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Molecular Oncology Jul 2020Particle therapy using protons or heavier ions is currently the most advanced form of radiotherapy and offers new opportunities for improving cancer care and research.... (Review)
Review
Particle therapy using protons or heavier ions is currently the most advanced form of radiotherapy and offers new opportunities for improving cancer care and research. Ions deposit the dose with a sharp maximum - the Bragg peak - and normal tissue receives a much lower dose than what is delivered by X-ray therapy. Particle therapy has also biological advantages due to the high linear energy transfer of the charged particles around the Bragg peak. The introduction of particle therapy has been slow in Europe, but within the last decade, more than 20 clinical facilities have opened and facilitated access to this frontline therapy. In this review article, the basic concepts of particle therapy are reviewed along with a presentation of the current clinical indications, the European clinical research, and the established networks.
Topics: Cooperative Behavior; Databases as Topic; Europe; Heavy Ion Radiotherapy; Humans; Proton Therapy; Randomized Controlled Trials as Topic
PubMed: 32223048
DOI: 10.1002/1878-0261.12677 -
Canadian Urological Association Journal... Feb 2023Medical imaging involving ionizing radiation is common in the clinical setting. Little is known about the level of radiation safety training for medical trainees and...
INTRODUCTION
Medical imaging involving ionizing radiation is common in the clinical setting. Little is known about the level of radiation safety training for medical trainees and attending physicians. We sought to identify the level of radiation safety knowledge and training at the undergraduate, postgraduate, and attending physician level.
METHODS
A 29-question survey was sent by email to two sites in Canada. We pooled the results of medical students, residents, and attending physicians. The primary outcome was to describe the amount of radiation safety training among these groups. The secondary outcomes were to describe the frequency of radiation exposure, level of radiation knowledge, and preferred training method for radiation safety.
RESULTS
Of 115 surveys that were properly completed, 31 (26.9%) medical students, 17 (14.7%) residents, and 67 (58.3%) attending physicians responded. A greater number of medical students (41.9%) reported they had zero hours of training time for radiation safety compared to attending physicians (14.9%) (p<0.05). A higher number of attending physicians (47.8%) and residents (64.7%) participated in patient care involving fluoroscopy daily or at least several times per week compared to medical students (3.2%) (p<0.001). Attending physicians had the greatest number of correct responses to radiation safety questions. Online courses and workshops were the preferred training methods.
CONCLUSIONS
Radiation safety training is an important component of medical education for medical trainees and attending physicians. Current radiation safety training requirements and procedures at various levels of medical training in Canada should be addressed. Implementing radiation safety education may improve adherence to the radiation safety principles.
PubMed: 36218313
DOI: 10.5489/cuaj.8087 -
Advances in Clinical and Experimental... Jun 2022Radiotherapy is the main treatment for nasopharyngeal carcinoma. The radioresistance mechanism of cells is related to miRNAs.
BACKGROUND
Radiotherapy is the main treatment for nasopharyngeal carcinoma. The radioresistance mechanism of cells is related to miRNAs.
OBJECTIVES
To investigate the miRNA profiling of HONE1 and CNE2 after X-ray therapy.
MATERIAL AND METHODS
The HONE1 and CNE2 cells were treated with X-ray at 4 Gy, 8 Gy, 16 Gy, and 20 Gy doses. The cell lines CNE2 with the best therapy effects and HONE1 with the worst therapy effects were screened out. Apoptosis and cell viability were detected with flow cytometry and Cell Counting Kit-8 (CCK-8). High-throughput sequencing was performed. A miRNA library was constructed. The miRNA annotation expression distribution, family prediction and target gene interaction, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were conducted.
RESULTS
The 24-hour 20 Gy dose X-rays were selected as the optimal therapy conditions. The CNE2_C, CNE2_M, HONE1_C and HONE1_M miRNAs accounted for 26.5%, 31.7%, 21.3%, and 22.9% of the Cleandata reads count, respectively, and the contents of rRNAs accounted for 24.9%, 14.7%, 25.1%, and 25.1% of the Cleandata reads count, respectively. The miRNAs with differential expression between the HONE1 and CNE2 cell lines including hsa-miR-21-5p, hsa-let-7a-5p, hsa-miR-125a-5p, hsa-miR-26a-5p, hsa-let-7f-5p, hsa-miR-20a-5p, and hsa-miR-24a-3p. There were also differentially expressed miRNAs in HONE1_C vs. HONE1_M, such as hsa-miR-21-5p and hsa-let-7i-5p. The differentially expressed miRNA in CNE2_C vs. CNE2_M was hsa-miR-148b-3p. The Gene Ontology analysis showed that the differentially expressed miRNA interacting genes in HONE1_M vs. CNE2_M were mainly enriched in biological process such as negative and positive regulation of transcription from RNA polymerase II promoter, cellular component such as cytosol and molecular function such as protein binding factor. The KEGG pathway analysis revealed that the differentially expressed miRNA interacting genes in HONE1_M vs. CNE2_M were enriched in the cancer-related pathways, such as pathways in cancer, MAPK signaling pathway and Wnt signaling pathway.
CONCLUSIONS
Twelve miRNAs and 9 genes which contribute to X-ray radiation resistance were identified. Among those with differential expression between the HONE1 and CNE2 cell lines, which played a regulatory role in multiple pathways, were hsa-miR-20a-5p, hsa-let-7a-5p, hsa-let-7f5p, hsa-let-7i-5p, hsa-miR-30e-5p, hsa-miR-148b-3p, and hsa-miR-200c-3p. The corresponding genes were MAPK1, SOS1, TGFBR1, TGFBR2, TP53, CASP3, CCNE2, PTEN, and CDK2.
Topics: Cell Line, Tumor; Gene Expression Profiling; Humans; MicroRNAs; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms
PubMed: 35275451
DOI: 10.17219/acem/146580 -
Buffalo Medical Journal Feb 1915
PubMed: 36887775
DOI: No ID Found -
Journal of Clinical Oncology : Official... Nov 2009The purpose of this study was to compare the outcome of patients with intermediate-risk rhabdomyosarcoma (RMS) treated with standard VAC (vincristine, dactinomycin, and... (Randomized Controlled Trial)
Randomized Controlled Trial
Vincristine, actinomycin, and cyclophosphamide compared with vincristine, actinomycin, and cyclophosphamide alternating with vincristine, topotecan, and cyclophosphamide for intermediate-risk rhabdomyosarcoma: children's oncology group study D9803.
PURPOSE
The purpose of this study was to compare the outcome of patients with intermediate-risk rhabdomyosarcoma (RMS) treated with standard VAC (vincristine, dactinomycin, and cyclophosphamide) chemotherapy to that of patients treated with VAC alternating with vincristine, topotecan, and cyclophosphamide (VAC/VTC).
PATIENTS AND METHODS
Patients were randomly assigned to 39 weeks of VAC versus VAC/VTC; local therapy began after week 12. Patients with parameningeal RMS with intracranial extension (PME) were treated with VAC and immediate x-ray therapy. The primary study end point was failure-free survival (FFS). The study was designed with 80% power (5% two-sided alpha level) to detect an increase in 5-year FFS from 64% to 75% with VAC/VTC.
RESULTS
A total of 617 eligible patients were entered onto the study: 264 were randomly assigned to VAC and 252 to VAC/VTC; 101 PME patients were nonrandomly treated with VAC. Treatment strata were embryonal RMS, stage 2/3, group III (33%); embryonal RMS, group IV, less than age 10 years (7%); alveolar RMS or undifferentiated sarcoma (UDS), stage 1 or group I (17%); alveolar RMS/UDS (27%); and PME (16%). At a median follow-up of 4.3 years, 4-year FFS was 73% with VAC and 68% with VAC/VTC (P = .3). There was no difference in effect of VAC versus VAC/VTC across risk groups. The frequency of second malignancies was similar between the two treatment groups.
CONCLUSION
For intermediate-risk RMS, VAC/VTC does not significantly improve FFS compared with VAC.
Topics: Antineoplastic Combined Chemotherapy Protocols; Child; Child, Preschool; Cyclophosphamide; Dactinomycin; Disease-Free Survival; Female; Humans; Infant; Kaplan-Meier Estimate; Male; Neoplasm Staging; Rhabdomyosarcoma; Topotecan; Vincristine
PubMed: 19770373
DOI: 10.1200/JCO.2009.22.3768 -
Journal of Radiation Research Jun 2023Japanese national oncological experts convened to evaluate the efficacy and safety of particle beam therapy (PT) for pulmonary, liver and lymph node oligometastases...
Comprehensive analysis of Japanese nationwide cohort data of particle beam therapy for pulmonary, liver and lymph node oligometastases: particle beam therapy versus high-precision X-ray radiotherapy.
Japanese national oncological experts convened to evaluate the efficacy and safety of particle beam therapy (PT) for pulmonary, liver and lymph node oligometastases (P-OM, L-OM and LN-OM, respectively) and to conduct a statistically comparative analysis of the local control (LC) rate and overall survival (OS) rate of PT versus those of X-ray stereotactic body radiotherapy (X-SBRT) and X-ray intensity-modulated radiotherapy (X-IMRT). They conducted [1] an analysis of the efficacy and safety of metastasis-directed therapy with PT for P-OM, L-OM and LN-OM using a Japanese nationwide multi-institutional cohort study data set; [2] a systematic review of X-ray high-precision radiotherapy (i.e. X-SBRT/X-IMRT) and PT for P-OM, L-OM and LN-OM; and [3] a statistical comparison between LC and OS of the cohort data set in PT and that of the extracted historical data set in X-SBRT/X-IMRT from the preceding systematic review. Safety was evaluated as the incidence of grade ≥ 3 adverse events, while statistical comparisons of LC and OS were conducted by estimating the incidence rate ratios (IRR) for local progression and mortality, respectively. This study demonstrated that PT provided durable LC (3-year LC rate: 72.8-83.2%) with acceptable OS (3-year OS rate: 38.5-68.1%) and risk of severe toxicity incidence of 0.8-3.5% in radical metastasis-directed therapy for P-OM, L-OM and LN-OM. Compared to LC with X-SBRT or X-IMRT, LC with PT was potentially superior for P-OM; superior for L-OM; and equivalent for LN-OM. In particular, this study demonstrated that PT may be a new treatment option for L-OM tumors measuring > 5 cm.
Topics: Humans; Cohort Studies; East Asian People; Liver; Radiosurgery; Retrospective Studies; Treatment Outcome; X-Rays; Neoplasm Metastasis
PubMed: 37053162
DOI: 10.1093/jrr/rrad004 -
PloS One 2016This work investigates X-PACT (X-ray Psoralen Activated Cancer Therapy): a new approach for the treatment of solid cancer. X-PACT utilizes psoralen, a potent anti-cancer...
This work investigates X-PACT (X-ray Psoralen Activated Cancer Therapy): a new approach for the treatment of solid cancer. X-PACT utilizes psoralen, a potent anti-cancer therapeutic with current application to proliferative disease and extracorporeal photopheresis (ECP) of cutaneous T Cell Lymphoma. An immunogenic role for light-activated psoralen has been reported, contributing to long-term clinical responses. Psoralen therapies have to-date been limited to superficial or extracorporeal scenarios due to the requirement for psoralen activation by UVA light, which has limited penetration in tissue. X-PACT solves this challenge by activating psoralen with UV light emitted from novel non-tethered phosphors (co-incubated with psoralen) that absorb x-rays and re-radiate (phosphoresce) at UV wavelengths. The efficacy of X-PACT was evaluated in both in-vitro and in-vivo settings. In-vitro studies utilized breast (4T1), glioma (CT2A) and sarcoma (KP-B) cell lines. Cells were exposed to X-PACT treatments where the concentrations of drug (psoralen and phosphor) and radiation parameters (energy, dose, and dose rate) were varied. Efficacy was evaluated primarily using flow cell cytometry in combination with complimentary assays, and the in-vivo mouse study. In an in-vitro study, we show that X-PACT induces significant tumor cell apoptosis and cytotoxicity, unlike psoralen or phosphor alone (p<0.0001). We also show that apoptosis increases as doses of phosphor, psoralen, or radiation increase. Finally, in an in-vivo pilot study of BALBc mice with syngeneic 4T1 tumors, we show that the rate of tumor growth is slower with X-PACT than with saline or AMT + X-ray (p<0.0001). Overall these studies demonstrate a potential therapeutic effect for X-PACT, and provide a foundation and rationale for future studies. In summary, X-PACT represents a novel treatment approach in which well-tolerated low doses of x-ray radiation are delivered to a specific tumor site to generate UVA light which in-turn unleashes both short- and potentially long-term antitumor activity of photo-active therapeutics like psoralen.
Topics: Animals; Apoptosis; Cell Line, Tumor; Cell Transformation, Neoplastic; Dose-Response Relationship, Radiation; Ficusin; Mice; Neoplasms; X-Ray Therapy
PubMed: 27583569
DOI: 10.1371/journal.pone.0162078 -
Journal of Gastrointestinal Oncology Feb 2020Proton beam therapy (PBT) delivers less dose to nearby normal organs compared to X-ray therapy (XRT), which is particularly relevant for treating liver cancers given... (Review)
Review
Proton beam therapy (PBT) delivers less dose to nearby normal organs compared to X-ray therapy (XRT), which is particularly relevant for treating liver cancers given that both mean and low liver dose are among the most significant predictors of radiation induced liver disease (RILD). High-dose PBT has been shown to achieve excellent long-term tumor control with minimal toxicity in hepatocellular carcinoma (HCC) patients. Increasing data support ablative PBT for patients with unresectable cholangiocarcinoma or liver metastases, especially those with larger tumors not suitable for XRT.
PubMed: 32175119
DOI: 10.21037/jgo.2019.04.02 -
Journal of Radiation Research Jul 2022Castration-resistant prostate cancer shows resistance to not only androgen deprivation therapy (ADT) but also X-ray therapy. On the other hand, carbon ion beams have a...
Castration-resistant prostate cancer shows resistance to not only androgen deprivation therapy (ADT) but also X-ray therapy. On the other hand, carbon ion beams have a high biological effect and are used for various cancers showing resistance to X-ray therapy. The purposes of this study are to clarify the difference in the sensitivity of Castration-resistant prostate cancer to X-ray and carbon ion beams and to elucidate the mechanism. The androgen-insensitive prostate cancer cell line LNCaP-LA established by culturing the androgen-sensitive prostate cancer cell line LNCaP for 2 years in androgen-free medium was used for this study. First, colony formation assays were performed to investigate its sensitivity to X-ray and carbon ion beams. Next, DNA mutation analysis on 409 cancer-related genes and comprehensive transcriptome analysis (RNA-seq) were performed with a next-generation sequencer. Lethal dose 50 values of X-rays for LNCaP and LNCaP-LA were 1.4 Gy and 2.8 Gy, respectively (P < 0.01). The Lethal dose 50 values of carbon ion beams were 0.9 Gy and 0.7 Gy, respectively (P = 0.09). On DNA mutation analysis, AR mutation was observed specifically in LNCaP-LA. From RNA-seq, 181 genes were identified as differentially expressed genes (DEGs; FDR <0.10, P < 0.00076) between LNCaP and LNCaP-LA. Function analysis suggested that cell death was suppressed in LNCaP-LA, and pathway analysis suggested that the NRF2-pathway involved in intracellular oxidative stress prevention was activated in LNCaP-LA. LNCaP-LA showed X-ray resistance compared to LNCaP and sensitivity to carbon ion beams. The AR mutation and the NRF2-pathway were suggested as causes of resistance.
Topics: Androgen Antagonists; Carbon; Castration; Cell Line, Tumor; DNA; Humans; Male; NF-E2-Related Factor 2; Prostatic Neoplasms; Prostatic Neoplasms, Castration-Resistant; Receptors, Androgen; X-Rays
PubMed: 35589101
DOI: 10.1093/jrr/rrac022 -
Chinese Clinical Oncology Sep 2017Stereotactic body radiation therapy (SBRT) stems from the initial developments of intra-cranial stereotactic radiosurgery (SRS). Despite similarity in their names and... (Review)
Review
Stereotactic body radiation therapy (SBRT) stems from the initial developments of intra-cranial stereotactic radiosurgery (SRS). Despite similarity in their names and clinical goals of delivering a sufficiently high tumoricidal dose, maximal sparing of the surrounding normal tissues and a short treatment course, SBRT technologies have transformed from the early days of body frame-based treatments with X-ray verification to primarily image-guided procedures with cone-beam CT or stereoscopic X-ray systems and non-rigid body immo-bilization. As a result of the incorporation of image-guidance systems and multi-leaf col-limators into mainstream linac systems, and treatment planning systems that have also evolved to allow for routine dose calculations to permit intensity modulated radiotherapy and volumetric modulated arc therapy (VMAT), SBRT has disseminated rapidly in the community to manage many disease sites that include oligometastases, spine lesions, lung, prostate, liver, renal cell, pelvic tumors, and head and neck tumors etc. In this article, we review the physical principles and paradigms that led to the widespread adoption of SBRT practice as well as technical caveats specific to individual SBRT technologies. From the perspective of treatment delivery, we categorically described (I) C-arm linac-based SBRT technologies; (II) robotically manipulated X-band CyberKnife® technology; and (III) emerging specialized systems for SBRT that include integrated MRI-linear accelerators and the imaged-guided Gamma Knife Perfexion Icon system with expanded multi-isocenter treatments of skull-based tumors, head-and-neck and cervical-spine lesions.
Topics: Cone-Beam Computed Tomography; Humans; Male; Neoplasms; Radiosurgery; Radiotherapy; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Conformal; Radiotherapy, Image-Guided; Radiotherapy, Intensity-Modulated
PubMed: 28917250
DOI: 10.21037/cco.2017.06.19