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
apollo3232完成签到,获得积分10
2秒前
Eid完成签到,获得积分10
8秒前
研友_Z119gZ完成签到 ,获得积分10
8秒前
mit完成签到 ,获得积分0
9秒前
许xx完成签到 ,获得积分10
12秒前
鸿鹄在天涯完成签到 ,获得积分10
19秒前
快乐太英完成签到 ,获得积分10
21秒前
叶远望完成签到 ,获得积分10
24秒前
1111chen完成签到 ,获得积分20
25秒前
xu发布了新的文献求助10
26秒前
xu完成签到,获得积分10
37秒前
croissante完成签到 ,获得积分10
1分钟前
橙汁摇一摇完成签到 ,获得积分10
1分钟前
duxiao完成签到 ,获得积分10
1分钟前
温如军完成签到 ,获得积分10
1分钟前
稳重傲晴完成签到 ,获得积分10
1分钟前
HR112完成签到 ,获得积分10
1分钟前
HXL完成签到 ,获得积分10
1分钟前
迈克老狼完成签到 ,获得积分10
1分钟前
天天快乐应助fatcat采纳,获得10
1分钟前
优秀的dd完成签到 ,获得积分10
1分钟前
isedu完成签到,获得积分10
1分钟前
ruiii完成签到 ,获得积分10
1分钟前
fatcat完成签到,获得积分10
1分钟前
糖宝完成签到 ,获得积分10
1分钟前
南望完成签到 ,获得积分10
1分钟前
marska完成签到,获得积分10
2分钟前
不辞完成签到 ,获得积分10
2分钟前
叶痕TNT完成签到 ,获得积分10
2分钟前
Xie完成签到 ,获得积分10
2分钟前
阿包完成签到 ,获得积分10
2分钟前
xixi很困完成签到 ,获得积分10
2分钟前
嗯哼应助阔达芾采纳,获得20
2分钟前
bing完成签到 ,获得积分10
2分钟前
Febrine0502完成签到,获得积分10
2分钟前
安青兰完成签到 ,获得积分10
2分钟前
Fiona完成签到 ,获得积分10
2分钟前
loren313完成签到,获得积分0
2分钟前
安子完成签到,获得积分10
2分钟前
彩色的冷梅完成签到 ,获得积分10
2分钟前
高分求助中
Spray / Wall-interaction Modelling by Dimensionless Data Analysis 2000
Aspects of Babylonian celestial divination: the lunar eclipse tablets of Enūma Anu Enlil 500
Mathematics and Finite Element Discretizations of Incompressible Navier—Stokes Flows 500
Dictionary of socialism 350
Mixed-anion Compounds 300
Geochemistry, 2nd Edition 地球化学经典教科书第二版 300
Idoxuridine 260
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 3196852
求助须知:如何正确求助?哪些是违规求助? 2845520
关于积分的说明 8054339
捐赠科研通 2510132
什么是DOI,文献DOI怎么找? 1342314
科研通“疑难数据库(出版商)”最低求助积分说明 639355
邀请新用户注册赠送积分活动 608669