Wellman Center for Photomedicine, Massachusetts General Hospital/Harvard Medical School, Boston, United States.
Radiation Monitoring Devices, Inc., Watertown, United States.
Radiother Oncol. 2018 Dec;129(3):589-594. doi: 10.1016/j.radonc.2018.06.016. Epub 2018 Jun 29.
Radiation therapy is the gold standard treatment for inoperable malignant tumors. However, due to the heterogeneity of the tumor, some regions are more radio resistant and can lead to metastasis and tumor recurrence. In this study, we propose combining traditional X-ray treatment with UVC-emitting LuPO:Pr nanoparticles (NPs) to increase the tumor control as well as to reduce tumor recurrence and metastasis. These NPs convert ionizing radiation into UVC-photons (UVC range: 200-280 nm) locally at the tumor site. Unlike X-ray, UVC-photons damage DNA directly via an oxygen-independent mechanism, which could improve treatment of radioresistant tumors such as hypoxic tumors.
The effect of X-ray generated UVC-photons was tested on human fibroblasts incubated with NPs prior to radiation treatment. The surviving fraction of the cells was assessed by means of colony formation assay. Experiments were performed on normal and UVC sensitive cell lines to demonstrate the presence of UVC photons during treatment. In addition, UV-specific DNA damages were investigated using an immunofluorescence assay to measure cyclopyrimidine dimers (CPDs).
Combined treatment showed an increased cell death of over 50%, compared to radiation alone. This results in a dose equivalent of 4 Gy for the combined treatment with 2 Gy irradiation. The formation of CPDs and the increased effect on UV sensitive cells indicate the presence of UV photons. The generated amount of CPDs is comparable to an UVC exposure of about 15 J × m.
Combining NPs with ionizing radiation results in a localized dose surge, which could increase tumor control. It could also allow lowering the total applied dose to minimize unwanted side effects to the surrounding normal tissue while maintaining tumor control.
放射疗法是治疗不可手术的恶性肿瘤的金标准。然而,由于肿瘤的异质性,一些区域对辐射的抵抗力更强,可能导致转移和肿瘤复发。在这项研究中,我们提出将传统的 X 射线治疗与发射 UVC 光的 LuPO:Pr 纳米粒子(NPs)结合使用,以提高肿瘤控制率,并降低肿瘤复发和转移的风险。这些 NPs 可将电离辐射转化为局部肿瘤部位的 UVC 光子(UVC 范围:200-280nm)。与 X 射线不同,UVC 光子通过非氧依赖机制直接损伤 DNA,这可以改善缺氧肿瘤等放射抗性肿瘤的治疗效果。
在进行放射治疗之前,将 NPs 孵育于人类成纤维细胞中,然后测试 X 射线产生的 UVC 光子的作用。通过集落形成试验评估细胞的存活分数。在正常和 UVC 敏感的细胞系中进行实验,以证明在治疗过程中存在 UVC 光子。此外,通过免疫荧光测定法研究了 UV 特异性 DNA 损伤,以测量环丁嘧啶二聚体(CPDs)。
与单独放射治疗相比,联合治疗导致细胞死亡增加超过 50%。这相当于联合治疗时 2Gy 照射的等效剂量为 4Gy。CPD 的形成和对 UV 敏感细胞的增强作用表明存在 UV 光子。产生的 CPD 数量与约 15J×m 的 UVC 暴露相当。
将 NPs 与电离辐射相结合可导致局部剂量激增,从而提高肿瘤控制率。这也可以降低总应用剂量,以最大程度地减少对周围正常组织的不良副作用,同时保持肿瘤控制。