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Bertho A, Ortiz R, Maurin M, Juchaux M, Gilbert C, Espenon J, Ramasamy G, Patriarca A, De Marzi L, Pouzoulet F, Prezado Y. Thoracic Proton Minibeam Radiation Therapy: Tissue Preservation and Survival Advantage Over Conventional Proton Therapy. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)00510-8. [PMID: 38621606 DOI: 10.1016/j.ijrobp.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Proton minibeam radiation therapy (pMBRT) is an innovative radiation therapy approach that highly modulates the spatial dimension of the dose delivery using narrow, parallel, and submillimetric proton beamlets. pMBRT has proven its remarkable healthy tissue preservation in the brain and skin. This study assesses the potential advantages of pMBRT for thoracic irradiations compared with conventional radiation therapy in terms of normal tissue toxicity. The challenge here was the influence of respiratory motion on the typical peak and valley dose patterns of pMBRT and its potential biologic effect. METHODS AND MATERIALS The whole thorax of naïve C57BL/6 mice received one fraction of high dose (18 Gy) pMBRT or conventional proton therapy (CPT) without any respiratory control. The development of radiation-induced pulmonary fibrosis was longitudinally monitored using cone beam computed tomography. Anatomopathologic analysis was carried out at 9 months postirradiation and focused on the reaction of the lungs' parenchyma and the response of cell types involved in the development of radiation-induced fibrosis and lung regeneration as alveolar type II epithelial cells, club cells, and macrophages. RESULTS pMBRT has milder effects on survival, skin reactions, and lung fibrosis compared with CPT. The pMBRT-induced lung changes were more regional and less severe, with evidence of potential reactive proliferation of alveolar type II epithelial cells and less extensive depletion of club cells and macrophage invasion than the more damaging effects observed in CPT. CONCLUSIONS pMBRT appears suitable to treat moving targets, holding a significant ability to preserve healthy lung tissue, even without respiratory control or precise targeting.
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Affiliation(s)
- Annaïg Bertho
- Institut Curie, Université PSL, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France; Université Paris-Saclay, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France
| | - Ramon Ortiz
- Institut Curie, Université PSL, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France; Université Paris-Saclay, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France
| | - Mathieu Maurin
- Institut Curie, PSL Research University, INSERM U932, Paris, France
| | - Marjorie Juchaux
- Institut Curie, Université PSL, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France; Université Paris-Saclay, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France
| | - Cristèle Gilbert
- Institut Curie, Université PSL, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France; Université Paris-Saclay, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France
| | - Julie Espenon
- Institut Curie, Université PSL, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France; Université Paris-Saclay, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France
| | - Gabriel Ramasamy
- Institut Curie, PSL Research University, Département de Recherche Translationnelle, CurieCoreTech-Experimental Radiation therapy (RadeXp), Paris, France
| | - Annalisa Patriarca
- Centre de Protonthérapie d'Orsay, Radiation Oncology Department, Campus Universitaire, Institut Curie, PSL University, Orsay, France
| | - Ludovic De Marzi
- Centre de Protonthérapie d'Orsay, Radiation Oncology Department, Campus Universitaire, Institut Curie, PSL University, Orsay, France; Institut Curie, Campus Universitaire, PSL University, University Paris Saclay, INSERM, Orsay
| | - Frédéric Pouzoulet
- Institut Curie, PSL Research University, Département de Recherche Translationnelle, CurieCoreTech-Experimental Radiation therapy (RadeXp), Paris, France; Institut Curie, PSL University, Université Paris-Saclay, Inserm, Laboratoire de Recherche Translationnelle en Oncologie, Orsay, France
| | - Yolanda Prezado
- Institut Curie, Université PSL, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France; Université Paris-Saclay, CNRS UMR3347, INSERM U1021, Signalisation Radiobiologie et Cancer, Orsay, France.
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2
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He Z, Chen M, Luo Z. Identification of immune-related genes and integrated analysis of immune-cell infiltration in melanoma. Aging (Albany NY) 2024; 16:911-927. [PMID: 38217549 PMCID: PMC10817386 DOI: 10.18632/aging.205427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/04/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVE This study was conducted to screen out immune-related genes in connection with the prognosis of melanoma, construct a prognosis model and explore the relevant mechanisms. METHODS AND MATERIALS 1973 genes associated with immune system were derived from the Immport database, and RNA-seq data of melanoma and information of patients were searched from the Xena database. Cox univariate analysis, Lasso analysis and Cox multivariate analysis were used to screen out six genes to construct the model. Then the risk scores were estimated for patients based on our constructed prognosis model. Estimate was used to affirm that the model was about immune infiltration, and CIBERSORT was used to screen out immune cells associated with prognosis. TIDE was applied to predict the efficacy of immunotherapy. Finally, GSE65904 and GSE19234 were used to confirm the effectiveness of the model. RESULTS ADCYAP1R1, GPI, NTS might cause poor prognosis while IFITM1, KIR2DL4, LIF were more likely conductive to prognosis of melanoma patients and a model of prognosis was constructed on the basis of these six genes. The effectiveness of the model has been proven by the ROC curve, and the miRNAs targeting the screened genes were found out, suggesting that the immune system might impact on the prognosis of melanoma by T cell CD8+, T cell CD4+ memory and NK cells. CONCLUSIONS In this study, the screened six genes were associated with the prognosis of melanoma, which was conductive to clinical prognostic prediction and individualized treatment strategy.
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Affiliation(s)
- Zhenghao He
- Department of Plastic Surgery, Zhongshan City People's Hospital, Zhongshan 528403, Guangdong, China
| | - Manli Chen
- Department of Plastic Surgery, Zhongshan City People's Hospital, Zhongshan 528403, Guangdong, China
| | - Zhijun Luo
- Department of Plastic Surgery, Zhongshan City People's Hospital, Zhongshan 528403, Guangdong, China
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3
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Lu Q, Yan W, Zhu A, Tubin S, Mourad WF, Yang J. Combining spatially fractionated radiation therapy (SFRT) and immunotherapy opens new rays of hope for enhancing therapeutic ratio. Clin Transl Radiat Oncol 2024; 44:100691. [PMID: 38033759 PMCID: PMC10684810 DOI: 10.1016/j.ctro.2023.100691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/04/2023] [Accepted: 10/15/2023] [Indexed: 12/02/2023] Open
Abstract
Spatially Fractionated Radiation Therapy (SFRT) is a form of radiotherapy that delivers a single large dose of radiation within the target volume in a heterogeneous pattern with regions of peak dosage and regions of under dosage. SFRT types can be defined by how the heterogeneous pattern of radiation is obtained. Immune checkpoint inhibitors (ICIs) have been approved for various malignant tumors and are widely used to treat patients with metastatic cancer. The efficacy of ICI monotherapy is limited due to the "cold" tumor microenvironment. Fractionated radiotherapy can achieve higher doses per fraction to the target tumor, and induce immune activation (immodulate tumor immunogenicity and microenvironment). Therefore, coupling ICI therapy and fractionated radiation therapy could significantly improve the outcome of metastatic cancer. This review focuses on both preclinical and clinical studies that use a combination of radiotherapy and ICI therapy in cancer.
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Affiliation(s)
- Qiuxia Lu
- Foshan Fosun Chancheng Hospital, P.R. China
- Junxin Precision Oncology Group, P.R. China
| | - Weisi Yan
- Baptist Health System, Lexington, KY, United States
- Junxin Precision Oncology Group, P.R. China
| | - Alan Zhu
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, United States
| | - Slavisa Tubin
- Albert Einstein Collage of Medicine New York, Center for Ion Therapy, Medaustron, Austria
| | - Waleed F. Mourad
- Department of Radiation Medicine Markey Cancer Center, University of Kentucky - College of Medicine, United States
| | - Jun Yang
- Foshan Fosun Chancheng Hospital, P.R. China
- Junxin Precision Oncology Group, P.R. China
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Lukas L, Zhang H, Cheng K, Epstein A. Immune Priming with Spatially Fractionated Radiation Therapy. Curr Oncol Rep 2023; 25:1483-1496. [PMID: 37979032 PMCID: PMC10728252 DOI: 10.1007/s11912-023-01473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE OF REVIEW This review aims to summarize the current preclinical and clinical evidence of nontargeted immune effects of spatially fractionated radiation therapy (SFRT). We then highlight strategies to augment the immunomodulatory potential of SFRT in combination with immunotherapy (IT). RECENT FINDINGS The response of cancer to IT is limited by primary and acquired immune resistance, and strategies are needed to prime the immune system to increase the efficacy of IT. Radiation therapy can induce immunologic effects and can potentially be used to synergize the effects of IT, although the optimal combination of radiation and IT is largely unknown. SFRT is a novel radiation technique that limits ablative doses to tumor subvolumes, and this highly heterogeneous dose deposition may increase the immune-rich infiltrate within the targeted tumor with enhanced antigen presentation and activated T cells in nonirradiated tumors. The understanding of nontargeted effects of SFRT can contribute to future translational strategies to combine SFRT and IT. Integration of SFRT and IT is an innovative approach to address immune resistance to IT with the overall goal of improving the therapeutic ratio of radiation therapy and increasing the efficacy of IT.
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Affiliation(s)
- Lauren Lukas
- Department of Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Hualin Zhang
- Department of Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Karen Cheng
- Department of Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alan Epstein
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Momeni S, Shanei A, Sazgarnia A, Azmoonfar R, Ghorbani F. Increased radiosensitivity of melanoma cells through cold plasma pretreatment mediated by ICG. JOURNAL OF RADIATION RESEARCH 2023; 64:751-760. [PMID: 37586714 PMCID: PMC10516736 DOI: 10.1093/jrr/rrad042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/13/2023] [Indexed: 08/18/2023]
Abstract
Radiation therapy (RT) is the primary treatment for many cancers, but its effectiveness is reduced due to radioresistance and side effects. The study aims to investigate an emerging treatment for cancer, cold atmospheric plasma (CAP), as a selectable treatment between cancerous and healthy cells and its role in the occurrence of photodynamic therapy (PDT) utilizing indocyanine green (ICG) as a photosensitizer. We examined whether the efficiency of radiotherapy could be improved by combining CAP with ICG. The PDT effect induced by cold plasma irradiation and the radiosensitivity of ICG were investigated on DFW and HFF cell lines. Then, for combined treatment, ICG was introduced to the cells and treated with radiotherapy, followed by cold plasma treatment simultaneously and 24-h intervals. MTT and colony assays were used to determine the survival of treated cells, and flow cytometry was used to identify apoptotic cells. Despite a decrease in the survival of melanoma cells in CAP, ICG did not affect RT. Comparing the ICG + CAP group with CAP, a significant reduction in cell survival was observed, confirming the photodynamic properties of plasma utilizing ICG. The treatment outcome depends on the duration of CAP. The results for healthy and cancer cells also confirmed the selectivity of plasma function. Moreover, cold plasma sensitized melanoma cells to radiotherapy, increasing treatment efficiency. Treatment of CAP with RT can be effective in treating melanoma. The inclusion of ICG results in plasma treatment enhancement. These findings help to select an optimal strategy for a combination of plasma and radiotherapy.
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Affiliation(s)
- Sara Momeni
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Ahmad Shanei
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Ameneh Sazgarnia
- Department of Medical Physics, Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran
| | - Rasool Azmoonfar
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Farzaneh Ghorbani
- Department of Medical Physics and Radiology, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
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Charalampopoulou A, Barcellini A, Frittitta GE, Fulgini G, Ivaldi GB, Magro G, Liotta M, Orlandi E, Pullia MG, Tabarelli de Fatis P, Facoetti A. In Vitro Effects of Photon Beam and Carbon Ion Radiotherapy on the Perineural Invasion of Two Cell Lines of Neurotropic Tumours. Life (Basel) 2023; 13:794. [PMID: 36983949 PMCID: PMC10056732 DOI: 10.3390/life13030794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/16/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Primary mucosal melanoma (PMM) and pancreatic ductal adenocarcinoma (PDAC) are two aggressive malignancies, characterized by intrinsic radio-chemoresistance and neurotropism, a histological feature resulting in frequent perineural invasion (PNI), supported by neurotrophic factors secreted in the tumour microenvironment (TME), such as neurotrophin-3 (NT-3). Carbon-ion radiotherapy (CIRT) could represent an effective option in unresectable PMM and PDAC. Only a few data about the effects of CIRT on PNI in relation to NT-3 are available in the literature, despite the numerous pieces of evidence revealing the peculiar effects of this type of radiation on tumour cell migration. This in vitro study investigated for the first time the response of PMM and PDAC cells to NT-3 and evaluated the effects of conventional photon beam radiotherapy (XRT) and CIRT on cell viability, proliferation, and migration. Our results demonstrated the greater capacity of C-ions to generally decrease cell viability, proliferation, and migration, while the addition of NT-3 after both types of irradiation determined an increase in these features, maintaining a dose-dependent trend and acting more effectively as a chemoattractant than inductor in the case of migration.
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Affiliation(s)
- Alexandra Charalampopoulou
- Radiobiology Unit, Research and Development Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
- Hadron Academy PhD Course, Istituto Universitario di STUDI Superiori (IUSS), 27100 Pavia, Italy
| | - Amelia Barcellini
- Radiation Oncology Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
| | - Giuseppe Emanuele Frittitta
- Radiobiology Unit, Research and Development Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
- Biology and Biotechnology Department, University of Pavia, 27100 Pavia, Italy
| | - Giorgia Fulgini
- Radiobiology Unit, Research and Development Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
- Biology and Biotechnology Department, University of Pavia, 27100 Pavia, Italy
| | | | - Giuseppe Magro
- Medical Physics Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
| | - Marco Liotta
- Medical Physics Unit, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Ester Orlandi
- Radiation Oncology Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
| | - Marco Giuseppe Pullia
- Physics Unit, Research and Development Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
| | | | - Angelica Facoetti
- Radiobiology Unit, Research and Development Department, CNAO National Center for Oncological Hadrontherapy, 27100 Pavia, Italy
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7
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Comparison of the dosimetric response of two Sr salts irradiated with 60Co γ-rays and synchrotron X-rays at ultra-high dose rate. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2023.110923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
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8
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Momeni S, Shanei A, Sazgarnia A, Attaran N, Aledavood SA. The Synergistic Effect of Cold Atmospheric Plasma Mediated Gold Nanoparticles Conjugated with Indocyanine Green as An Innovative Approach to Cooperation with Radiotherapy. CELL JOURNAL 2023; 25:51-61. [PMID: 36680484 PMCID: PMC9868434 DOI: 10.22074/cellj.2022.559078.1097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The multimodality treatment of cancer provides a secure and effective approach to improve the outcome of treatments. Cold atmospheric plasma (CAP) has got attention because of selectively target and kills cancer cells. Likewise, gold nanoparticles (GNP) have been introduced as a radiosensitizer and drug delivery with high efficacy and low toxicity in cancer treatment. Conjugating GNP with indocyanine green (ICG) can develop a multifunctional drug to enhance radio and photosensitivity. The purpose of this study is to evaluate the anticancer effects of GNP@ICG in radiotherapy (RT) and CAP on DFW melanoma cancer and HFF fibroblast normal cell lines. MATERIALS AND METHODS In this experimental study, the cells were irradiated to RT and CAP, alone and in combination with or without GNP@ICG at various time sequences between RT and CAP. Apoptosis Annexin V/PI, MTT, and colony formation assays evaluated the therapeutic effect. Finally, the index of synergism was calculated to compare the results. RESULTS Most crucially, the cell viability assay showed that RT was less toxic to tumors and normal cells, but CAP showed a significant anti-tumor effect on melanoma cells with selective toxicity. In addition, cold plasma sensitized melanoma cells to radiotherapy so increasing treatment efficiency. This effect is enhanced with GNP@ICG. In comparison to RT alone, the data showed that combination treatment greatly decreased monolayer cell colonization and boosted apoptotic induction. CONCLUSION The results provide new insights into the development of better approaches in radiotherapy of melanoma cells assisted plasma and nanomedicine.
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Affiliation(s)
- Sara Momeni
- . Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Shanei
- . Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,P.O.Box: 8174673461Department of Medical PhysicsSchool of MedicineIsfahan University of
Medical SciencesIsfahanIran
P.O.Box: 9177948564Medical Physics Research CenterMashhad University of Medical SciencesMashhadIran
Emails:,
| | - Ameneh Sazgarnia
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,P.O.Box: 8174673461Department of Medical PhysicsSchool of MedicineIsfahan University of
Medical SciencesIsfahanIran
P.O.Box: 9177948564Medical Physics Research CenterMashhad University of Medical SciencesMashhadIran
Emails:,
| | - Neda Attaran
- Department of Medical Nanotechnology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Seyed Amir Aledavood
- Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Baiocco G, Bartzsch S, Conte V, Friedrich T, Jakob B, Tartas A, Villagrasa C, Prise KM. A matter of space: how the spatial heterogeneity in energy deposition determines the biological outcome of radiation exposure. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2022; 61:545-559. [PMID: 36220965 PMCID: PMC9630194 DOI: 10.1007/s00411-022-00989-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/03/2022] [Indexed: 05/10/2023]
Abstract
The outcome of the exposure of living organisms to ionizing radiation is determined by the distribution of the associated energy deposition at different spatial scales. Radiation proceeds through ionizations and excitations of hit molecules with an ~ nm spacing. Approaches such as nanodosimetry/microdosimetry and Monte Carlo track-structure simulations have been successfully adopted to investigate radiation quality effects: they allow to explore correlations between the spatial clustering of such energy depositions at the scales of DNA or chromosome domains and their biological consequences at the cellular level. Physical features alone, however, are not enough to assess the entity and complexity of radiation-induced DNA damage: this latter is the result of an interplay between radiation track structure and the spatial architecture of chromatin, and further depends on the chromatin dynamic response, affecting the activation and efficiency of the repair machinery. The heterogeneity of radiation energy depositions at the single-cell level affects the trade-off between cell inactivation and induction of viable mutations and hence influences radiation-induced carcinogenesis. In radiation therapy, where the goal is cancer cell inactivation, the delivery of a homogenous dose to the tumour has been the traditional approach in clinical practice. However, evidence is accumulating that introducing heterogeneity with spatially fractionated beams (mini- and microbeam therapy) can lead to significant advantages, particularly in sparing normal tissues. Such findings cannot be explained in merely physical terms, and their interpretation requires considering the scales at play in the underlying biological mechanisms, suggesting a systemic response to radiation.
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Affiliation(s)
- Giorgio Baiocco
- Radiation Biophysics and Radiobiology Group, Physics Department, University of Pavia, Pavia, Italy.
| | - Stefan Bartzsch
- Institute for Radiation Medicine, Helmholtz Centre Munich, Munich, Germany
- Department of Radiation Oncology, Technical University of Munich, Munich, Germany
| | - Valeria Conte
- Istituto Nazionale Di Fisica Nucleare INFN, Laboratori Nazionali Di Legnaro, Legnaro, Italy
| | - Thomas Friedrich
- Department of Biophysics, GSI Helmholtz Centre for Heavy Ion Research, Darmstadt, Germany
| | - Burkhard Jakob
- Department of Biophysics, GSI Helmholtz Centre for Heavy Ion Research, Darmstadt, Germany
| | - Adrianna Tartas
- Biomedical Physics Division, Institute of Experimental Physics, University of Warsaw, Warsaw, Poland
| | - Carmen Villagrasa
- IRSN, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay aux Roses, France
| | - Kevin M Prise
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
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Schneider T, Fernandez-Palomo C, Bertho A, Fazzari J, Iturri L, Martin OA, Trappetti V, Djonov V, Prezado Y. Combining FLASH and spatially fractionated radiation therapy: The best of both worlds. Radiother Oncol 2022; 175:169-177. [PMID: 35952978 DOI: 10.1016/j.radonc.2022.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/23/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022]
Abstract
FLASH radiotherapy (FLASH-RT) and spatially fractionated radiation therapy (SFRT) are two new therapeutical strategies that use non-standard dose delivery methods to reduce normal tissue toxicity and increase the therapeutic index. Although likely based on different mechanisms, both FLASH-RT and SFRT have shown to elicit radiobiological effects that significantly differ from those induced by conventional radiotherapy. With the therapeutic potential having been established separately for each technique, the combination of FLASH-RT and SFRT could therefore represent a winning alliance. In this review, we discuss the state of the art, advantages and current limitations, potential synergies, and where a combination of these two techniques could be implemented today or in the near future.
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Affiliation(s)
- Tim Schneider
- Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, Signalisation Radiobiologie et Cancer, 91400 Orsay, France; Université Paris-Saclay, CNRS UMR3347, Inserm U1021, Signalisation Radiobiologie et Cancer, 91400 Orsay, France
| | | | - Annaïg Bertho
- Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, Signalisation Radiobiologie et Cancer, 91400 Orsay, France; Université Paris-Saclay, CNRS UMR3347, Inserm U1021, Signalisation Radiobiologie et Cancer, 91400 Orsay, France
| | - Jennifer Fazzari
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, 3012 Bern, Switzerland
| | - Lorea Iturri
- Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, Signalisation Radiobiologie et Cancer, 91400 Orsay, France; Université Paris-Saclay, CNRS UMR3347, Inserm U1021, Signalisation Radiobiologie et Cancer, 91400 Orsay, France
| | - Olga A Martin
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, 3012 Bern, Switzerland; Division of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, VIC 3000, Australia; University of Melbourne, Parkville, VIC 3010, Australia
| | - Verdiana Trappetti
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, 3012 Bern, Switzerland
| | - Valentin Djonov
- Institute of Anatomy, University of Bern, Baltzerstrasse 2, 3012 Bern, Switzerland
| | - Yolanda Prezado
- Institut Curie, Université PSL, CNRS UMR3347, Inserm U1021, Signalisation Radiobiologie et Cancer, 91400 Orsay, France; Université Paris-Saclay, CNRS UMR3347, Inserm U1021, Signalisation Radiobiologie et Cancer, 91400 Orsay, France.
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11
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Microbeam Radiation Therapy controls local growth of radioresistant melanoma and treats out-of-field locoregional metastasis. Int J Radiat Oncol Biol Phys 2022; 114:478-493. [DOI: 10.1016/j.ijrobp.2022.06.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 11/21/2022]
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12
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Trappetti V, Fazzari J, Fernandez-Palomo C, Smyth L, Potez M, Shintani N, de Breuyn Dietler B, Martin OA, Djonov V. Targeted Accumulation of Macrophages Induced by Microbeam Irradiation in a Tissue-Dependent Manner. Biomedicines 2022; 10:biomedicines10040735. [PMID: 35453485 PMCID: PMC9025837 DOI: 10.3390/biomedicines10040735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/08/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
Radiation therapy (RT) is a vital component of multimodal cancer treatment, and its immunomodulatory effects are a major focus of current therapeutic strategies. Macrophages are some of the first cells recruited to sites of radiation-induced injury where they can aid in tissue repair, propagate radiation-induced fibrogenesis and influence tumour dynamics. Microbeam radiation therapy (MRT) is a unique, spatially fractionated radiation modality that has demonstrated exceptional tumour control and reduction in normal tissue toxicity, including fibrosis. We conducted a morphological analysis of MRT-irradiated normal liver, lung and skin tissues as well as lung and melanoma tumours. MRT induced distinct patterns of DNA damage, reflecting the geometry of the microbeam array. Macrophages infiltrated these regions of peak dose deposition at variable timepoints post-irradiation depending on the tissue type. In normal liver and lung tissue, macrophages clearly demarcated the beam path by 48 h and 7 days post-irradiation, respectively. This was not reflected, however, in normal skin tissue, despite clear DNA damage marking the beam path. Persistent DNA damage was observed in MRT-irradiated lung carcinoma, with an accompanying geometry-specific influx of mixed M1/M2-like macrophage populations. These data indicate the unique potential of MRT as a tool to induce a remarkable accumulation of macrophages in an organ/tissue-specific manner. Further characterization of these macrophage populations is warranted to identify their organ-specific roles in normal tissue sparing and anti-tumour responses.
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Affiliation(s)
- Verdiana Trappetti
- Institute of Anatomy, University of Bern, Baltzerstarsse 2, 3012 Bern, Switzerland; (V.T.); (J.F.); (C.F.-P.); (M.P.); (N.S.); (B.d.B.D.); (O.A.M.)
| | - Jennifer Fazzari
- Institute of Anatomy, University of Bern, Baltzerstarsse 2, 3012 Bern, Switzerland; (V.T.); (J.F.); (C.F.-P.); (M.P.); (N.S.); (B.d.B.D.); (O.A.M.)
| | - Cristian Fernandez-Palomo
- Institute of Anatomy, University of Bern, Baltzerstarsse 2, 3012 Bern, Switzerland; (V.T.); (J.F.); (C.F.-P.); (M.P.); (N.S.); (B.d.B.D.); (O.A.M.)
| | - Lloyd Smyth
- Department of Obstetrics and Gynaecology, Royal Women’s Hospital, University of Melbourne, Melbourne, VIC 3052, Australia;
| | - Marine Potez
- Institute of Anatomy, University of Bern, Baltzerstarsse 2, 3012 Bern, Switzerland; (V.T.); (J.F.); (C.F.-P.); (M.P.); (N.S.); (B.d.B.D.); (O.A.M.)
- Department of Immunology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Nahoko Shintani
- Institute of Anatomy, University of Bern, Baltzerstarsse 2, 3012 Bern, Switzerland; (V.T.); (J.F.); (C.F.-P.); (M.P.); (N.S.); (B.d.B.D.); (O.A.M.)
| | - Bettina de Breuyn Dietler
- Institute of Anatomy, University of Bern, Baltzerstarsse 2, 3012 Bern, Switzerland; (V.T.); (J.F.); (C.F.-P.); (M.P.); (N.S.); (B.d.B.D.); (O.A.M.)
| | - Olga A. Martin
- Institute of Anatomy, University of Bern, Baltzerstarsse 2, 3012 Bern, Switzerland; (V.T.); (J.F.); (C.F.-P.); (M.P.); (N.S.); (B.d.B.D.); (O.A.M.)
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan St., Melbourne, VIC 3000, Australia
- Department of Oncology, University of Melbourne, Parkville, VIC 3010, Australia
| | - Valentin Djonov
- Institute of Anatomy, University of Bern, Baltzerstarsse 2, 3012 Bern, Switzerland; (V.T.); (J.F.); (C.F.-P.); (M.P.); (N.S.); (B.d.B.D.); (O.A.M.)
- Correspondence:
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Moghaddasi L, Reid P, Bezak E, Marcu LG. Radiobiological and Treatment-Related Aspects of Spatially Fractionated Radiotherapy. Int J Mol Sci 2022; 23:3366. [PMID: 35328787 PMCID: PMC8954016 DOI: 10.3390/ijms23063366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/13/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
The continuously evolving field of radiotherapy aims to devise and implement techniques that allow for greater tumour control and better sparing of critical organs. Investigations into the complexity of tumour radiobiology confirmed the high heterogeneity of tumours as being responsible for the often poor treatment outcome. Hypoxic subvolumes, a subpopulation of cancer stem cells, as well as the inherent or acquired radioresistance define tumour aggressiveness and metastatic potential, which remain a therapeutic challenge. Non-conventional irradiation techniques, such as spatially fractionated radiotherapy, have been developed to tackle some of these challenges and to offer a high therapeutic index when treating radioresistant tumours. The goal of this article was to highlight the current knowledge on the molecular and radiobiological mechanisms behind spatially fractionated radiotherapy and to present the up-to-date preclinical and clinical evidence towards the therapeutic potential of this technique involving both photon and proton beams.
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Affiliation(s)
- Leyla Moghaddasi
- Department of Medical Physics, Austin Health, Ballarat, VIC 3350, Australia;
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5001, Australia;
| | - Paul Reid
- Radiation Health, Environment Protection Authority, Adelaide, SA 5000, Australia;
| | - Eva Bezak
- School of Physical Sciences, University of Adelaide, Adelaide, SA 5001, Australia;
- Cancer Research Institute, University of South Australia, Adelaide, SA 5001, Australia
| | - Loredana G. Marcu
- Cancer Research Institute, University of South Australia, Adelaide, SA 5001, Australia
- Faculty of Informatics and Science, University of Oradea, 1 Universitatii Str., 410087 Oradea, Romania
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Non-Targeted Effects of Synchrotron Radiation: Lessons from Experiments at the Australian and European Synchrotrons. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12042079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Studies have been conducted at synchrotron facilities in Europe and Australia to explore a variety of applications of synchrotron X-rays in medicine and biology. We discuss the major technical aspects of the synchrotron irradiation setups, paying specific attention to the Australian Synchrotron (AS) and the European Synchrotron Radiation Facility (ESRF) as those best configured for a wide range of biomedical research involving animals and future cancer patients. Due to ultra-high dose rates, treatment doses can be delivered within milliseconds, abiding by FLASH radiotherapy principles. In addition, a homogeneous radiation field can be spatially fractionated into a geometric pattern called microbeam radiotherapy (MRT); a coplanar array of thin beams of microscopic dimensions. Both are clinically promising radiotherapy modalities because they trigger a cascade of biological effects that improve tumor control, while increasing normal tissue tolerance compared to conventional radiation. Synchrotrons can deliver high doses to a very small volume with low beam divergence, thus facilitating the study of non-targeted effects of these novel radiation modalities in both in-vitro and in-vivo models. Non-targeted radiation effects studied at the AS and ESRF include monitoring cell–cell communication after partial irradiation of a cell population (radiation-induced bystander effect, RIBE), the response of tissues outside the irradiated field (radiation-induced abscopal effect, RIAE), and the influence of irradiated animals on non-irradiated ones in close proximity (inter-animal RIBE). Here we provide a summary of these experiments and perspectives on their implications for non-targeted effects in biomedical fields.
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Schültke E. Flying rats and microbeam paths crossing: the beauty of international interdisciplinary science. Int J Radiat Biol 2022; 98:466-473. [PMID: 34995153 DOI: 10.1080/09553002.2021.2024293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Microbeam radiotherapy (MRT) is a still experimental radiotherapy approach. Two combined parameters contribute to an excellent normal tissue protection and an improved control of malignant tumors in small animal models, compared to conventional radiotherapy: dose deposition at a high dose rate and spatial fractionation at the micrometre level. The international microbeam research community expects to see clinical MRT trials within the next ten years.Physics-associated research is still widely regarded as a male domain. Thus, the question was asked whether this is reflected in the scientific contributions to the field of microbeam radiotherapy. METHOD A literature search was conducted using Pubmed, Semantic Scholar and other sources to look specifically for female contributors to the field of microbeam radiotherapy development. CONCLUSION The original idea for MRT was patented in 1994 by an all-male research team. In approximately 50% of all publications related to microbeam radiotherapy, however, either the first or the senior author is a woman. The contribution of those women who have been driving the development of both technical and biomedical aspects of MRT in the last two decades is highlighted.
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Affiliation(s)
- Elisabeth Schültke
- Department of Radooncology, Rostock University Medical Center, Rostock, Germany
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Bazyar S, O’Brien ET, Benefield T, Roberts VR, Kumar RJ, Gupta GP, Zhou O, Lee YZ. Immune-Mediated Effects of Microplanar Radiotherapy with a Small Animal Irradiator. Cancers (Basel) 2021; 14:155. [PMID: 35008319 PMCID: PMC8750301 DOI: 10.3390/cancers14010155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 12/30/2022] Open
Abstract
Spatially fractionated radiotherapy has been shown to have effects on the immune system that differ from conventional radiotherapy (CRT). We compared several aspects of the immune response to CRT relative to a model of spatially fractionated radiotherapy (RT), termed microplanar radiotherapy (MRT). MRT delivers hundreds of grays of radiation in submillimeter beams (peak), separated by non-radiated volumes (valley). We have developed a preclinical method to apply MRT by a commercial small animal irradiator. Using a B16-F10 murine melanoma model, we first evaluated the in vitro and in vivo effect of MRT, which demonstrated significant treatment superiority relative to CRT. Interestingly, we observed insignificant treatment responses when MRT was applied to Rag-/- and CD8-depleted mice. An immuno-histological analysis showed that MRT recruited cytotoxic lymphocytes (CD8), while suppressing the number of regulatory T cells (Tregs). Using RT-qPCR, we observed that, compared to CRT, MRT, up to the dose that we applied, significantly increased and did not saturate CXCL9 expression, a cytokine that plays a crucial role in the attraction of activated T cells. Finally, MRT combined with anti-CTLA-4 ablated the tumor in half of the cases, and induced prolonged systemic antitumor immunity.
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Affiliation(s)
- Soha Bazyar
- Department of Radiation Oncology, University of Maryland, Maryland, MD 21201, USA;
| | - Edward Timothy O’Brien
- Department of Physics and Astronomy, The University of North Carolina, Chapel Hill, NC 27514, USA;
| | - Thad Benefield
- Department of Radiology, The University of North Carolina, Chapel Hill, NC 27514, USA;
| | | | - Rashmi J. Kumar
- Medical Scientist Training Program, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA;
| | - Gaorav P. Gupta
- Department of Radiation Oncology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA;
| | - Otto Zhou
- Department of Applied Physics Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA;
| | - Yueh Z. Lee
- Department of Radiology, The University of North Carolina, Chapel Hill, NC 27514, USA;
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
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