Physical and Biological Characteristics of Particle Therapy for Oncologists

Byun, Hwa Kyung; Han, Min Cheol; Yang, Kyung Mi; Kim, Jin Sung; Yoo, Gyu Sang; Koom, Woong Sub; Kim, Yong Bae

doi:10.4143/crt.2021.066

Cited by 36 publications

(23 citation statements)

References 46 publications

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“…Reports dating as far back as 1902–1904 corroborate the application of radium in treating neck carcinomas and delivering radiation through glass tubes placed in close proximity to the tumors—a precursor of interstitial brachytherapy [ 3 ]. At present, photon beam radiotherapy in the form of low-LET X-rays is the standard and most widely used treatment in clinical settings worldwide [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

DNA Damage Clustering after Ionizing Radiation and Consequences in the Processing of Chromatin Breaks

et al. 2022

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Charged-particle radiotherapy (CPRT) utilizing low and high linear energy transfer (low-/high-LET) ionizing radiation (IR) is a promising cancer treatment modality having unique physical energy deposition properties. CPRT enables focused delivery of a desired dose to the tumor, thus achieving a better tumor control and reduced normal tissue toxicity. It increases the overall radiation tolerance and the chances of survival for the patient. Further improvements in CPRT are expected from a better understanding of the mechanisms governing the biological effects of IR and their dependence on LET. There is increasing evidence that high-LET IR induces more complex and even clustered DNA double-strand breaks (DSBs) that are extremely consequential to cellular homeostasis, and which represent a considerable threat to genomic integrity. However, from the perspective of cancer management, the same DSB characteristics underpin the expected therapeutic benefit and are central to the rationale guiding current efforts for increased implementation of heavy ions (HI) in radiotherapy. Here, we review the specific cellular DNA damage responses (DDR) elicited by high-LET IR and compare them to those of low-LET IR. We emphasize differences in the forms of DSBs induced and their impact on DDR. Moreover, we analyze how the distinct initial forms of DSBs modulate the interplay between DSB repair pathways through the activation of DNA end resection. We postulate that at complex DSBs and DSB clusters, increased DNA end resection orchestrates an increased engagement of resection-dependent repair pathways. Furthermore, we summarize evidence that after exposure to high-LET IR, error-prone processes outcompete high fidelity homologous recombination (HR) through mechanisms that remain to be elucidated. Finally, we review the high-LET dependence of specific DDR-related post-translational modifications and the induction of apoptosis in cancer cells. We believe that in-depth characterization of the biological effects that are specific to high-LET IR will help to establish predictive and prognostic signatures for use in future individualized therapeutic strategies, and will enhance the prospects for the development of effective countermeasures for improved radiation protection during space travel.

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Section: Introductionmentioning

confidence: 99%

DNA Damage Clustering after Ionizing Radiation and Consequences in the Processing of Chromatin Breaks

et al. 2022

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“…As other highly conformal photon therapy techniques, PBT is indicated for tumors located close to serial organs, where a small radiation overdose can lead to severe complications. Irregular shaped lesions close to critical structures are suitable for proton radiotherapy treatment [3,8].…”

Section: Proton Therapy For Different Cancersmentioning

confidence: 99%

Proton beam therapy

et al. 2021

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Proton beam therapy (PBT) is an advanced type of radiotherapy that shows a dosimetric advantage over photon beam therapy and provides superior dose distribution. PBT may improve patient survival by improving the local disease control while reducing toxicity to normal organs, which may result in fewer treatment related complications. During the last decade technological progress opened up new possibilities in the planning and conducting PBT, so indications were gradually expanded to different cancers. However, many biological aspects of PBT are still unclear, and its role in clinical settings is controversial. Proton therapy is considered to be safe and effective for different types of pediatric cancers, and that it is suitable in treatment of ocular melanomas, chordomas and chondrosarcomas. Future research and more prospective clinical studies with long term follow up are required in order to clearly determine the benefits and proper indications for PBT.

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“…Radiation therapy must deliver the prescribed dose to the target volume while avoiding excessive exposure to normal organs. Particle [e.g., proton ( 1 ), carbon-ion ( 2 )] therapy (PT) provides sharper dose distributions compared to conventional X-ray therapy by utilising the Bragg peak ( 3 ). Moreover, compared to conventional radiation treatments, PT enables dose escalation which improves tumour control rates and minimizes radiation exposure to organs at risk (OAR) ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Dosimetric comparison of robust angles in carbon-ion radiation therapy for prostate cancer

Shin

Kim²,

Han³

et al. 2023

Front. Oncol.

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The objective of this study is to compare the plan robustness at various beam angles. Hence, the influence of the beam angles on robustness and linear energy transfer (LET) was evaluated in gantry-based carbon-ion radiation therapy (CIRT) for prostate cancer. 10 patients with prostate cancer were considered, and a total dose of 51.6 Gy (Relative biological effectiveness (RBE) was prescribed for the target volume in 12 fractions. Five beam field plans comprising two opposed fields with different angle pairs were characterized. Further, dose parameters were extracted, and the RBE-weighted dose and LET values for all angle pairs were compared. All plans considering the setup uncertainty satisfied the dose regimen. When a parallel beam pair was used for perturbed scenarios to take into account set-up uncertainty in the anterior direction, the LET clinical treatment volume (CTV) D95% standard deviation was 1.5 times higher, and the standard deviation of RBE-weighted CTV D95% was 7.9 times higher compared to an oblique pair. The oblique beam fields were superior in terms of dose sparing for the rectum compared to the dose distribution using two conventional lateral opposed fields for prostate cancer.

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Physical and Biological Characteristics of Particle Therapy for Oncologists

Cited by 36 publications

References 46 publications

DNA Damage Clustering after Ionizing Radiation and Consequences in the Processing of Chromatin Breaks

DNA Damage Clustering after Ionizing Radiation and Consequences in the Processing of Chromatin Breaks

Proton beam therapy

Dosimetric comparison of robust angles in carbon-ion radiation therapy for prostate cancer

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