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
幸福大白发布了新的文献求助10
刚刚
帅哥发布了新的文献求助10
1秒前
2秒前
2秒前
浅笑初妍给辛夷的求助进行了留言
3秒前
3秒前
繁荣的问薇完成签到,获得积分10
4秒前
4秒前
5秒前
8秒前
8秒前
小羊要加油完成签到,获得积分10
8秒前
不配.给zs的求助进行了留言
8秒前
万勇发布了新的文献求助10
8秒前
哈哈发布了新的文献求助10
8秒前
不配.应助帅哥采纳,获得10
9秒前
小小鱼发布了新的文献求助10
11秒前
不配.应助愉快睫毛采纳,获得20
11秒前
Zr关闭了Zr文献求助
11秒前
11秒前
13秒前
李二二发布了新的文献求助30
14秒前
16秒前
小蘑菇应助iiiid采纳,获得10
17秒前
慕青应助wenzheng采纳,获得10
17秒前
充电宝应助夏哈哈采纳,获得10
20秒前
20秒前
李健的粉丝团团长应助OL采纳,获得10
21秒前
pbc完成签到,获得积分10
21秒前
小老板发布了新的文献求助10
22秒前
gg完成签到,获得积分20
23秒前
明明完成签到 ,获得积分10
24秒前
寻桃阿玉完成签到 ,获得积分10
24秒前
gg发布了新的文献求助10
25秒前
小蘑菇应助BK2008采纳,获得10
26秒前
29秒前
30秒前
30秒前
30秒前
31秒前
高分求助中
Spray / Wall-interaction Modelling by Dimensionless Data Analysis 2000
Evolution 3rd edition 1500
ALA生合成不全マウスでの糖代謝異常の分子機構解析 520
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
Handbook on People's China (1957) 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 3189052
求助须知:如何正确求助?哪些是违规求助? 2838497
关于积分的说明 8019989
捐赠科研通 2501333
什么是DOI,文献DOI怎么找? 1335547
科研通“疑难数据库(出版商)”最低求助积分说明 637595
邀请新用户注册赠送积分活动 605656