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Good Timing Matters: The Spatially Fractionated High Dose Rate Boost Should Come First

SIMPLE SUMMARY: The administration of X-rays with therapeutic intent (radiotherapy) can cause severe unwanted adverse effects in tissues other than those that were the intended radiation target, such as tissues located in the path of the beam or close to the target region. The results of small anima...

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Autores principales: Schültke, Elisabeth, Jaekel, Felix, Bartzsch, Stefan, Bräuer-Krisch, Elke, Requardt, Herwig, Laissue, Jean Albert, Blattmann, Hans, Hildebrandt, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9738329/
https://www.ncbi.nlm.nih.gov/pubmed/36497446
http://dx.doi.org/10.3390/cancers14235964
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author Schültke, Elisabeth
Jaekel, Felix
Bartzsch, Stefan
Bräuer-Krisch, Elke
Requardt, Herwig
Laissue, Jean Albert
Blattmann, Hans
Hildebrandt, Guido
author_facet Schültke, Elisabeth
Jaekel, Felix
Bartzsch, Stefan
Bräuer-Krisch, Elke
Requardt, Herwig
Laissue, Jean Albert
Blattmann, Hans
Hildebrandt, Guido
author_sort Schültke, Elisabeth
collection PubMed
description SIMPLE SUMMARY: The administration of X-rays with therapeutic intent (radiotherapy) can cause severe unwanted adverse effects in tissues other than those that were the intended radiation target, such as tissues located in the path of the beam or close to the target region. The results of small animal studies suggest that the risk for adverse effects may be significantly reduced if the X-ray dose is administered extremely fast, as the so-called high dose rate radiotherapy. Microbeam irradiation and pencilbeam irradiation are two new experimental concepts of high dose rate radiotherapy with spatial dose fractionation at the micrometre range. The results of our studies show how the inclusion of these concepts into a conventional broad beam radiotherapy schedule could improve cancer radiotherapy for patients with malignant brain tumours. ABSTRACT: Monoplanar microbeam irradiation (MBI) and pencilbeam irradiation (PBI) are two new concepts of high dose rate radiotherapy, combined with spatial dose fractionation at the micrometre range. In a small animal model, we have explored the concept of integrating MBI or PBI as a simultaneously integrated boost (SIB), either at the beginning or at the end of a conventional, low-dose rate schedule of 5x4 Gy broad beam (BB) whole brain radiotherapy (WBRT). MBI was administered as array of 50 µm wide, quasi-parallel microbeams. For PBI, the target was covered with an array of 50 µm × 50 µm pencilbeams. In both techniques, the centre-to-centre distance was 400 µm. To assure that the entire brain received a dose of at least 4 Gy in all irradiated animals, the peak doses were calculated based on the daily BB fraction to approximate the valley dose. The results of our study have shown that the sequence of the BB irradiation fractions and the microbeam SIB is important to limit the risk of acute adverse effects, including epileptic seizures and death. The microbeam SIB should be integrated early rather than late in the irradiation schedule.
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spelling pubmed-97383292022-12-11 Good Timing Matters: The Spatially Fractionated High Dose Rate Boost Should Come First Schültke, Elisabeth Jaekel, Felix Bartzsch, Stefan Bräuer-Krisch, Elke Requardt, Herwig Laissue, Jean Albert Blattmann, Hans Hildebrandt, Guido Cancers (Basel) Article SIMPLE SUMMARY: The administration of X-rays with therapeutic intent (radiotherapy) can cause severe unwanted adverse effects in tissues other than those that were the intended radiation target, such as tissues located in the path of the beam or close to the target region. The results of small animal studies suggest that the risk for adverse effects may be significantly reduced if the X-ray dose is administered extremely fast, as the so-called high dose rate radiotherapy. Microbeam irradiation and pencilbeam irradiation are two new experimental concepts of high dose rate radiotherapy with spatial dose fractionation at the micrometre range. The results of our studies show how the inclusion of these concepts into a conventional broad beam radiotherapy schedule could improve cancer radiotherapy for patients with malignant brain tumours. ABSTRACT: Monoplanar microbeam irradiation (MBI) and pencilbeam irradiation (PBI) are two new concepts of high dose rate radiotherapy, combined with spatial dose fractionation at the micrometre range. In a small animal model, we have explored the concept of integrating MBI or PBI as a simultaneously integrated boost (SIB), either at the beginning or at the end of a conventional, low-dose rate schedule of 5x4 Gy broad beam (BB) whole brain radiotherapy (WBRT). MBI was administered as array of 50 µm wide, quasi-parallel microbeams. For PBI, the target was covered with an array of 50 µm × 50 µm pencilbeams. In both techniques, the centre-to-centre distance was 400 µm. To assure that the entire brain received a dose of at least 4 Gy in all irradiated animals, the peak doses were calculated based on the daily BB fraction to approximate the valley dose. The results of our study have shown that the sequence of the BB irradiation fractions and the microbeam SIB is important to limit the risk of acute adverse effects, including epileptic seizures and death. The microbeam SIB should be integrated early rather than late in the irradiation schedule. MDPI 2022-12-02 /pmc/articles/PMC9738329/ /pubmed/36497446 http://dx.doi.org/10.3390/cancers14235964 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schültke, Elisabeth
Jaekel, Felix
Bartzsch, Stefan
Bräuer-Krisch, Elke
Requardt, Herwig
Laissue, Jean Albert
Blattmann, Hans
Hildebrandt, Guido
Good Timing Matters: The Spatially Fractionated High Dose Rate Boost Should Come First
title Good Timing Matters: The Spatially Fractionated High Dose Rate Boost Should Come First
title_full Good Timing Matters: The Spatially Fractionated High Dose Rate Boost Should Come First
title_fullStr Good Timing Matters: The Spatially Fractionated High Dose Rate Boost Should Come First
title_full_unstemmed Good Timing Matters: The Spatially Fractionated High Dose Rate Boost Should Come First
title_short Good Timing Matters: The Spatially Fractionated High Dose Rate Boost Should Come First
title_sort good timing matters: the spatially fractionated high dose rate boost should come first
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9738329/
https://www.ncbi.nlm.nih.gov/pubmed/36497446
http://dx.doi.org/10.3390/cancers14235964
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