Innovative Radiation Therapies
With 9.6 million deaths in 2018, cancer is the second leading cause of death in the world (World Cancer Report, 2020). Each year, about 50% of all the people who have developed cancer are given radiation therapy at some point or another of their treatment. This non-invasive tool has become essential to treat tumors. Unfortunately, the conventional techniques currently used in clinic induce major side effects due to damage in healthy tissues. In addition, some tumors respond poorly to conventional treatments, in particular because of their radioresistance. Therefore, there is an urgent need for disruptions in technologies and protocols in the clinic to develop a precision medicine approach and personalized patient care.
This Topic is an initiative of the ambitious iNanoTheRad project of Université Paris-Saclay, which promotes innovative strategies based on irradiation by new sources (high-dose rates, high LET, spatially structured beams, plasmas) and the addition of tumor targeted nano-agents and drugs to improve the effects of radiotherapy. Strategies for treatment personalization based on artificial intelligence are also considered. This Topic is interdisciplinary and open to international experts and researchers in medical physics, radiation chemistry and physics, in numerical simulations and artificial intelligence, the development of radiation sources, radiobiology, nanoscience, nanomedicine, plasma medicine, radiotherapy, and oncology. It is intended to give visibility to important results and ideas concerning the formulation of the next generation of secured and personalized radiotherapy treatments from the lab bench to clinical applications.
Dr. Gérard Baldacchino
Prof. Dr. Eric Deutsch
Dr. Marie Dutreix
Prof. Dr. Sandrine Lacombe
Dr. Erika Porcel
Dr. Charlotte Robert
Dr. Emmanuelle Bourneuf
Dr. João Santos Sousa
Dr. Aurélien de la Lande
- radiotherapy innovation
- new radiation sources
- new radiotherapy strategies
- radiosensitizing nanoparticles
- advanced strategies for radiotherapy
- external radiotherapy in clinic
- AI and imaging for radiation therapies
- new sources and associated dosimetry for radiotherapy
- new radiation therapies modalities
- nanoparticle-enhanced radiotherapies in diagnosis and treatment
- first principles simulations
|First Decision (median)
Journal of Clinical Medicine
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Published Papers (9 papers)
The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.
Title: New Radiation Oncology Optimization Principles Based on In Vivo Predictive Assay and Recent Developments in Molecular Radiation Biology
Authors: Anders Brahme
Affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
Abstract: The recent understanding that most TP53-intact normal tissues are low-dose hypersensitive (LDHS) and low-dose apoptotic (LDA) implies that the well-known fractionation window at ≈ 2 Gy/Fr defines the optimal tolerance level for most organs at risk and not at all the tumor dose when using IMRT. This necessitates new approaches to biologically optimized radiation therapy, requiring that the maximum dose to organs at risk should be ≤2.3 Gy/Fr, and especially that it should be of low ionization density or LET. The fractionation window is due to low-dose initiation of full DNA repair capability in normal tissues at ≈½ Gy, and we should use this acquired repair advantage to its full extent up to ≈2.3 Gy where otherwise the high dose apoptosis (HDA) may set in. Thus biologically optimized treatments should be focused on the application of a low number of high tumor-dose intensity- and/or radiation quality-modulated photon, electron or lower LET light ion beams. Doing so, reduces the total dose and the risk for secondary cancers and generating a real tumor cure without risk for subsequent caspase-3-induced accelerated tumor cell repopulation. The light ions should truly have the lowest possible LET in normal tissues to retain the fractionation window property but still have a high LET only in the gross tumor region to simultaneously maximize tumor cell inactivation. This necessitates the use of the lightest ions, from helium to ≈boron, as this fractionation advantage is practically lost for carbon and heavier ions. This unique property of the lightest ions is combined with the highest possible apoptosis and senescence in front of the Bragg peak and can best be characterized as allowing molecular radiation therapy since surrounding normal tissues are only exposed to a low dose and LET that causes easily repairable low dose damage. Many other new associated ideas are also discussed, such as optimal use of IMRT, molecular tumor imaging with MRSI, PET-CT and phase contrast X-rays, TP53 cell survival radiation biology, biologically optimized radiation therapy: BIOART, quantum biology of curative radiation therapy, 4D-space-time radiation therapy optimization, the influence of microdosimetric heterogeneity on the dose response relation, optimal time dose fractionation, accounting for tumor hypoxia, biologically optimal radiation quality, secondary cancer risks, mutant TP53 reactivation, and optimal dose delivery techniques since they are all involved directly or indirectly in these new principles for true optimization of radiation therapy.