Cardiac radioablation—A systematic review

Ree, Martijn H. van der; Blanck, Oliver; Limpens, Jacqueline; Lee, Charlie H.; Balgobind, Brian V.; Dieleman, Edith; Wilde, Arthur A.M.; Zei, Paul C.; Groot, Joris R. de; Slotman, Ben J.; Cuculich, Phillip S.; Robinson, Clifford G.; Postema, Pieter G.

doi:10.1016/j.hrthm.2020.03.013

Cited by 114 publications

(116 citation statements)

References 36 publications

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“…An exception to this rule is the treatment of noncancer diseases, where actually the Bragg peak delivers high doses, generally in single fractions, to small normal tissue volumes [ 110 ]. This topic is now growing especially for non-invasive treatment of cardiac arrhythmias, already in clinical trials with SBRT [ 111 , 112 ]. Pre-clinical studies with C-ions therapy in a swine model gave excellent results [ 113 , 114 ].…”

Section: Rbementioning

confidence: 99%

Carbon Ion Radiobiology

Tinganelli

Durante

2020

Cancers

158

134

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Radiotherapy using accelerated charged particles is rapidly growing worldwide. About 85% of the cancer patients receiving particle therapy are irradiated with protons, which have physical advantages compared to X-rays but a similar biological response. In addition to the ballistic advantages, heavy ions present specific radiobiological features that can make them attractive for treating radioresistant, hypoxic tumors. An ideal heavy ion should have lower toxicity in the entrance channel (normal tissue) and be exquisitely effective in the target region (tumor). Carbon ions have been chosen because they represent the best combination in this direction. Normal tissue toxicities and second cancer risk are similar to those observed in conventional radiotherapy. In the target region, they have increased relative biological effectiveness and a reduced oxygen enhancement ratio compared to X-rays. Some radiobiological properties of densely ionizing carbon ions are so distinct from X-rays and protons that they can be considered as a different “drug” in oncology, and may elicit favorable responses such as an increased immune response and reduced angiogenesis and metastatic potential. The radiobiological properties of carbon ions should guide patient selection and treatment protocols to achieve optimal clinical results.

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Section: Rbementioning

confidence: 99%

Carbon Ion Radiobiology

Tinganelli

Durante

2020

Cancers

158

134

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“…Yet, the underlying electrophysiologic effects of the fibroting and sub-fibroting doses (e.g., <30 Gy) remained unknown beyond healthy animal models. Some additional data could be obtained from pre-clinical studies with carbon ions or protons whose radiobiology might be slightly different as compared to photons (57). Of note, pre-clinical data about scar development at the ventricular level (temporal onset and dose-response relationship) after high dose irradiation are very limited since most studies reported data about atrial tissue (pulmonary veins or cavo-tricuspid isthmus) or AV node irradiation.…”

Section: From Pre-clinical Data To First Patientsmentioning

confidence: 99%

Stereotactic Radiotherapy for the Management of Refractory Ventricular Tachycardia: Promise and Future Directions

Jumeau

Özşahin

Schwitter

et al. 2020

Front. Cardiovasc. Med.

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Ventricular tachycardia (VT) caused by myocardial scaring bears a significant risk of mortality and morbidity. Antiarrhythmic drug therapy (AAD) and catheter ablation remain the cornerstone of VT management, but both treatments have limited efficacy and potential adverse effects. Stereotactic body radiotherapy (SBRT) is routinely used in oncology to treat non-invasively solid tumors with high precision and efficacy. Recently, this technology has been evaluated for the treatment of VT. This review presents the basic underlying principles, proof of concept, and main results of trials and case series that used SBRT for the treatment of VT refractory to AAD and catheter ablation.

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“…As shown in Figure 3, the same PET camera was recently used for irradiation of AV nodes and ventricles in swine hearts at GSI [47]. Radiotherapy for treatment of heart arrhythmia is considered a very promising non-invasive alternative to catheter ablation [65], and recent results with stereotactic radiosurgery for ventricular arrhythmia are very encouraging [66]. Charged particles are potentially much more effective for these kinds of treatment [67] because they require single high doses, and with X-rays, this can cause severe toxicity in the normal heart and other surrounding critical structures such as esophagus and lungs.…”

Section: Gsimentioning

confidence: 99%

Radioactive Beams in Particle Therapy: Past, Present, and Future

Durante

Parodi

2020

Front. Phys.

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Heavy ion therapy can deliver high doses with high precision. However, image guidance is needed to reduce range uncertainty. Radioactive ions are potentially ideal projectiles for radiotherapy because their decay can be used to visualize the beam. Positron-emitting ions that can be visualized with PET imaging were already studied for therapy application during the pilot therapy project at the Lawrence Berkeley Laboratory, and later within the EULIMA EU project, the GSI therapy trial in Germany, MEDICIS at CERN, and at HIMAC in Japan. The results show that radioactive ion beams provide a large improvement in image quality and signal-to-noise ratio compared to stable ions. The main hindrance toward a clinical use of radioactive ions is their challenging production and the low intensities of the beams. New research projects are ongoing in Europe and Japan to assess the advantages of radioactive ion beams for therapy, to develop new detectors, and to build sources of radioactive ions for medical synchrotrons.

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Cardiac radioablation—A systematic review

Cited by 114 publications

References 36 publications

Carbon Ion Radiobiology

Carbon Ion Radiobiology

Stereotactic Radiotherapy for the Management of Refractory Ventricular Tachycardia: Promise and Future Directions

Radioactive Beams in Particle Therapy: Past, Present, and Future

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