Computational approaches in the estimation of radiobiological damage for human-malignant cells irradiated with clinical proton and carbon beams

PURPOSE

The use of Monte Carlo (MC) simulations capable of reproducing radiobiological effects of ionising radiation on human cell lines is of great importance, especially for cases involving protons and heavier ion beams. In the latter, huge uncertainties can arise mainly related to the effects of the secondary particles produced in the beam-tissue interaction. This paper reports on a detailed MC study performed using Geant4-based approach on three cancer cell lines, the HTB-177, CRL-5876 and MCF-7, that were previously irradiated with therapeutic proton and carbon ion beams.

METHODS

A Geant4-based approach used jointly with analytical calculations has been developed to provide a more realistic estimation of the radiobiological damage produced by proton and carbon beams in tissues, reproducing available data obtained from in vitro cell irradiations. The MC "Hadrontherapy" Geant4 application and the Local Effect Model: LEM I, LEM II and LEM III coupled with the different numerical approaches: RapidRusso (RR) and RapidScholz (RS) were used in the study.

RESULTS

Experimental survival curves are compared with those evaluated using the highlighted Geant4 MC-based approach via chi-square statistical analysis, for the combinations of radiobiological models and numerical approaches, as outlined above.

CONCLUSION

This study has presented a comparison of the survival data from MC simulations to experimental survival data for three cancer cell lines. An overall best level of agreement was obtained for the HTB-177 cells.

Estimation of the relative biological effectiveness (RBE) of the Lu-DOTA-iPSMA177<!--Q1:CorrectlyacknowledgingtheprimaryfundersandgrantIDsofyourresearchisimportanttoensurecompliancewithfunderpolicies.Pleasemakesurethatfundersarementionedaccordingly.--> radiopharmaceutical

Relative biological effectiveness is a radiobiological parameter relevant in radiotherapy planning and useful in evaluating the physiological impact of radiation in different tissues. Targeted radionuclide therapy allows the selective and specific deposition of higher radiation doses in a noninvasive way and without collateral effects through the administration of radiopharmaceuticals. Lu-DOTA-177(hydrazinylnicotinoyl-Lys-(Nal)-NH-CO-NH-Glu) also called Lu-iPSMA177 is a third generation radiopharmaceutical composed by a peptide that recognizes the prostate-specific membrane antigen (PSMA), a membrane protein overexpressed in several types of cancer and that mediates the radiopharmaceutical's recognition of cancer cells. The present study reports radiobiological parameters of Lu-iPSMA177 and demonstrates the superiority of targeted radiopharmaceuticals over external radiotherapy treatment options in terms of their relative biological effectiveness. The relative biological effectiveness value of 1.020±0.003 for the LINAC, estimated by fitting the linear-quadratic model equation to the resulting survival curves, was like those of 1.25±0.04,1.060±0.005and1.00±0.04 obtained by an alternative method in relation to the mean lethal doses at 90, 80 or 60 survival percent respectively. While the relative biological effectiveness values of 5.65±0.13,4.72±0.27and2.87±0.19 estimated for Lu-iPSMA177 were significantly higher than those for the LINAC. The results confirm that the biological effect produced by the deposition of a radiation absorbed dose delivered by the LINAC can be induced with a quarter of that dose using Lu-iPSMA177 due to the energy distribution, dose-rate and energy fluence.

Radiobiological quantities in proton-therapy: Estimation and validation using Geant4-based Monte Carlo simulations

PURPOSE

The Geant4 Monte Carlo simulation toolkit was used to reproduce radiobiological parameters measured by irradiating three different cancerous cell lines with monochromatic and clinical proton beams.

METHODS

The experimental set-up adopted for irradiations was fully simulated with a dedicated open-source Geant4 application. Cells survival fractions was calculated coupling the Geant4 simulations with two analytical radiobiological models: one based on the LEM (Local Effect Model) approach and the other on a semi-empirical parameterisation. Results was evaluated and compared with experimental data.

RESULTS AND CONCLUSIONS

The results demonstrated the Geant4 ability to reproduce radiobiological quantities for different cell lines.

MATLAB®-based fitting method to evaluate survival fractions after multimodal treatment

To easily analyse and visualize cell kill dynamics measured by survival fraction after single or combined treatments a MATLAB®-based application was developed. A statistical analysis with different options of visualisation of single and combined treatment effects can be performed in a few steps not requiring advanced knowledge of statistical programs.

pATM and γH2AX are effective radiation biomarkers in assessing the radiosensitivity of 12C6+ in human tumor cells

Background

Tumour radiosensitivity would be particularly useful in optimizing the radiation dose during radiotherapy. The aim of the current study was to evaluate the potential value of phosphorylated H2AX (γH2AX) and ATM (pATM) in assessing ¹²C⁶⁺ radiosensitivity of tumour cells.

Methods

Human cervical carcinoma HeLa cells, hepatoma HepG2 cells, and mucoepidermoid carcinoma MEC-1 cells were irradiated with different doses of ¹²C⁶⁺. The survival fraction was assayed with clonogenic survival method and the foci of γH2AX and pATM was visualized using immunocytochemical methods. Flow cytometry was used to assay γH2AX, pATM and the cell cycle.

Results

The survival fraction decreased immediately in dose-dependent manner, but in turn, significantly increased during 24 h after ¹²C⁶⁺ irradiation. Both γH2AX and pATM foci accumulated linearly with doses and with a maximum induction at 0.5 h for γH2AX and 0.5 or 4 h for pATM, respectively, and a fraction foci kept for 24 h. The expression of γH2AX and pATM was in relation to cell cycle. The G0/G1 phase cells had the highest expression of γH2AX after 0.5 h irradiation and then decreased to a lower level at 24 h after irradiation. An obvious increase of pATM in G2/M phase was shown after 24 h of 2 and 4 Gy irradiation. The significant G2/M phase arrest was shown. There was a close relationship between the clonogenic survival and γH2AX and pATM expression both in timing and dose in response to ¹²C⁶⁺.

Conclusions

The rate of γH2AX and pATM formation and loss may be an important factor in the response of cells to ¹²C⁶⁺. pATM and γH2AX are effective radiation biomarkers in assessing the radiosensitivity of ¹²C⁶⁺ in human tumor cells.

Multiple imputation for cure rate quantile regression with censored data

The main challenge in the context of cure rate analysis is that one never knows whether censored subjects are cured or uncured, or whether they are susceptible or insusceptible to the event of interest. Considering the susceptible indicator as missing data, we propose a multiple imputation approach to cure rate quantile regression for censored data with a survival fraction. We develop an iterative algorithm to estimate the conditionally uncured probability for each subject. By utilizing this estimated probability and Bernoulli sample imputation, we can classify each subject as cured or uncured, and then employ the locally weighted method to estimate the quantile regression coefficients with only the uncured subjects. Repeating the imputation procedure multiple times and taking an average over the resultant estimators, we obtain consistent estimators for the quantile regression coefficients. Our approach relaxes the usual global linearity assumption, so that we can apply quantile regression to any particular quantile of interest. We establish asymptotic properties for the proposed estimators, including both consistency and asymptotic normality. We conduct simulation studies to assess the finite-sample performance of the proposed multiple imputation method and apply it to a lung cancer study as an illustration.

Statistical and radiobiological analysis of the so-called thyroid stunning

Background

The origin of the reduction in thyroid uptake after a low activity iodine scan, so-called stunning effect, is still controversial. Two explanations prevail: an individual cell stunning that reduces its capability to store iodine without altering its viability, and/or a significant cell-killing fraction that reduces the number of cells in the tissue still taking up iodine. Our aim is to analyze whether this last assumption could explain the observed reduction.

Methods

The survival fraction after administration of a small radioiodine activity was computed by two independent methods: the application of the statistical theory underlying tissue control probability on recent clinical studies of thyroid remnant ¹³¹I ablation and the use of the radiosensitivities reported in human thyroid cell assays for different radioiodine isotopes.

Results

Both methods provided survival fractions in line with the uptake reduction observed after a low ¹³¹I activity scan. The second method also predicts a similar behavior after a low ¹²³I or ¹²⁴I activity scan.

Conclusions

This study shows that the cell-killing fraction is sufficient to explain the uptake reduction effect for ¹³¹I and ¹²³I after a low activity scan and that even if some still living cells express a stunning effect just after irradiation (as shown in vitro), they will mostly die with time. As the β/α value is very low, this therapy fractionation should not impact the patient outcome in agreement with recent studies. However, in case of huge uptake heterogeneity, pre-therapy scan could specifically kills high-uptake cells and by the way could reduce the cross irradiation to the low-uptake cells during the therapy, resulting in a reduction of the ablation success rate.

Electronic supplementary material

The online version of this article (doi:10.1186/s13550-015-0144-9) contains supplementary material, which is available to authorized users.