Division of Biomedical Physics in Radiation Oncology, German Cancer Research Center, Heidelberg, Germany.
MIISM, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Med Phys. 2024 Oct;51(10):7439-7452. doi: 10.1002/mp.17335. Epub 2024 Aug 2.
Ultrahigh dose-rate radiation (UHDR) produces less hydrogen peroxide (HO) in pure water, as suggested by some experimental studies, and is used as an argument for the validity of the theory that FLASH spares the normal tissue due to less reactive oxygen species (ROS) production. In contrast, most Monte Carlo simulation studies suggest the opposite.
We aim to unveil the effect of UHDR on HO production in pure water and its underlying mechanism, to serve as a benchmark for Monte Carlo simulation. We hypothesized that the reaction of solvated electrons ( ) removing hydroxyl radicals (•OH), the precursor of HO, is the reason why UHDR leads to a lower G-value (molecules/100 eV) for HO (G[HO]), because: 1, the third-order reaction between and •OH is more sensitive to increased instantaneous ROS concentration by UHDR than a two-order reaction of •OH self-reaction producing HO; 2, has two times higher diffusion coefficient and higher reaction rate constant than that of •OH, which means would dominate the competition for •OH and benefit more from the inter-track effect of UHDR. Meanwhile, we also experimentally verify the theory of long-lived radicals causing lower G(HO) in conventional irradiation, which is mentioned in some simulation studies.
HO was measured by Amplex UltraRed assay. 430.1 MeV/u carbon ions (50 and 0.1 Gy/s), 9 MeV electrons (600 and 0.62 Gy/s), and 200 kV x-ray tube (10 and 0.1 Gy/s) were employed. For three kinds of water (real hypoxic: 1% O; hypoxic: 1% O and 5% CO; and normoxic: 21% O), unbubbled and bubbled samples with NO, the scavenger of , were irradiated by carbon ions and electrons with conventional and UHDR at different absolute dose levels. Normoxic water dissolved with sodium nitrate (NaNO), another scavenger of , and bubbled with NO was irradiated by x-ray to verify the results of low-LET electron beam.
UHDR leads to a lower G(HO) than conventional irradiation. O and CO can both increase G(HO). NO increases G(HO) of both UHDR and conventional irradiation and eliminates the difference between them for carbon ions. However, NO decreases G(HO) in electron conventional irradiation but increases G(HO) in the case of UHDR, ending up with no dose-rate dependency of G(HO). Three-spilled carbon UHDR does not have a lower G(HO) than one-spilled UHDR. However, the electron beam shows a lower G(HO) for three-spilled UHDR than for one-spilled UHDR. Normoxic water with NO or NaNO can both eliminate the dose rate dependency of HO production for x-ray.
UHDR has a lower G(HO) than the conventional irradiation for both high LET carbon and low LET electron and x-ray beams. Both scavengers for , NO and NaNO, eliminate the dose-rate dependency of G(HO), which suggests is the reason for decreased G(HO) for UHDR. Three-spilled UHDR versus one-spilled UHDR indicates that the assumption of residual radicals reducing G(HO) of conventional irradiation may only be valid for low LET electron beam.
一些实验研究表明,超高剂量率辐射(UHDR)在纯水中产生的过氧化氢(HO)较少,这被用作FLASH 由于产生较少的活性氧物种(ROS)而保护正常组织的理论有效性的论据。相比之下,大多数蒙特卡罗模拟研究表明恰恰相反。
我们旨在揭示 UHDR 对纯水中 HO 产生的影响及其潜在机制,为蒙特卡罗模拟提供基准。我们假设,溶剂化电子( )去除羟基自由基(•OH),即 HO 的前体,是 UHDR 导致 HO 的 G 值(每 100 eV 的分子数)(G[HO])较低的原因,因为:1,•OH 自反应产生 HO 的三阶反应比•OH 自身反应产生 HO 的二阶反应对增加的瞬时 ROS 浓度更为敏感;2, 具有比•OH 高两倍的扩散系数和更高的反应速率常数,这意味着 将在•OH 的竞争中占据主导地位,并从 UHDR 的轨道间效应中获益更多。同时,我们还通过实验验证了一些模拟研究中提到的常规辐照中长寿命自由基导致较低 G(HO)的理论。
通过 Amplex UltraRed 测定法测定 HO。使用 430.1 MeV/u 碳离子(50 和 0.1 Gy/s)、9 MeV 电子(600 和 0.62 Gy/s)和 200 kV X 射线管(10 和 0.1 Gy/s)。对于三种水(真实缺氧:1% O;缺氧:1% O 和 5% CO;和常氧:21% O),未曝气和曝气的样品用 NO 作为 的清除剂,用碳离子和电子进行辐照,包括常规和 UHDR,在不同的绝对剂量水平下进行。常氧水中溶解有亚硝酸钠(NaNO),另一种 的清除剂,并用 NO 曝气,用 X 射线辐照,以验证低 LET 电子束的结果。
UHDR 导致 G(HO)低于常规辐照。O 和 CO 都可以增加 G(HO)。NO 增加 UHDR 和常规辐照的 G(HO),并消除碳离子之间的差异。然而,NO 降低了常规电子辐照中的 G(HO),但增加了 UHDR 中的 G(HO),最终 G(HO)没有剂量率依赖性。三注 UHDR 并不比单注 UHDR 具有更低的 G(HO)。然而,电子束的 UHDR 比单注 UHDR 具有更低的 G(HO)。有 NO 或 NaNO 的常氧水可以消除 X 射线产生的 HO 产量的剂量率依赖性。
UHDR 对高 LET 碳和低 LET 电子和 X 射线束的常规辐照具有更低的 G(HO)。两种 的清除剂,NO 和 NaNO,消除了 G(HO)的剂量率依赖性,这表明 是 UHDR 降低 G(HO)的原因。三注 UHDR 与单注 UHDR 相比,表明残留自由基降低常规辐照 G(HO)的假设可能仅对低 LET 电子束有效。