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Journal of Radiation Research
Journal Prestige (SJR): 0.734  Citation Impact (citeScore): 2 Number of Followers: 3  Open Access journalISSN (Print) 0449-3060 - ISSN (Online) 1349-9157 Published by Oxford University Press  [424 journals]
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- 2022 Terasima Award
Pages: 1 - 1
Abstract: .
PubDate: Fri, 20 Jan 2023 00:00:00 GMT
DOI: 10.1093/jrr/rrac073
Issue No: Vol. 64, No. 1 (2023)
- External exposure assessment in the Fukushima accident area for
governmental policy planning in Japan: part 1. Methodologies for personal
dosimetry applied after the accident
Pages: 2 - 10
Abstract: AbstractThe evacuation order areas established due to the accident at the Tokyo Electric Power Company Holdings’ (TEPCO) Fukushima Daiichi Nuclear Power Plant (FDNPP) have been reorganized according to the decrease in ambient dose rates and the decontamination progress. The Japanese government decided to decontaminate the difficult-to-return areas and lift the evacuation order by 2030. This radiation protection strategy can be optimized by examining emergency exposure situations to date and the existing exposure after the accident. This article reviews the methods that can determine the individual radiation doses of residents who should return to their homes when the evacuation order is lifted in the specific reconstruction reproduction base area and the difficult-to-return areas outside this base area and summarizes the points to be considered when implementing these methods. In Part 1 of this article, we review the efforts made by the Japanese government and research institutes to assess radiation doses to residents after the FDNPP accident.
PubDate: Mon, 12 Dec 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac079
Issue No: Vol. 64, No. 1 (2022)
- Epigenetic regulation of RARB overcomes the radio-resistance of colorectal
carcinoma cells via cancer stem cells
Pages: 11 - 23
Abstract: AbstractCancer stem cells (CSCs) are able to survive after cancer therapies, leading to cancer progression and recurrence in colorectal carcinoma (CRC). Therapies targeting CSCs are believed to be promising strategies for efficiently eradicating cancers. This study was to investigate that how retinoic acid receptor beta (RARB) affected the biological characteristics of CSCs and radio-resistance in CRC and the epigenetic mechanism. The sensitivity of CSCs isolated from HCT116 cells to radiotherapy was reduced compared with the parental cells. Using database querying, we found that RARB was one of the most significantly downregulated gene in radio-resistant cells in CRC. Also, RARB was poorly expressed in our isolated CSCs, and overexpression of RARB inhibited the properties of CSCs and enhanced radiotherapy sensitivity. Mechanistically, the methylation of RARB was higher in CSCs compared with HCT116 cells, which was significantly reduced after the application of DNA methylation inhibitor 5-azacytidine (5-azaC). DNA methyltransferases (DNMT1) was found to be recruited into the RARB promoter. 5-AzaC treatment inhibited DNMT1 activity and improved radiotherapy sensitivity by promoting RARB expression. Our results imply that inhibition of DNMT1 can display a new mechanism for the epigenetic mediation of RARB in radio-resistant CRC.
PubDate: Mon, 10 Oct 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac060
Issue No: Vol. 64, No. 1 (2022)
- The effect of modulation of gut microbiome profile on radiation-induced
carcinogenesis and survival
Pages: 24 - 32
Abstract: AbstractNon-lethal doses of ionizing radiation (IR) delivered to humans because of terrorist events, nuclear accidents or radiotherapy can result in carcinogenesis. Means of protecting against carcinogenesis are lacking. We questioned the role of the gut microbiome in IR-induced carcinogenesis. The gut microbiome was modulated by administering broad spectrum antibiotics (Ab) in the drinking water. Mice were given Ab 3 weeks before and 3 weeks after 3 Gy total body irradiation (TBI) or for 6 weeks one month after TBI. Three weeks of Ab treatment resulted in a 98% reduction in total 16S rRNA counts for 4 out of 6 of the phylum groups detected. However, 3 more weeks of Ab treatment (6 weeks total) saw an expansion in the phylum groups Proteobacteria and Actinobacteria. The Ab treatment altered the bacteria diversity in the gut, and shortened the lifespan when Ab were administered before and after TBI. Mortality studies indicated that the adverse Ab lifespan effects were due to a decrease in the time in which solid tumors started to appear and not to any changes in hematopoietic or benign tumors. In contrast, when Ab were administered one month after TBI, lifespan was unchanged compared to the control TBI group. Use of broad-spectrum antibiotics to simulate the germ-free condition did not afford an advantage on carcinogenesis or lifespan.
PubDate: Mon, 17 Oct 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac062
Issue No: Vol. 64, No. 1 (2022)
- AKBA inhibits radiotherapy resistance in lung cancer by inhibiting maspin
methylation and regulating the AKT/FOXO1/p21 axis
Pages: 33 - 43
Abstract: AbstractAcetyl-keto-b-boswellic acid (AKBA) functions in combating human malignant tumors, including lung cancer. However, the function of AKBA in regulating the radioresistance of lung cancer and its underlying mechanism still need to be elucidated. Radiation-resistant lung cancer cells (RA549) were established. Quantitative real-time polymerase chain reaction (QRT-PCR) and Western blot were employed to examine the messenger RNA (mRNA) and protein expressions. After being treated with AKBA and different doses of X-ray, cell proliferation and survival were examined using colony formation assay and cell-counting kit-8 (CCK-8) assay. The cellular localization of Forkhead box 1 (FOXO1) was measured by immunofluorescence (IF). Flow cytometry was employed to analyze cell cycle and apoptosis. In addition, in vivo experiment was performed to determine the effect of AKBA on the sensitivity of tumors to radiation. Herein, we found that AKBA could enhance the radiosensitivity in RA549, suppress cell proliferation, induce cell apoptosis and arrest cell cycle. It was observed that maspin was lowly expressed and hypermethylated in RA549 cells compared to that in A549 cells, while these changes were all eliminated by AKBA treatment. Maspin knockdown could reverse the regulatory effects of AKBA on radioresistance and cellular behaviors of RA549 cells. In addition, we found that AKBA treatment could repress the phosphorylation of Serine/Threonine Kinase (AKT), and FOXO1, increase the translocation of FOXO1 and p21 level in RA549 cells, which was abolished by maspin knockdown. Moreover, results of tumor xenograft displayed that AKBA could enhance the sensitivity of tumor to radiation through the maspin/AKT/FOXO1/p21 axis. We discovered that AKBA enhanced the radiosensitivity of radiation-resistant lung cancer cells by regulating maspin-mediated AKT/FOXO1/p21 axis.
PubDate: Wed, 26 Oct 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac064
Issue No: Vol. 64, No. 1 (2022)
- A preclinical model to investigate normal tissue damage following
fractionated radiotherapy to the head and neck
Pages: 44 - 52
Abstract: AbstractRadiotherapy (RT) of head and neck (H&N) cancer is known to cause both early- and late-occurring toxicities. To better appraise normal tissue responses and their dependence on treatment parameters such as radiation field and type, as well as dose and fractionation scheme, a preclinical model with relevant endpoints is required. 12-week old female C57BL/6 J mice were irradiated with 100 or 180 kV X-rays to total doses ranging from 30 to 85 Gy, given in 10 fractions over 5 days. The radiation field covered the oral cavity, swallowing structures and salivary glands. Monte Carlo simulations were employed to estimate tissue dose distribution. The follow-up period was 35 days, in order to study the early radiation-induced effects. Baseline and post irradiation investigations included macroscopic and microscopic examinations of the skin, lips, salivary glands and oral mucosa. Saliva sampling was performed to assess the salivary gland function following radiation exposure. A dose dependent radiation dermatitis in the skin was observed for doses above 30 Gy. Oral mucositis in the tongue appeared as ulcerations on the ventral surface of the tongue for doses of 75–85 Gy. The irradiated mice showed significantly reduced saliva production compared to controls. In summary, a preclinical model to investigate a broad panel of normal tissue responses following fractionated irradiation of the H&N region was established. The optimal dose to study early radiation-induced effects was found to be around 75 Gy, as this was the highest tolerated dose that gave acute effects similar to that observed in cancer patients.
PubDate: Mon, 17 Oct 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac066
Issue No: Vol. 64, No. 1 (2022)
- Estimation of radiological impact of the activities of Olusosun Dump Site
on workers and dwellers of Olusosun, in Lagos Southwest Nigeria
Pages: 53 - 62
Abstract: AbstractThis study assessed the potential radiological risks associated with the activities on Olusosun dump site on workers and dwellers of Olusosun community. The activity concentrations of 238U, 232Th and 40K from of soil and water samples were determined using High-Purity Germanium (HPGe) detector. The background radiation level of Olusosun dump site was measured using a portable Geiger-Müller counter-Radeye B20 survey meter. The mean value of background radiation was 1.46 mSv/yr. This value is about 46% higher than the recommended reference level of 1.0 mSv/yr for the public. The mean activity concentrations of 238U, 232Th and 40K in the soil samples were 19.1 ± 3.2, 29.1 ± 4.4 and 171.5 ± 6.1 Bq/kg respectively which are about 45.4%, 35.3% and 59.2% lower than the world’s average levels. For the water samples, the mean activity concentrations obtained for 238U, 232Th and 40K are 0.4 ± 0.4, 0.8 ± 0.2 and 0.8 ± 0.3 Bq/l respectively. These are about 99.9% and 20% lower than WHO reference levels for 238U and 232Th. The mean absorbed dose rate in air (D), Annual effective dose (AED) outdoor, Radium Equivalent (Req), External hazard index (Hex) internal hazard index (Hin) and Excess lifetime cancer risk (ELCR) from soil samples were 33.6 nGy/h, 41.0 μSv/yr, 73.1 Bq/kg and 0.2, 0.3 and $1.4\times{10}^{-4}$, respectively. Absorbed dose in air D, AED outdoor, Req, Hex, Hin and ELCR are 41.1%, 41.4%, 80.3%, 80%, 75% and 50% lower than their corresponding world’s average and references. The estimated AEDw from ingestion of water is 148.9 ± 50.4 μSv/yr, this is about 49% higher than the WHO reference level of 100.0 μSv/y from ingestion of water. The radiological hazard indices estimated from soil samples do not indicate any potential risks to the users. The elevated background radiation level of the dump site, and AEDw from ingestion of water, however, suggest that the activities on Olusosun dump site pose potential radiological risks on workers on the site and the public from consumption of water from Olusosun community.
PubDate: Mon, 14 Nov 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac067
Issue No: Vol. 64, No. 1 (2022)
- Radiation-induced NF-κB activation is involved in cochlear damage in mice
via promotion of a local inflammatory response
Pages: 63 - 72
Abstract: AbstractThe radiation-induced inflammatory response is involved in radiation damage to the cochlea and causes sensorineural hearing loss (SNHL). NF-κB, as the master switch of the inflammatory response, regulates the expression of many inflammation-related genes and thus the inflammatory response. Therefore, in this study we used a mouse model to determine whether radiation-induced NF-κB activation is involved in damage to the cochlea and to investigate the underlying mechanism. Eventually, we found that NF-κB was activated after radiation of the cochleae and the activation reached a maximum at 2–6 h after radiation. And morphological analysis showed severe damage to the cochleae after radiation, but this damage was significantly ameliorated by JSH-23 (an inhibitor of NF-κB) pretreatment. Along with these morphological changes, the expression levels of proinflammatory molecules (including proinflammatory cytokines IL-6, TNF-α, COX-2 and inflammation-related proteins VCAM-1, MIP-1β) in the cochlear tissues were significantly increased after radiation, but were significantly decreased by JSH-23 pretreatment compared to radiation alone. Therefore, these results indicated that radiation-induced NF-κB activation was involved in damage to the cochleae and resultant SNHL via its promotion of the inflammatory response mediated by overexpression of some proinflammatory molecules in cochlear tissues, and inhibition of radiation-induced NF-κB was conducive to preventing such damage.
PubDate: Mon, 17 Oct 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac068
Issue No: Vol. 64, No. 1 (2022)
- Elekta Unity MR-linac commissioning: mechanical and dosimetry tests
Pages: 73 - 84
Abstract: AbstractWe report the commissioning results of Elekta Unity for the dosimetric performance and mechanical quality assurance (QA), and propose additional commissioning procedures. Mechanical tests included multi-leaf collimator (MLC) positional accuracy, radiation isocenter diameter at the center and off-center position, and coincidence between the magnetic resonance (MR) image center and radiation isocenter. Comparisons between the measurements and calculations of the simple irradiated field, intensity modulated radiation therapy (IMRT) commissioning, MLC output factor ratio, validation of independent dose calculation software and end-to-end testing were performed to evaluate dosimetric performance. The average values of the MLC positional accuracy for film- and imaging device-based analysis were −0.1 and 0.3 mm, respectively. The measured radiation isocenter size was 0.41 mm, and the off-center results were within 1 mm. The coincidence was −0.21, −1.19 and 0.49 mm along the x-, y- and z-axes, respectively. The calculated percent depth doses (PDD) and profiles agreed with the measurements. The results of independent dose calculation were within the action level recommended by American Associations of Physicist in Medicine. The gamma passing rate (GPR) for IMRT commissioning was 98.6 ± 0.9%, and end-to-end testing of adapted plans showed agreement within 2% between the measurement and calculation. We reported the results of mechanical and dosimetric performances of Elekta Unity, and proposed novel commissioning procedures. Our results should provide knowledge to the physics community for enhancing the QA programs.
PubDate: Mon, 14 Nov 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac072
Issue No: Vol. 64, No. 1 (2022)
- Enhanced tumor inhibiting effect of 131I-BDI-1-based radioimmunotherapy
and cytosine deaminase gene therapy modulated by a radio-sensitive
promoter in nude mice bearing bladder cancer
Pages: 85 - 90
Abstract: AbstractRadioimmunotherapy (RIT) has great potential in cancer therapy. However, its efficacy in numerous tumors is restricted due to myelotoxicity, thereby limiting the dose of radionuclide. To increase tumor radiosensitivity, we incorporated the recombinant lentivirus into the EJ cells (bladder cancer [BC] cells), and examined the combined anti-tumor effects of RIT with 131I-BDI-1(131I-monoclonal antibody against human BC-1) and gene therapy (GT). The recombinant lentivirus was constructed and packed. The animal xenograft model was built and when the tumor reached about 0.5 cm in diameter, the mice were randomly separated into four groups: (1) RIT + GT: the xenografts were continuously incorporated with the recombinant lentivirus for two days. And 7.4 MBq 131I-BDI-1 was IV-injected, and 10 mg prodrug 5-fluorocytosine (FC) was IV-injected for 7 days, (2) RIT: same dose of 131I-BDI-1 as the previous group mice, (3) GT: same as the first group, except no 131I-BDI-1, and (4) Untreated. Compute tumor volumes in all groups. After 28 days the mice were euthanized and the tumors were extracted and weighed, and the inhibition rate was computed. The RIT + GT mice, followed by the RIT mice, exhibited markedly slower tumor growth, compared to the control mice. The tumor size was comparable between the GT and control mice. The tumor inhibition rates after 28 days of incubation were 42.85 ± 0.23%, 27.92 ± 0.21% and 0.57 ± 0.11% for the four groups, respectively. In conclusion, RIT, combined with GT, suppressed tumor development more effectively than RIT or GT alone. This data highlights the potent additive effect of radioimmune and gene therapeutic interventions against cancer.
PubDate: Wed, 23 Nov 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac075
Issue No: Vol. 64, No. 1 (2022)
- Correlation between the expression of LAT1 in cancer cells and the
potential efficacy of boron neutron capture therapy
Pages: 91 - 98
Abstract: AbstractBoron neutron capture therapy (BNCT) is a binary cancer therapy that involves boron administration and neutron irradiation. The nuclear reaction caused by the interaction of boron atom and neutron produces heavy particles with highly cytocidal effects and destruct tumor cells, which uptake the boron drug. p-Boronophenylalanine (BPA), an amino acid derivative, is used in BNCT. Tumor cells with increased nutrient requirements take up more BPA than normal tissues via the enhanced expression of LAT1, an amino acid transporter. The current study aimed to assess the correlation between the expression of LAT1 and the uptake capacity of BPA using genetically modified LAT1-deficient/enhanced cell lines. We conducted an in vitro study, SCC7 tumor cells wherein LAT1 expression was altered using CRISPR/Cas9 were used to assess BPA uptake capacity. Data from The Cancer Genome Atlas (TCGA) were used to examine the expression status of LAT1 in human tumor tissues, the potential impact of LAT1 expression on cancer prognosis and the potential cancer indications for BPA-based BNCT. We discovered that the strength of LAT1 expression strongly affected the BPA uptake ability of tumor cells. Among the histologic types, squamous cell carcinomas express high levels of LAT1 regardless of the primary tumor site. The higher LAT1 expression in tumors was associated with a higher expression of cell proliferation markers and poorer patient prognosis. Considering that BPA concentrate more in tumors with high LAT1 expression, the results suggest that BNCT is effective for cancers having poor prognosis with higher proliferative potential and nutritional requirements.
PubDate: Mon, 14 Nov 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac077
Issue No: Vol. 64, No. 1 (2022)
- Translocations are induced in hematopoietic stem cells after irradiation
of fetal mice
Pages: 99 - 104
Abstract: AbstractAlthough mammalian fetuses have been suggested to be sensitive to radiation, an increased frequency of translocations was not observed in blood lymphocytes from atomic bomb (A-bomb) survivors who were exposed to the bomb in utero and examined as adults. Since experiments using hematopoietic cells of mice and rats confirmed this finding, it was hypothesized that either irradiated fetal hematopoietic stem cells (f-HSCs) cannot generate exchange-type chromosomal aberrations or cells bearing induced aberrations are eliminated before the animals reach adulthood. In the present study, pregnant mice (12.5–15.5 days post coitum [dpc]) were irradiated with 2 Gy of X-rays and long-term HSCs (LT-HSCs) were isolated 24 h later. Multicolor fluorescence in situ hybridization (mFISH) analysis of LT-HSC clones proliferated in vitro showed that nine out of 43 (21%) clones from fetuses and 21 out of 41 (51%) clones from mothers bore translocations. These results indicate that cells with translocations can arise in mouse f-HSCs but exist at a lower frequency than in the mothers 24 h after X-ray exposure. Thus, it seems likely that translocation-bearing f-HSCs are generated but subsequently disappear, so that the frequency of lymphocyte translocations may decrease and reach the control level by the time the animals reach adulthood.
PubDate: Thu, 24 Nov 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac078
Issue No: Vol. 64, No. 1 (2022)
- Evaluation of OrthoChromic OC-1 films for photon radiotherapy application
Pages: 105 - 112
Abstract: AbstractA new film dosimetry system consists of the new OrthoChromic™ OC-1 film, and a novel calibration procedure was evaluated. Two films, C1 and C2, were exposed simultaneously using the 6FFF beam with a step-wedge pattern of five steps ranging from 590 to 3000 cGy. C1 was used for calibration, and C2 was used for calibration curve validation. The second scan of C2 was done by rotating the film by 90-deg. To evaluate the effectiveness of the non-uniform scanner response correction with the new system, a film was exposed to a 20 × 20 cm2 field. The beam profile measured with the film was compared to the IBA cc04 measurements in water. Films were irradiated to characterize the energy response, dynamic range and temporal growth effect. Open (MLC-defined) and clinical fields were radiated to evaluate the overall performance of the new system. The new calibration procedure was validated with an average dose difference of 1.6% and a gamma (2%,2 mm) passing rate of 100%. With C2 scanned 90-deg rotated, the average dose difference was 1.3%. The average difference between cc04 and film was 0.4%. The St between films and diode/cc04 were within −0.3% difference for 1 × 1 to 14 × 14 cm2 and −2.8% for 0.5 × 0.5 cm2. For clinical fields, the average gamma (3%,2 mm) was 98.8%. These results were consistent with EBT3 film and MapCheck measurements with a dose > 400 cGy. The results have shown that the OC-1 film system can achieve accurate results for QA measurements, but more considerable uncertainty was observed within the low dose range.
PubDate: Thu, 01 Dec 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac080
Issue No: Vol. 64, No. 1 (2022)
- The radiation response measurement of a single and multiple cell
ionization of neuroblastoma cells by infrared laser trap
Pages: 113 - 125
Abstract: AbstractNeuroblastoma (NB) is a common type of cancer found mostly in infants and arising from the immature neural crest cells of the sympathetic nervous system. Using laser trapping (LT) technique, the present work contributes to advancing radiotherapy (RT), a leading treatment method for cancer. A single, 2-cells, 3-cells, 4-cells, and 5-cells were trapped using the high-intensity gradient infrared laser at 1064 nm and allowed to become ionized. In this work, a systematic study of Threshold Ionization Energy (TIE) and Threshold Radiation Dose (TRD) versus mass for both single and multi-cell ionization using laser trapping (LT) techniques on NB is presented. The results show that TIE increased as the mass of cells increased, meanwhile TRD decreased with the increase of cell mass. We observed an inverse correlation between TRD and cell mass. We demonstrate how to compute the maximum radiation dosage for cell death using the LT technique. Results show a possible blueprint for computing the TRD in vivo. The use of multiple cell ionization to determine radiation dosage along with better data accuracy concerning the tumor size and density will have profound implications for radiation dosimetry. The diminution in TRD becomes more significant in multiple cell ionization as we see in TRD vs the number of cells entering the trap. This is due to the chain effect generated by radiation and the absorption by water molecules at 1064 nm. This result provides us with better insight into the optimization of the therapeutic ratio.
PubDate: Thu, 15 Dec 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac082
Issue No: Vol. 64, No. 1 (2022)
- The impact of the COVID-19 pandemic on radiotherapy in Japan: nationwide
surveys from May 2020 through June 2021
Pages: 126 - 132
Abstract: AbstractA longitudinal online questionnaire survey on the impact of coronavirus disease 2019 (COVID-19) on the operation of radiotherapy departments in Japan was conducted. Approximately 26.1–70.9% of the radiotherapy departments participated, and their responses were collected in May, July and November 2020, and February and June 2021. The survey results revealed that while the number of patients receiving radiotherapy decreased in 41.2% and 30.7% of institutions in May 2020 and June 2021, respectively, it increased in 4% and 16.8% of institutions in May 2020 and June 2021, respectively. There were a few institutions limiting or postponing patient treatments in June 2021. The hypofractionated regimen was used more during the pandemic than during the pre-pandemic period, particularly for the treatment of breast and prostate cancers as well as for palliation. Infection control measures for patients and staff were followed. Approximately 20% of the respondent institutions had cases of patients with COVID-19 infection receiving radiotherapy. Most institutions encountered challenges in the continuous provision of radiotherapy for patients with COVID-19. In conclusion, COVID-19 had a multifaceted impact on the operations of radiotherapy departments in Japan. Further follow-up and analysis are warranted to understand the long-term impact of COVID-19 on radiotherapy.
PubDate: Fri, 16 Sep 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac055
Issue No: Vol. 64, No. 1 (2022)
- Radiosurgery effects and adverse effects in symptomatic eloquent
brain-located Cavernomas
Pages: 133 - 141
Abstract: AbstractIn this study, the dose schedule efficacy, safety and late adverse effects of stereotactic radiosurgery (SRS) were evaluated for patients with symptomatic cavernomas who were not eligible for surgery and treated with SRS. Between January 2013 and December 2018, 53 patients with cavernomas were treated using SRS with the CyberKnife® system. Patients’ diseases were deeply located or were in subcortical functional brain regions. In addition to bleeding, 23 (43.4%) patients had epilepsy, 12 (22.6%) had neurologic symptoms and 16 patients (30.2%) had severe headaches. The median volume was 741 (range, 421–1351) mm3, and the median dose was 15 (range, 14–16) Gy in one fraction. After treatment, six (50%) of 12 patients with neurologic deficits still had deficits. Rebleeding after treatment developed in only two (3.8%) patients. The drug was completely stopped in 14 (60.9%) out of 23 patients who received epilepsy treatment, and the dose of levetiracetam decreased from 2000 mg to 1000 mg in four (17.3%) of nine patients. Radiologically, complete response (CR) was observed in 13 (24.5%) patients, and partial responses (PR) were observed in 32 (60.2%) patients. Clinical response of CR was observed in 30 (56.6%) patients, PR was observed in 16 (30.2%), stable disease (SD) was observed in three (5.7%) and four (7.5%) patients progressed. In conclusion, SRS applied in the appropriate dose schedule may be an effective and reliable method in terms of symptom control and prevention of rebleeding, especially in patients with inoperable cavernomas.
PubDate: Sat, 08 Oct 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac056
Issue No: Vol. 64, No. 1 (2022)
- Recurrence patterns and progression-free survival after chemoradiotherapy
with or without consolidation durvalumab for stage III non-small cell lung
cancer
Pages: 142 - 153
Abstract: AbstractChemoradiotherapy followed by consolidation durvalumab (CCRT+D) improves survival in patients with stage III non-small-cell lung cancer (NSCLC). We compared recurrence patterns and survival in the CCRT+D and CCRT cohorts. We conducted a multicenter, retrospective study in Japan. Patients who received CCRT for stage III NSCLC were included in this study. Of 178 eligible patients, 136 were in the CCRT+D and 42 were in the CCRT cohorts. Locoregional recurrence (LR), LR plus distant metastases (DM), and DM were observed in 20.6%, 8.8%, 27.9% of the CCRT+D, and 26.2%, 16.7% and 33.3% of the CCRT cohorts, respectively. In-field recurrence was the most common LR pattern in both cohorts. Squamous cell carcinoma and PD-L1 expression < 1%, and female sex and EGFR mutations were significantly associated with an increased risk of LR and DM. In patients with any risk factors for LR, the incidence of LR was similar in the CCRT+D and CCRT (39.5% vs 45.5%). The 24 month progression-free survival (PFS) and overall survival (OS) were 40.3% and 69.4% in the CCRT+D and 24.7% and 61.0% in the CCRT cohorts, respectively. Poor performance status and no consolidation durvalumab were significantly associated with shorter PFS. There was a significant difference in PFS between the CCRT+D and CCRT in the propensity score-matched cohort (HR = 0.51, P = 0.005). In conclusion, consolidation durvalumab decreased both LR and DM, and significantly improved PFS. However, in-field recurrence was still a major problem, as well as DM.
PubDate: Thu, 22 Sep 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac057
Issue No: Vol. 64, No. 1 (2022)
- A phase II study of concurrent chemoradiotherapy with 5-fluorouracil and
mitomycin-C for squamous cell carcinoma of the anal canal (the JROSG
10–2 trial)
Pages: 154 - 161
Abstract: AbstractThis study assessed the efficacy of chemoradiotherapy for squamous cell carcinoma of the anal canal (SCCAC). Patients with T1–4N0-3M0 SCCAC received chemoradiotherapy with 5-fluorouracil (5-FU, 800 mg/m2/day, 96-h infusion) and mitomycin-C (MMC, 10 mg/m2 bolus). Patients treated with 3-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) were administered 36.0 Gy in 20 fractions or 49.5 Gy in 33 fractions for elective nodal irradiation and 59.4 Gy in 33 fractions for primary tumor and metastatic nodal irradiation. The sample size was considered sufficient to estimate 95% confidence intervals (CIs) for the true 2-year disease-free survival (DFS) within a width of +15% when the expected true 2-year DFS was 70%. The primary endpoint was 2-year DFS. The secondary endpoints were 2-year overall survival (OS), locoregional control (LC), colostomy-free survival (CFS) and adverse events. Thirty-one patients were enrolled between January 2014 and July 2019. The median follow-up was 33.3 months (range, 16.2–65.8 months). Among the 31 patients, 13%, 32%, 16% and 39% had stage I, II, IIIA and IIIB disease, respectively. Thirty patients were treated with IMRT. Complete response (CR) was achieved in 27 patients. The 2-year DFS, OS, LC and CFS rates were 77.4% (95% CI, 58.4–88.5%), 93.5% (95% CI, 76.6–98.3%), 83.9% (95% CI, 65.5–92.9%) and 80.6% (95% CI, 61.9–90.8%), respectively. One patient experienced grade 3 late adverse events; however, no grade ≥ 4 late adverse events occurred. Good DFS with a low rate of late adverse events was observed. Chemoradiotherapy with 5-FU and MMC was effective for SCCAC.
PubDate: Sun, 23 Oct 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac069
Issue No: Vol. 64, No. 1 (2022)
- Comparison of dosimetries of carbon-ion pencil beam scanning, proton
pencil beam scanning and volumetric modulated arc therapy for locally
recurrent rectal cancer
Pages: 162 - 170
Abstract: AbstractWe compared the dose distributions of carbon-ion pencil beam scanning (C-PBS), proton pencil beam scanning (P-PBS) and Volumetric Modulated Arc Therapy (VMAT) for locally recurrent rectal cancer.The C-PBS treatment planning computed tomography (CT) data sets of 10 locally recurrent rectal cancer cases were randomly selected. Three treatment plans were created using identical prescribed doses. The beam angles for C-PBS and P-PBS were identical. Dosimetry, including the dose received by 95% of the planning target volume (PTV) (D95%), dose to the 2 cc receiving the maximum dose (D2cc), organ at risk (OAR) volume receiving > 15Gy (V15) and > 30Gy (V30), was evaluated. Statistical significance was assessed using the Wilcoxon signed-rank test. Mean PTV-D95% values were > 95% of the volume for P-PBS and C-PBS, whereas that for VMAT was 94.3%. However, PTV-D95% values in P-PBS and VMAT were < 95% in five and two cases, respectively, due to the OAR dose reduction. V30 and V15 to the rectum/intestine for C-PBS (V30 = 4.2 ± 3.2 cc, V15 = 13.8 ± 10.6 cc) and P-PBS (V30 = 7.3 ± 5.6 cc, V15 = 21.3 ± 13.5 cc) were significantly lower than those for VMAT (V30 = 17.1 ± 10.6 cc, V15 = 55.2 ± 28.6 cc). Bladder-V30 values with P-PBS/C-PBS (3.9 ± 4.8 Gy(RBE)/3.0 ± 4.0 Gy(RBE)) were significantly lower than those with VMAT (7.9 ± 8.1 Gy). C-PBS provided superior dose conformation and lower OAR doses compared with P-PBS and VMAT. C-PBS may be the best choice for cases in which VMAT and P-PBS cannot satisfy dose constraints. C-PBS could be another choice for cases in which VMAT and P-PBS cannot satisfy dose constraints, thereby avoiding surgical resection.
PubDate: Sat, 19 Nov 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac074
Issue No: Vol. 64, No. 1 (2022)
- Development of deep-inspiration breath-hold system that monitors the
position of the chest wall using infrared rangefinder
Pages: 171 - 179
Abstract: AbstractWe conducted a prospective study to quantitatively evaluate the movement of the chest wall to establish the simple and reproducible deep-inspiration breath-hold (DIBH) method. The left nipple position was monitored to confirm the inspiratory state. Planning computed tomography (CT) was performed under DIBH and free-breath. We conducted radiation plans with DIBH and free-breath CT and evaluated organ at risk (OAR) and target doses according to two different plans. The relationship between positioning errors of the chest wall and patient factors was evaluated using univariate analysis and fixed-effects models. Twenty-three patients aged ≤ 60 years were enrolled during January–August 2021; 358 daily radiation treatments were evaluated. The median time of treatment room occupancy was 16 minutes (interquartile range, 14–20). The area of the planning target volume (PTV) surrounded by the 95% isodose line was more extensive in DIBH than in free breathing (71.6% vs 69.5%, P < 0.01), whereas the cardiac and left anterior descending (LAD) artery doses were lower (both P < 0.01). In the fixed-effects model analysis, the occupation time of the treatment room was correlated with positioning error. The difference between the planned and irradiated dose was the largest in the LAD branch of the coronary artery (−2.5 Gy), although the OAR dose decreased owing to positional error. The current DIBH method, wherein a single point on the chest wall is monitored to confirm that the patient is in an inspiratory state, allows radiation to be performed in a short time with a small dose error.
PubDate: Thu, 15 Dec 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac083
Issue No: Vol. 64, No. 1 (2022)
- Development of independent dose verification plugin using Eclipse
scripting API for brachytherapy
Pages: 180 - 185
Abstract: AbstractIn this study, an independent dose verification plugin (DVP) using the Eclipse Scripting Application Programming Interface (ESAPI) for brachytherapy was developed. The DVP was based on the general 2D formalism reported in AAPM-TG43U1. The coordinate and orientation of each source position were extracted from the translation matrix acquired from the treatment planning system (TPS), and the distance between the source and verification point (r) was calculated. Moreover, the angles subtended by the center-tip and tip-tip of the hypothetical line source with respect to the verification point (θ and β) were calculated. With r, θ, β and the active length of the source acquired from the TPS, the geometry function was calculated. As the TPS calculated the radial dose function, g(r), and 2D anisotropy function, F(r,θ), by interpolating and extrapolating the corresponding table stored in the TPS, the DVP calculated g(r) and F(r,θ) independently from equations fitted with the Monte Carlo data. The relative deviation of the fitted g(r) and F(r,θ) for the GammaMed Plus HDR 192Ir source was 0.5% and 0.9%, respectively. The acceptance range of the relative dose difference was set to ±1.03% based on the relative deviation between the fitted functions and Monte Carlo data, and the linear error propagation law. For 64 verification points from sixteen plans, the mean of absolute values of the relative dose difference was 0.19%. The standard deviation (SD) of the relative dose difference was 0.17%. The DVP maximizes efficiency and minimizes human error for the brachytherapy plan check.
PubDate: Sun, 09 Oct 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac063
Issue No: Vol. 64, No. 1 (2022)
- Planning study: prone versus supine position for stereotactic body
radiotherapy in prostate by CyberKnife
Pages: 186 - 194
Abstract: AbstractThis study aimed to clarify the differences in radiotherapy dose characteristics and delivery efficiency between the supine and prone positions in patients with prostate cancer using the CyberKnife. The planning computed tomography (CT) and delineations of the prone position were obtained by rotating the supine CT images with delineations of 180° using image processing software. The optimization parameters for planning target volume (PTV) and organs at risk (OARs) were based on the prone position. The optimization parameters determined for the prone position were applied to the supine position for optimization and dose calculation. The dosimetric characteristics of the PTV and OARs, and delivery efficiency were compared between the two different patient positions. The plans in the prone position resulted in better PTV conformity index (nCI), rectum V90%, V80%, V75%, V50% and bladder V50%. A significant difference was observed in treatment time and depth along the central axis (dCAX) between the two plans. The mean treatment time per fraction and dCAX for the supine and prone positions were 20.9 ± 1.7 min versus 19.8 ± 1.3 min (P = 0.019) and 151.1 ± 33.6 mm versus 233.2 ± 8.8 mm (P < 0.001), respectively. In this study the prone position was found to improve dosimetric characteristics and delivery efficiency compared with the supine position during prostate cancer treatment with the CyberKnife.
PubDate: Mon, 31 Oct 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac065
Issue No: Vol. 64, No. 1 (2022)
- Tolerance levels of mass density for adaptive helical tomotherapy using
MVCT
Pages: 195 - 201
Abstract: AbstractDaily dose distributions for adaptive radiotherapy (ART) using helical tomotherapy (HT) are calculated using megavoltage computed tomography (MVCT). Generally, the MVCT number is converted to mass density (MD) using an MD calibration table (MVCT-MD table). The aims of this study are to calculate the tolerance levels of the MD for ART and to evaluate the tolerance levels using clinical patient plans. These tolerance levels of MD were calculated based on the tissue maximum ratio (TMR) of 6MV flattening-filter-free (FFF) beam of HT and the effective tissue thickness data from an International Commission on Radiological Protection 110 phantom data for lung, adipose/muscle and cartilage/spongy-bone. These tolerance levels were determined by considering both the MD causing a dose error of 2% and the variation in MVCT numbers. Subsequently, the stability of the MD values was estimated with the standard deviations (SD) in the MVCT number over 6 months. The dose distribution for clinical patient plans was calculated using the MVCT-MD table with added tolerance levels. These tolerance levels were determined as MD differences causing a dose error of 2%, and were ± 0.049 g/cm3, ± 0.030 g/cm3 and ± 0.049 g/cm3 for lung, adipose/muscle and cartilage/spongy-bone, respectively. The calculated dose distribution errors using the MVCT-MD table added tolerance levels were within 2%. We proposed these tolerance levels in MD for the quality control of the MVCT-MD table.
PubDate: Mon, 14 Nov 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac071
Issue No: Vol. 64, No. 1 (2022)
- Correction to: Prediction of proton beam range in phantom with metals
based on monochromatic energy CT images
Pages: 202 - 202
Abstract: This is a correction to: Qianqian Meng, Jing Li, Wei Jiang, Birong Hu, Feng Xu, Xiaomeng Shi, Renming Zhong, Prediction of proton beam range in phantom with metals based on monochromatic energy CT images, Journal of Radiation Research, 2022, rrac051, https://doi.org/10.1093/jrr/rrac051
PubDate: Thu, 10 Nov 2022 00:00:00 GMT
DOI: 10.1093/jrr/rrac085
Issue No: Vol. 64, No. 1 (2022)
