RESUMEN
BACKGROUND: Resistance to radiotherapy is frequently encountered in patients with glioblastoma multiforme. It is caused at least partially by the high glutathione content in the tumour tissue. Therefore, the administration of the glutathione synthesis inhibitor Buthionine-SR-Sulfoximine (BSO) should increase survival time. METHODS: BSO was tested in combination with an experimental synchrotron-based treatment, microbeam radiation therapy (MRT), characterized by spatially and periodically alternating microscopic dose distribution. One hundred thousand F98 glioma cells were injected into the right cerebral hemisphere of adult male Fischer rats to generate an orthotopic small animal model of a highly malignant brain tumour in a very advanced stage. Therapy was scheduled for day 13 after tumour cell implantation. At this time, 12.5% of the animals had already died from their disease. The surviving 24 tumour-bearing animals were randomly distributed in three experimental groups: subjected to MRT alone (Group A), to MRT plus BSO (Group B) and tumour-bearing untreated controls (Group C). Thus, half of the irradiated animals received an injection of 100 µM BSO into the tumour two hours before radiotherapy. Additional tumour-free animals, mirroring the treatment of the tumour-bearing animals, were included in the experiment. MRT was administered in bi-directional mode with arrays of quasi-parallel beams crossing at the tumour location. The width of the microbeams was ≈28 µm with a center-to-center distance of ≈400 µm, a peak dose of 350 Gy, and a valley dose of 9 Gy in the normal tissue and 18 Gy at the tumour location; thus, the peak to valley dose ratio (PVDR) was 31. RESULTS: After tumour-cell implantation, otherwise untreated rats had a mean survival time of 15 days. Twenty days after implantation, 62.5% of the animals receiving MRT alone (group A) and 75% of the rats given MRT + BSO (group B) were still alive. Thirty days after implantation, survival was 12.5% in Group A and 62.5% in Group B. There were no survivors on or beyond day 35 in Group A, but 25% were still alive in Group B. Thus, rats which underwent MRT with adjuvant BSO injection experienced the largest survival gain. CONCLUSIONS: In this pilot project using an orthotopic small animal model of advanced malignant brain tumour, the injection of the glutathione inhibitor BSO with MRT significantly increased mean survival time.
Asunto(s)
Neoplasias Encefálicas/mortalidad , Butionina Sulfoximina/farmacología , Glioma/mortalidad , Glutatión/metabolismo , Radioterapia/métodos , Sincrotrones , Animales , Antimetabolitos/farmacología , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/terapia , Terapia Combinada , Relación Dosis-Respuesta en la Radiación , Glioma/patología , Glioma/terapia , Masculino , Proyectos Piloto , Ratas , Ratas Endogámicas F344 , Tasa de SupervivenciaRESUMEN
Microbeam radiation therapy (MRT) uses highly collimated, quasi-parallel arrays of X-ray microbeams of 50-600keV, produced by third generation synchrotron sources, such as the European Synchrotron Radiation Facility (ESRF), in France. The main advantages of highly brilliant synchrotron sources are an extremely high dose rate and very small beam divergence. High dose rates are necessary to deliver therapeutic doses in microscopic volumes, to avoid spreading of the microbeams by cardiosynchronous movement of the tissues. The minimal beam divergence results in the advantage of steeper dose gradients delivered to a tumor target, thus achieving a higher dose deposition in the target volume in fractions of seconds, with a sharper penumbra than that produced in conventional radiotherapy. MRT research over the past 20 years has yielded many results from preclinical trials based on different animal models, including mice, rats, piglets and rabbits. Typically, MRT uses arrays of narrow ( approximately 25-100 microm wide) microplanar beams separated by wider (100-400 microm centre-to-centre) microplanar spaces. The height of these microbeams typically varies from 1 to 100 mm, depending on the target and the desired preselected field size to be irradiated. Peak entrance doses of several hundreds of Gy are surprisingly well tolerated by normal tissues, up to approximately 2 yr after irradiation, and at the same time show a preferential damage of malignant tumor tissues; these effects of MRT have now been extensively studied over nearly two decades. More recently, some biological in vivo effects of synchrotron X-ray beams in the millimeter range (0.68-0.95 mm, centre-to-centre distances 1.2-4 mm), which may differ to some extent from those of microscopic beams, have been followed up to approximately 7 months after irradiation. Comparisons between broad-beam irradiation and MRT indicate a higher tumor control for the same sparing of normal tissue in the latter, even if a substantial fraction of tumor cells are not receiving a radiotoxic level of radiation. The hypothesis of a selective radiovulnerability of the tumor vasculature versus normal blood vessels by MRT, and of the cellular and molecular mechanisms involved remains under investigation. The paper highlights the history of MRT including salient biological findings after microbeam irradiation with emphasis on the vascular components and the tolerance of the central nervous system. Details on experimental and theoretical dosimetry of microbeams, core issues and possible therapeutic applications of MRT are presented.
Asunto(s)
Neoplasias Encefálicas/radioterapia , Encéfalo/efectos de la radiación , Radioterapia/métodos , Sincrotrones , Tecnología Radiológica/métodos , Rayos X , Animales , Vasos Sanguíneos/efectos de la radiación , Neoplasias Encefálicas/irrigación sanguínea , Fraccionamiento de la Dosis de Radiación , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Neoplasias/irrigación sanguínea , Radiometría , Radioterapia/instrumentación , Tecnología Radiológica/historiaRESUMEN
Microbeam radiation therapy (MRT), a form of experimental radiosurgery of tumours using multiple parallel, planar, micrometres-wide, synchrotron-generated X-ray beams ('microbeams'), can safely deliver radiation doses to contiguous normal animal tissues that are much higher than the maximum doses tolerated by the same normal tissues of animals or patients from any standard millimetres-wide radiosurgical beam. An array of parallel microbeams, even in doses that cause little damage to radiosensitive developing tissues, for example, the chick chorioallantoic membrane, can inhibit growth or ablate some transplanted malignant tumours in rodents. The cerebella of 100 normal 20 to 38g suckling Sprague-Dawley rat pups and of 13 normal 5 to 12kg weanling Yorkshire piglets were irradiated with an array of parallel, synchrotron-wiggler-generated X-ray microbeams in doses overlapping the MRT-relevant range (about 50-600Gy) using the ID17 wiggler beamline tangential to the 6GeV electron synchrotron ring at the European Synchrotron Radiation Facility in Grenoble, France. Subsequent favourable development of most animals over at least 1 year suggests that MRT might be used to treat children's brain tumours with less risk to the development of the central nervous system than is presently the case when using wider beams.
Asunto(s)
Neoplasias Encefálicas/fisiopatología , Neoplasias Encefálicas/radioterapia , Terapia por Rayos X/métodos , Animales , Relación Dosis-Respuesta en la Radiación , Humanos , Examen Neurológico , Terapia por Rayos X/efectos adversosRESUMEN
PURPOSE: Microbeam radiation therapy (MRT), a novel experimental radiosurgery that largely spares the developing CNS and other normal tissues, is tolerated well by developing animals and palliates advanced 9LGS tumors. This report, to our knowledge, is the first demonstration that gene-mediated immunotherapy (GMIMPR) enhances the efficacy of MRT for advanced 9LGS tumors. METHODS: Seventy-six male Fischer 344 rats were implanted ic with 10(4)9LGS cells on d0. By d14, the cells had generated approximately approximately 40 mm3 ic 9LGS tumours, experimental models for therapy of moderately aggressive human malignant astrocytomas. Each of the 14 untreated (control) rats died from a large (>100 mg) ic tumor before d29 (median, d21). On d14, the remaining 62 rats were given deliberately suboptimal microbeam radiation therapy (MRT) by a single lateral exposure of the tumor-bearing zone of the head to a 10.1 mm-wide, approximately approximately 11 mm-high array of 20-39 microm-wide, nearly parallel beams of synchrotron wiggler-generated radiation (mainly approximately 50-150 keV X-rays) that delivered 625 Gy peak skin doses at approximately approximately 211 microm ctc intervals in approximately approximately 300 ms either without additional treatments (MRT-only, 25 rats), with post-MRT GMIMPR (MRT+GMIMPR, 23 rats: multiple sc injections of irradiated (clonogenically-disabled) GM-CSF gene-transfected 9LGS cells), or with post-MRT IMPR (MRT+IMPR, 14 rats: multiple sc injections of irradiated (clonogenically-disabled) 9LGS cells. RESULTS: The median post-implantation survivals of rats in the MRT-only, MRT+GMIMPR and MRT+IMPR groups were over twice that of controls; further, approximately approximately 20% of rats in MRT-only and MRT+IMPR groups survived >1 yr with no obvious disabilities. Moreover, over 40% of MRT+GMIMPR rats survived >1 yr with no obvious disabilities, a significant (P<0.04) increase over the MRT-only and MRT+IMPR groups. SIGNIFICANCE: These data suggest that the combination of MRT+GMIMPR might be better than MRT only for unifocal CNS tumors, particularly in infants and young children.
Asunto(s)
Neoplasias Encefálicas/terapia , Gliosarcoma/terapia , Inmunoterapia/métodos , Radiocirugia/métodos , Factores de Edad , Animales , Neoplasias Encefálicas/inmunología , Neoplasias Encefálicas/cirugía , Terapia Combinada/métodos , Terapia Genética , Gliosarcoma/inmunología , Gliosarcoma/cirugía , Factor Estimulante de Colonias de Granulocitos y Macrófagos/genética , Factor Estimulante de Colonias de Granulocitos y Macrófagos/inmunología , Factor Estimulante de Colonias de Granulocitos y Macrófagos/uso terapéutico , Inmunización , Masculino , Dosificación Radioterapéutica , Ratas , Ratas Endogámicas F344 , Estadísticas no Paramétricas , Análisis de Supervivencia , TransfecciónRESUMEN
Microbeam radiosurgery (MBRS), also referred to as microbeam radiation therapy (MRT), was tested at the European Synchrotron Radiation Facility (ESRF). The left tibiofibular thigh of a mouse bearing a subcutaneously (sc) implanted mouse model (SCCVII) of aggressive human squamous-cell carcinoma was irradiated in two orthogonal exposures with or without a 16 mm aluminium filter through a multislit collimator (MSC) by arrays of nearly parallel microbeams spaced 200 microm on centre (oc). The peak skin-entrance dose from each exposure was 442 Gy, 625 Gy, or 884 Gy from 35 microm wide beams or 442 Gy from 70 microm wide beams. The 442/35, 625/35, 884/35 and 442/70 MBRSs yielded 25 day, 29 day, 37 day and 35 day median survival times (MST) (post-irradiation), respectively, exceeding the 20 day MST from 35 Gy-irradiation of SCCVIIs with a seamless 100 kVp X-ray beam.
Asunto(s)
Carcinoma de Células Escamosas/cirugía , Radiocirugia/métodos , Sincrotrones , Animales , Femenino , Humanos , Extremidad Inferior , Ratones , Ratones Endogámicos C3H , Modelos Animales , Trasplante de Neoplasias , Cuidados Paliativos , Tasa de SupervivenciaRESUMEN
Microbeam radiation therapy (MRT) has the potential to treat infantile brain tumours when other kinds of radiotherapy would be excessively toxic to the developing normal brain. MRT uses extraordinarily high doses of x-rays but provides unusual resistance to radioneurotoxicity, presumably from the migration of endothelial cells from 'valleys' into 'peaks', i.e., into directly irradiated microslices of tissues. We present a novel irradiation geometry which results in a tolerable valley dose for the normal tissue and a decreased peak-to-valley dose ratio (PVDR) in the tumour area by applying an innovative cross-firing technique. We propose an MRT technique to orthogonally crossfire two arrays of parallel, nonintersecting, mutually interspersed microbeams that produces tumouricidal doses with small PVDRs where the arrays meet and tolerable radiation doses to normal tissues between the microbeams proximal and distal to the tumour in the paths of the arrays.
Asunto(s)
Neoplasias Encefálicas/patología , Neoplasias Encefálicas/radioterapia , Encéfalo/patología , Encéfalo/efectos de la radiación , Planificación de la Radioterapia Asistida por Computador/métodos , Radioterapia Conformacional/métodos , Animales , Estudios de Factibilidad , Dosis de Radiación , Traumatismos por Radiación/prevención & control , Ratas , Resultado del TratamientoRESUMEN
5-bromodeoxyuridine (BUdR) provides in vitro measures of tumor cell proliferation. We used positron emission tomography to study tissue and plasma kinetics of [76Br]BUdR in tumor-bearing animals. In order to account for the slow washout of the major plasma metabolite, [76Br]bromide, a mathematical correction for the distribution volume of [76Br]bromide was applied. However, following correction specific tumor tracer retention was low or even zero and did not correlate with independent measures of proliferation. The kinetic characteristics of [76Br]BUdR make this tracer unsuitable for proliferation imaging.
Asunto(s)
Bromodesoxiuridina/farmacocinética , Neoplasias/metabolismo , Fármacos Sensibilizantes a Radiaciones/farmacocinética , Animales , Radioisótopos de Bromo/sangre , Bromodesoxiuridina/sangre , Gatos , Perros , Femenino , Citometría de Flujo , Semivida , Masculino , Matemática , Neoplasias/diagnóstico por imagen , Neoplasias/patología , Distribución Tisular , Tomografía Computarizada de EmisiónRESUMEN
PURPOSE: To examine whether wortmannin enhances radiation-induced apoptosis in human lymphoid cells. METHODS AND MATERIALS: Different concentrations of wortmannin (0-40 micrOM) were added to TK6 lymphoblastoid cell and whole blood cell cultures 15 min before irradiation (0-6-Gy X-rays). After irradiation, medium was changed and cells were left to incubate for 48 h. In blood samples, CD4, CD8, and CD20 lymphocytes were labeled using FITC-conjugated antibodies. All cell types were fixed in a diethyleneglycol-formaldehyde solution. DNA was stained with propidium iodide. Apoptosis was quantified using flow cytometry and confirmed using fluorescence microscopy. RESULTS: Wortmannin significantly enhances radiation-induced apoptosis in lymphoblastoid cells. Compared to the controls, wortmannin treatment only slightly enhanced radiation-induced apoptosis in quiescent T-lymphocytes and had no effect in quiescent B-lymphocytes. CONCLUSION: Wortmannin enhances radiation-induced apoptosis in a cell-type dependent manner. If the selective effect of wortmannin on proliferative tissues also exists in nonlymphoid tissues, it should enhance the therapeutic ratio of treatments for tumors located in poorly proliferative healthy tissues. Further studies are needed to compare the effects of wortmannin in human tumor cells and various normal cells including proliferative and quiescent cells.
Asunto(s)
Androstadienos/farmacología , Apoptosis/efectos de los fármacos , Linfocitos B/efectos de los fármacos , Fármacos Sensibilizantes a Radiaciones/farmacología , Linfocitos T/efectos de los fármacos , Androstadienos/administración & dosificación , Linfocitos B/citología , Linfocitos B/efectos de la radiación , División Celular , Células Cultivadas/efectos de los fármacos , Ensayos de Selección de Medicamentos Antitumorales , Citometría de Flujo , Humanos , Microscopía Fluorescente , Fármacos Sensibilizantes a Radiaciones/administración & dosificación , Linfocitos T/citología , Linfocitos T/efectos de la radiación , WortmaninaRESUMEN
PURPOSE: To investigate sources of variation in radiosensitivity displayed by cancer patients and blood donors using the leukocyte apoptosis assay. METHODS AND MATERIALS: Probes were obtained from 105 healthy blood donors, 48 cancer patients displaying normal sensitivity to radiotherapy, 12 cancer patients displaying hypersensitivity to radiotherapy, 12 Ataxia telangiectasia blood donors, and 4 additional individuals with genetic diseases of potentially modified radiosensitivity; 2 neurofibromatosis (NF) donors, a Nijmegen breakage syndrome (NBS) donor, and an Immunodeficiency, Chromosome fragility, Facial anomaly syndrome (ICF) donor. Heparinized blood was diluted in medium, irradiated, and left to incubate for 48 h. CD4 and CD8 T-lymphocyte DNA was stained with propidium iodide and the cells were analyzed by flow cytometry. RESULTS: Radiation-induced apoptosis depended on age and cell type. Cohorts of hypersensitive cancer patients, NBS and AT donors displayed compromised apoptotic response. An asymmetric apoptotic response of T-lymphocytes was observed in an ICF donor and a cryptic hypersensitivity donor. Two NF donors displayed no abnormal sensitivity to radiotherapy but compromised apoptotic T-cell response to X-rays. CONCLUSION: Our studies reveal 4 physiologic sources of variation in radiation response-2 are genetic: cryptic hypersensitivity and hereditary disease, and 2 are epigenetic: cell type and donor age. They emphasize the important role of proteins involved in the recognition and repair of DNA double-strand breaks in determining the response of individuals to radiotherapy.
Asunto(s)
Apoptosis/fisiología , Linfocitos T CD4-Positivos/efectos de la radiación , Linfocitos T CD8-positivos/efectos de la radiación , Neoplasias/radioterapia , Tolerancia a Radiación/fisiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Ataxia Telangiectasia/genética , Donantes de Sangre , Niño , Preescolar , Estudios de Cohortes , Humanos , Persona de Mediana Edad , Neoplasias/genética , Neoplasias/patología , Tolerancia a Radiación/genéticaRESUMEN
PURPOSE: Cells from ataxia-telangiectasia (A-T) patients are extremely sensitive to radiation but display decreased apoptosis, as measured during the first 3 days following radiation. To explain this apparent contradiction, we examined apoptosis in normal and A-T cells at late time points following radiation, under the assumption that radiation-induced apoptosis is delayed in the A-T cells. METHODS AND MATERIALS: Blood cells and lymphoblastoid cell lines from A-T patients, as well as healthy donors, were irradiated with X-rays. Apoptosis was measured at different time points (up to 7 and 30 days for lymphocytes and lymphoblastoid cells, respectively) using a flow cytometric method based on the reduction of intracellular DNA content (sub-G1 population). RESULTS: Compared to normal cells, CD4 and CD8 A-T lymphocytes displayed constantly reduced levels of radiation-induced apoptosis for up to 7 days after treatment. A-T lymphoblastoid cells, however, displayed a delayed and prolonged apoptosis. CONCLUSION: A-T lymphoblastoid cells show high levels of delayed radiation-induced apoptosis, which may contribute to the high cellular radiosensitivity displayed by the A-T phenotype. ATM (the gene mutated in A-T) plays different roles in the apoptotic response to ionizing radiation in quiescent lymphocytes and proliferative lymphoblastoid cells.
Asunto(s)
Apoptosis/fisiología , Ataxia Telangiectasia/radioterapia , Linfocitos T CD4-Positivos/efectos de la radiación , Linfocitos T CD8-positivos/efectos de la radiación , Adolescente , Adulto , Anciano , Ataxia Telangiectasia/fisiopatología , Linfocitos T CD4-Positivos/fisiología , Linfocitos T CD8-positivos/fisiología , Línea Celular , Niño , Preescolar , Citometría de Flujo , Humanos , Persona de Mediana Edad , Tolerancia a Radiación/fisiología , Factores de TiempoRESUMEN
The tumour suppressor gene p53 and the intracellular signalling molecule ceramide have both been shown to play crucial roles in the induction of apoptosis by ionising radiation. In this study we examined whether p53 and ceramide are involved in independent signal pathways, inducing different types of apoptosis. TK6 (p53wt/wt) and WTK1 (p53mut/mut) lymphoblastoid cells were treated with ionising radiation or N-acetyl-D-sphingosine (C2-ceramide). Flow cytometry and fluorescence microscopy studies were performed to characterise the time kinetics and morphological features of induced apoptosis. Ceramide- and radiation-induced apoptotic cells display characteristic differences in morphology and DNA staining and ceramide-induced apoptosis is expressed much faster than radiation-induced apoptosis. Radiation-induced apoptosis is p53-dependent and ceramide-induced apoptosis is p53-independent. The p53 pathway and the ceramide pathway are two independent signal pathways leading to distinct types of apoptosis. Since p53 is very often dysfunctional in tumour cells, modifying the ceramide pathway is a promising strategy to increase tumour sensitivity to radiation and other anticancer agents.
Asunto(s)
Apoptosis , Genes p53/genética , Linfoma de Células B/genética , Mutación , Apoptosis/efectos de la radiación , Ceramidas/farmacología , Relación Dosis-Respuesta en la Radiación , Citometría de Flujo , Humanos , Linfoma de Células B/radioterapia , Microscopía Fluorescente , Fenotipo , Dispersión de Radiación , Transducción de Señal , Factores de Tiempo , Células Tumorales CultivadasRESUMEN
Fifteen cats were treated for squamous cell carcinoma of the nasal planum using proton beam radiation. The protocol used was accelerated with eight equal fractions given on four consecutive days, with a minimum of six hours between fractions. Total dose of radiation delivered was escalated with nine cats receiving 40.4 CGE (60Co Gy equivalent), and three cats each receiving 42.4 and 44.8 CGE. Complete response to the protocol was 60% (9/15), partial response was 33% (5 of 15), and no response was seen in 6.6% (1 of 15). Tumor control rate at one year was 64% and no cat had tumor recurrence after one year. Median survival was 946 days (+/- 516 days). Side effects were minimal with no severe reactions noted in the early or late period. This protocol offers an effective treatment for squamous cell carcinoma of the feline nasal planum with minimal side effects and may be adaptable to conventional radiation sources particularly when the field size is very small.
Asunto(s)
Carcinoma de Células Escamosas/veterinaria , Enfermedades de los Gatos/mortalidad , Enfermedades de los Gatos/radioterapia , Neoplasias Nasales/veterinaria , Terapia de Protones , Animales , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/radioterapia , Enfermedades de los Gatos/patología , Gatos , Femenino , Masculino , Neoplasias Nasales/mortalidad , Neoplasias Nasales/radioterapia , Dosificación Radioterapéutica , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
Two cats with large pituitary neoplasms (adenoma and adenocarcinoma) were treated with fractionated radiation therapy. Total doses of 40 Gy, respectively 36 Gy, were applied in 10 fractions of 4 Gy, and 3.6 Gy respectively. Side effects were minimal and transient. Anesthesia was well tolerated. Improvement of clinical signs could be observed during radiation therapy in both cats. One cat had a complete, the other a partial tumor response. One cat (suspicion of adenoma) was euthanized 1 3/4 years after therapy due to unrelated disease. No tumor was found on histopathology, however a small focal necrosis of brain tissue in the irradiated field was observed. The second animal with a pituitary adenocarcinoma was euthanized because of tumor recurrence 1 1/2 years after therapy. Radiation therapy was effective, despite the low total doses of radiation applied.
Asunto(s)
Adenocarcinoma/veterinaria , Enfermedades de los Gatos/radioterapia , Neoplasias Hipofisarias/veterinaria , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/radioterapia , Animales , Enfermedades de los Gatos/diagnóstico por imagen , Gatos , Femenino , Neoplasias Hipofisarias/diagnóstico por imagen , Neoplasias Hipofisarias/radioterapia , Tomografía Computarizada por Rayos X/veterinariaRESUMEN
The application of synchrotron radiation in medical research has become a mature field of research at synchrotron facilities worldwide. In the relatively short time that synchrotrons have been available to the scientific community, their characteristic beams of UV and X-ray radiation have been applied to virtually all areas of medical science which use ionizing radiation. The ability to tune intense monochromatic beams over wide energy ranges differentiates these sources from standard clinical and research tools. At the European Synchrotron Radiation Facility (Grenoble, France), a major research facility is operational on an advanced wiggler radiation beamport, ID17. The beamport is designed to carry out a broad range of research ranging from cell radiation biology to in vivo human studies. Medical imaging programs at ID17 include transvenous coronary angiography, computed tomography, mammography and bronchography. In addition, a major research program on microbeam radiation therapy is progressing. This paper will present a very brief overview of the beamline and the imaging and therapy programs.
Asunto(s)
Sincrotrones/instrumentación , Animales , Angiografía Coronaria/instrumentación , Europa (Continente) , Humanos , Radioterapia de Alta Energía/instrumentación , Investigación , Tomografía Computarizada por Rayos X/instrumentación , Difracción de Rayos X/instrumentaciónRESUMEN
Changing tumour positions induced by organ motion can impede the full exploitation of the strengths of conformal radiotherapy. The unnecessary irradiation of healthy tissue surrounding the target volume can be the consequence. To overcome this, one should measure tumour positions directly and continuously with high resolution in space and time. We have developed a novel tracking technique which will allow this. The method can also be used to survey and monitor the patient positioning. The proper functioning of our method has been technically demonstrated at PSI with the help of phantom irradiation with protons. Implementation into the clinical environment is now beginning.
Asunto(s)
Neoplasias/radioterapia , Planificación de la Radioterapia Asistida por Computador/métodos , Radioterapia Conformacional/métodos , Algoritmos , Campos Electromagnéticos , Diseño de Equipo , Humanos , Miniaturización , Fantasmas de Imagen , Protones , Planificación de la Radioterapia Asistida por Computador/instrumentación , Radioterapia Asistida por Computador/instrumentación , Radioterapia Asistida por Computador/métodosRESUMEN
Microbeam radiation therapy (MRT) is a currently experimental method of radiotherapy which is mediated by an array of parallel microbeams of synchrotron-wiggler-generated x-rays. Suitably selected, nominally supralethal doses of x-rays delivered to parallel microslices of tumor-bearing tissues in rats can be either palliative or curative while causing little or no serious damage to contiguous normal tissues. Although the pathogenesis of MRT-mediated tumor regression is not understood, as in all radiotherapy such understanding will be based ultimately on our understanding of the relationships among the following three factors: (1) microdosimetry, (2) damage to normal tissues, and (3) therapeutic efficacy. Although physical microdosimetry is feasible, published information on MRT microdosimetry to date is computational. This report describes Monte Carlo-based computational MRT microdosimetry using photon and/or electron scattering and photoionization cross-section data in the 1 eV through 100 GeV range distributed publicly by the U.S. Lawrence Livermore National Laboratory (LLNL) in the 1990s. These are compared with Monte Carlo-based microdosimetric computations using a code and physical data available in the 1980s. With the aim of using the PSI-version of GEANT Monte Carlo code for future macro- and micro/nano-dosimetric studies of Microbeam Radiation Therapy (MRT) a comparison of this code is made with the INHOM(EGS4) (version 1990), Dilmanian-CPE and Persliden-CPE Monte Carlo photon-electron codes (both version 1990) with which the absorbed dose distributions were calculated in 1990 and 1991 considering, (a) a single cylindrical microbeam, (b) multiple cylindrical microbeams in an orthogonal square bundle, and (c) multiple planar microbeams. It is shown that the PSI-version of GEANT can potentially deliver more accurate results (a) using presently the most advanced atomic data, and especially (b) employing "Single-collision" electron transport instead of only the "Condensed-history" electron transport as in code INHOM(EGS4). In contrast Dilmanian-CPE and Persliden-CPE codes deposit the electron energy locally instead of transporting it to the correct position.
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Radioterapia/instrumentación , Radioterapia/métodos , Algoritmos , Carbono , Relación Dosis-Respuesta en la Radiación , Transporte de Electrón , Electrones/uso terapéutico , Humanos , Hidrógeno , Iones , Método de Montecarlo , Neoplasias Experimentales/radioterapia , Nitrógeno , Oxígeno , Fantasmas de Imagen , Fotones/uso terapéutico , Radiometría/métodos , Dispersión de Radiación , Programas Informáticos , Agua , Rayos XRESUMEN
PURPOSE: To examine tissue lesions caused by microplanar beams of synchrotron-generated X-rays in Drosophila melanogaster using stereomicroscopy, light and electron microscopy. MATERIALS AND METHODS: Pupae were irradiated by 25-microm wide, 1.175 mm-high parallel microplanes at 100 microm on-centre intervals, at 20, 24, 32, 36, 48 or 72 h of development, with absorbed doses per microplane between 75 and 3,000 Gy. RESULTS: Transverse or longitudinal irradiation with in-slice absorbed doses of 75 or 375 Gy caused no recognizable effects. All pupae irradiated at or after 48 h developed normally. Conversely, the development to adulthood was delayed in 90% of pupae irradiated at 24h with doses of 750 Gy. However, neither those pupae nor adults that hatched after pupal irradiation at 48 and 72 h displayed morphological changes. Pupae exposed at 48 h of development to 3,000 Gy developed into adults with sharply delimited lesions in the irradiated microplanes of the compound eye or the cuticle of wings and abdomen. CONCLUSIONS: Post-mitotic eukaryotic cells can survive radiation doses of 3,000 Gy largely undamaged, even at the beginning of the terminal morphogenesis. The extremely sharp delimitation between damaged tissue microplanes and adjacent intact tissues may be relevant for future perspectives of radiosurgery.
Asunto(s)
Drosophila melanogaster/efectos de la radiación , Animales , Relación Dosis-Respuesta en la Radiación , Cabello/efectos de la radiación , Tórax/efectos de la radiación , Rayos XRESUMEN
PURPOSE: A retrospective study of radiation-induced apoptosis in CD4 and CD8 T-lymphocytes, from 12 cancer patients who displayed enhanced toxicity to radiation therapy and 9 ataxia telangiectasia patients, was performed to test for altered response compared to healthy blood-donors and normal cancer patients. METHODS AND MATERIALS: Three milliliters of heparinized blood from each donor was sent via express post to the Paul Scherrer Institute (PSI) for subsequent examination. The blood was diluted 1:10 in RPMI medium, irradiated with 0-, 2-, or 9-Gy X-rays, and incubated for 48 h. CD4 and CD8 T-lymphocytes were then labeled using FITC-conjugated antibodies, erythrocytes were lysed, and the DNA stained with propidium iodide. Subsequently, cells were analyzed using a Becton Dickinson FACScan flow cytometer. Radiation-induced apoptosis was recognized in leukocytes as reduced DNA content attributed to apoptosis-associated changes in chromatin structure. Apoptosis was confirmed by light microscopy, electron microscopy, and by the use of commercially available apoptosis detection kits (in situ nick translation and Annexin V). Data from hypersensitive individuals were compared to a standard database of 105 healthy blood-donors, and a database of 48 cancer patient blood donors who displayed normal toxicity to radiation therapy. To integrate radiosensitivity results from CD4 and CD8 T-lymphocytes after 2 and 9 Gy, z-score analyses were performed. RESULTS: A cohort of 12 hypersensitive patients was evaluated; 8 showed enhanced early toxicity, 3 showed enhanced late toxicity, and 1 showed both. The cohort displayed less radiation-induced apoptosis (-1.8 sigma) than average age-matched donors. A cohort of 9 ataxia telangiectasia homozygotes displayed even less apoptosis (-3.6 sigma). CONCLUSION: The leukocyte apoptosis assay appears to be a useful predictor of individuals likely to display increased toxicity to radiation therapy; however, validation of this requires a prospective study.
Asunto(s)
Apoptosis , Linfocitos T CD4-Positivos/efectos de la radiación , Linfocitos T CD8-positivos/efectos de la radiación , Tolerancia a Radiación , Adulto , Anciano , Anciano de 80 o más Años , Apoptosis/genética , Ataxia Telangiectasia/sangre , Ataxia Telangiectasia/genética , Linfocitos T CD4-Positivos/fisiología , Linfocitos T CD8-positivos/fisiología , Estudios de Cohortes , ADN/efectos de la radiación , Fragmentación del ADN , Homocigoto , Humanos , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Spontaneous tumours in dogs and cats are an excellent model for clinical human research, such as in developing proton conformation radiotherapy for humans. The kinetics of tumour cells can be used effectively to predict prognosis and response to therapy in patients with tumours. Knowledge of the kinetic parameters in these tumours is therefore important. In the present study the kinetic parameters evaluated included the labelling index (LI), relative movement (RM), mitotic index (MI), and potential doubling time (Tpot). These parameters were determined using in vivo labelling with bromodeoxyuridine, flow cytometry and histological preparation. Samples were obtained and evaluated from 72 dogs and 20 cats, presenting as patients in our clinic. Within the groups of epithelial and mesenchymal tumours from dogs and cats, the kinetic parameters LI, RM and MI were compared with Tpot. Significant correlations were observed for the comparison Tpot and LI. No correlation was found between Tpot and RM.