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
隐形的觅波完成签到 ,获得积分10
5秒前
Likz完成签到,获得积分10
6秒前
victory_liu完成签到,获得积分10
13秒前
DAHove完成签到 ,获得积分10
20秒前
00完成签到 ,获得积分10
22秒前
myp完成签到,获得积分10
29秒前
Yimi刘博完成签到 ,获得积分10
31秒前
whuhustwit完成签到,获得积分10
40秒前
眼睛大雨筠完成签到,获得积分10
45秒前
结实的德地完成签到,获得积分10
48秒前
三十四画生完成签到 ,获得积分10
49秒前
wujiwuhui完成签到,获得积分10
49秒前
Never stall完成签到 ,获得积分0
51秒前
科研废物完成签到 ,获得积分10
52秒前
57秒前
沿途东行完成签到 ,获得积分10
58秒前
EVEN完成签到 ,获得积分10
59秒前
1分钟前
TAO LEE完成签到 ,获得积分0
1分钟前
affff完成签到 ,获得积分10
1分钟前
研友_ZlvpxL完成签到,获得积分10
1分钟前
水晶李完成签到 ,获得积分10
1分钟前
gigi完成签到 ,获得积分10
1分钟前
Tonald Yang完成签到,获得积分20
1分钟前
jojo665完成签到 ,获得积分10
1分钟前
zhw完成签到 ,获得积分10
1分钟前
风趣的冬卉完成签到 ,获得积分10
1分钟前
胖胖橘完成签到 ,获得积分10
1分钟前
稳重的烙完成签到,获得积分10
1分钟前
没用的三轮完成签到,获得积分10
1分钟前
小墨应助科研通管家采纳,获得10
1分钟前
领导范儿应助科研通管家采纳,获得10
1分钟前
SciGPT应助科研通管家采纳,获得30
1分钟前
小墨应助科研通管家采纳,获得10
1分钟前
Bill Wang完成签到 ,获得积分10
1分钟前
Cyrilla完成签到,获得积分10
1分钟前
神勇的天问完成签到 ,获得积分10
1分钟前
Yolanda完成签到 ,获得积分10
1分钟前
LIJIngcan完成签到 ,获得积分10
1分钟前
王半书完成签到 ,获得积分10
1分钟前
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
2024 Medicinal Chemistry Reviews 400
Актуализированная стратиграфическая схема триасовых отложений Прикаспийского региона. Объяснительная записка 360
Dictionary of socialism 350
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 3192705
求助须知:如何正确求助?哪些是违规求助? 2841742
关于积分的说明 8034584
捐赠科研通 2505438
什么是DOI,文献DOI怎么找? 1338578
科研通“疑难数据库(出版商)”最低求助积分说明 638372
邀请新用户注册赠送积分活动 606929