Division of Gastroenterology Brigham and Women's Hospital Harvard Medical School 75 Francis St. Boston MA 02115 USA.
Harvard Radiation Oncology Program 55 Fruit Street Boston MA 02114 USA.
Adv Sci (Weinh). 2021 Apr 27;8(12):2100510. doi: 10.1002/advs.202100510. eCollection 2021 Jun.
Cancer patients undergoing therapeutic radiation routinely develop injury of the adjacent gastrointestinal (GI) tract mucosa due to treatment. To reduce radiation dose to critical GI structures including the rectum and oral mucosa, 3D-printed GI radioprotective devices composed of high-Z materials are generated from patient CT scans. In a radiation proctitis rat model, a significant reduction in crypt injury is demonstrated with the device compared to without ( < 0.0087). Optimal device placement for radiation attenuation is further confirmed in a swine model. Dosimetric modeling in oral cavity cancer patients demonstrates a 30% radiation dose reduction to the normal buccal mucosa and a 15.2% dose reduction in the rectum for prostate cancer patients with the radioprotectant material in place compared to without. Finally, it is found that the rectal radioprotectant device is more cost-effective compared to a hydrogel rectal spacer. Taken together, these data suggest that personalized radioprotectant devices may be used to reduce GI tissue injury in cancer patients undergoing therapeutic radiation.
癌症患者在接受治疗性放疗时,由于治疗会常规性地导致相邻胃肠道(GI)黏膜损伤。为了降低包括直肠和口腔黏膜在内的关键 GI 结构的辐射剂量,可根据患者 CT 扫描结果生成由高 Z 材料制成的 3D 打印 GI 放射防护装置。在放射性直肠炎大鼠模型中,与无防护装置相比,该装置可显著减少隐窝损伤(<0.0087)。在猪模型中进一步证实了用于辐射衰减的最佳装置放置位置。口腔癌患者的剂量学建模显示,与无防护装置相比,带有放射防护材料的情况下,正常颊黏膜的辐射剂量降低 30%,前列腺癌患者的直肠剂量降低 15.2%。最后发现,与水凝胶直肠间隔器相比,直肠放射防护装置更具成本效益。总之,这些数据表明,个性化放射防护装置可用于减少接受治疗性放疗的癌症患者的 GI 组织损伤。