Keshmiri Sarvenaz, Lemaire Gaëtan, Brocard Sylvan, Verry Camille, Bencheikh Yacine, Kefs Samy, Eling Laura, Serduc Raphaël, Adam Jean-François
Univ. Grenoble Alpes, INSERM, UA07 STROBE, 2280 rue de la piscine, 38610 Gières, France.
Centre Hospitalier Universitaire Grenoble-Alpes, Maquis du Grésivaudan, 38700 La Tronche, France.
Phys Imaging Radiat Oncol. 2024 Feb 28;30:100565. doi: 10.1016/j.phro.2024.100565. eCollection 2024 Apr.
Microbeam Radiation Therapy (MRT) aims to deliver higher doses to the target while minimizing radiation damage to healthy tissues using synchrotron x-ray microbeams. Translational MRT research has now started, driven by promising results from preclinical studies. This study aimed to propose a first dose-outcome model by analyzing micrometric dose distributions obtained with high-resolution 3D dose calculations, accounting for the inherent physical dose distribution complexity in MRT. The feasibility of integrating penMRT, our full Monte Carlo multiscale dose calculation algorithm based on PENELOPE into translational research on veterinary patients was also investigated.
Micrometric dose distributions were calculated in tumor-bearing rats and for a veterinary patient with penMRT, for conformal multi-directional MRT treatment plans. Absorbed dose maps were obtained with 0.005 × 0.005 × 1 mm voxel sizes. High-resolution dose-volume histograms were extracted and analyzed against radiobiology studies.
The complexity of the MRT dose distribution was properly rendered at a micrometer scale on 3D dose maps, with well separated dose regions observed on the differential dose-volume histograms. The median survival time of glioma-bearing rats varied linearly with the volume fraction of the planning target volume that received doses higher than 50 Gy (R = 0.98). The feasibility of using penMRT for treatment planning in large volumes has been shown on a veterinary patient.
This study demonstrated the significant added value of penMRT for planning and prescribing MRT treatments. It also shed light on the correlation between the high-resolution 3D dose distributions and the treatment outcome.
微束放射疗法(MRT)旨在利用同步加速器X射线微束在将对健康组织的辐射损伤降至最低的同时,向靶区输送更高剂量的辐射。在临床前研究取得有前景的结果的推动下,MRT的转化研究现已启动。本研究旨在通过分析高分辨率3D剂量计算获得的微米级剂量分布,提出首个剂量-结果模型,同时考虑MRT中固有的物理剂量分布复杂性。我们还研究了将基于PENELOPE的全蒙特卡罗多尺度剂量计算算法penMRT整合到兽医患者转化研究中的可行性。
使用penMRT为荷瘤大鼠和一名兽医患者计算了适形多方向MRT治疗计划的微米级剂量分布。以0.005×0.005×1mm的体素大小获得吸收剂量图。提取高分辨率剂量体积直方图并对照放射生物学研究进行分析。
MRT剂量分布的复杂性在3D剂量图上以微米尺度得到了恰当呈现,在微分剂量体积直方图上观察到剂量区域分离良好。荷胶质瘤大鼠的中位生存时间与接受高于50Gy剂量的计划靶体积的体积分数呈线性变化(R = 0.98)。在一名兽医患者身上已证明使用penMRT进行大体积治疗计划的可行性。
本研究证明了penMRT在规划和开具MRT治疗处方方面的显著附加值。它还揭示了高分辨率3D剂量分布与治疗结果之间的相关性。