
虚拟龙猫完成签到 ,获得积分10
53秒前
ybwei2008_163发布了新的文献求助10
54秒前
小李新人完成签到 ,获得积分10
54秒前
甜甜圈完成签到 ,获得积分10
55秒前
56秒前
饱满语风完成签到 ,获得积分10
1分钟前
111发布了新的文献求助10
1分钟前
doreen完成签到 ,获得积分10
1分钟前
无私迎海完成签到,获得积分10
1分钟前
周周完成签到 ,获得积分10
1分钟前
大个应助ZhMeY采纳,获得20
1分钟前
Layace完成签到 ,获得积分10
1分钟前
放眼天下完成签到 ,获得积分10
1分钟前
yuan发布了新的文献求助10
1分钟前
情怀应助科研通管家采纳,获得10
1分钟前
qh应助科研通管家采纳,获得10
1分钟前
丘比特应助ybwei2008_163采纳,获得10
1分钟前
PDIF-CN2完成签到,获得积分10
1分钟前
王云云完成签到 ,获得积分10
1分钟前
跳跃的谷雪完成签到 ,获得积分10
1分钟前
wmhappy完成签到 ,获得积分10
2分钟前
2分钟前
ybwei2008_163完成签到,获得积分20
2分钟前
高分求助中
Spray / Wall-interaction Modelling by Dimensionless Data Analysis 2000
Mathematics and Finite Element Discretizations of Incompressible Navier—Stokes Flows 500
A new species of Coccus (Homoptera: Coccoidea) from Malawi 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
Handbook on People's China (1957) 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 3190111
求助须知:如何正确求助?哪些是违规求助? 2839411
关于积分的说明 8023517
捐赠科研通 2502244
什么是DOI,文献DOI怎么找? 1336398
科研通“疑难数据库(出版商)”最低求助积分说明 637836
邀请新用户注册赠送积分活动 605974