Session 1: Radiobiology in therapy and space Marco Durante Status - - PowerPoint PPT Presentation

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Session 1: Radiobiology in therapy and space Marco Durante Status - - PowerPoint PPT Presentation

Oct 05, 2023 171 likes •392 views

Session 1: Radiobiology in therapy and space Marco Durante Status & Perspectives in Particle Therapy Alejandro Mazal Worldwide He, pions, Tot per Patients M.Jermann End of year Total Protons

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Session 1: Radiobiology in therapy and space

Marco Durante

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10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 100,000 2006 2007 2008 2009 2010 2011 2012 Total Protons Carbon He, pions, others

End ¡of ¡year ¡ Total ¡ Protons ¡ Carbon ¡ He, ¡pions, ¡

  • thers ¡

Tot ¡per ¡ year ¡ 2007 ¡ 61855 ¡ 53818 ¡ 4450 ¡ 3587 ¡ ¡ ¡ 2008 ¡ 70051 ¡ 61122 ¡ 5342 ¡ 3587 ¡ 8196 ¡ 2009 ¡ 76266 ¡ 67097 ¡ 5582 ¡ 3587 ¡ 6215 ¡ 2010 ¡ 84492 ¡ 73804 ¡ 7101 ¡ 3587 ¡ 8226 ¡ 2011 ¡

93547 ¡

81121 ¡ 8839 ¡ 3587 ¡

9055 ¡

Worldwide Patients Statistics yesterday 26/02/12

M.Jermann A.Mazal PTCOG

Status & Perspectives in Particle Therapy – Alejandro Mazal

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Depth dose distribution for ions

  • U. Weber

Status & Perspectives in Particle Therapy – Alejandro Mazal

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Damage complexity is largely dependent on ionisation density of the radiation

30-40% low-LET = complex 90% high-LET = complex

Simple DSB Complex DSB Clustered damage

1 2 3 10 20 30 40 50 60 70 80 90 100

  • r more

percentage of total number of lesions in cluster

low LET high LET

Peter O'Neill - Molecular basis for the relative biological effectiveness of densely ionizing radiation

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10 µm 10 µm 10 µm 55 MeV carbon 5 × 5 µm² matrix 20 MeV protons randomly distributed 20 MeV protons 5 × 5 µm² matrix 117 protons per spot Günther Dollinger - Low LET radiation focused to sub-micrometer shows enhanced radiobiological effectiveness (RBE)

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Right Ventricle Hypertrophy

Pulmonary/Cardiac function loss Early radiation-induced vascular damage

Limits tumor dose escalation

Pulmonary Hypertension

Early radiation-induced vascular damage

Angiostatin-converting enzyme (ACE) inhibition ameliorates pulmonary/cardiac function, but only when the heart is co- irradiated

Sonja van der Veen, University of Groningen, The Netherlands

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  • Dose deposition at 500nm around a AuNP of 100nm with a 85 keV X-ray beam.

§ In water Simulation results

Dose deposition around a AuNP of 100nm

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§ With a centred AuNP § AuNP : Increase of the dose up to a factor 100 with quasi-isotropic diffusion.

1µm

X-ray source

Z X Dose (eV/g)

8e11 6e11 4e11 2e11

1µm

X-ray source

Dose (eV/g) Z X

NP 1e14 8e13 6e13 4e13 2e13

Rachel DELORME

CEA, LIST, France

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Michael Krämer

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Michael Krämer

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1 2 3 4 5 6 REID in % NASA estimate

  • ur work

NASA estimate

  • ur work

Lunar, long (0.084 Sv) Mars, swing (1.03 Sv) Mars, surface (1.07 Sv)

Uwe Schneider, Cancer risk above 1 Gy and the impact for space radiation protection

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0.0001 0.001 0.01 0.1 1 20 40 60 80 100 120 140 Distance from Field Edge (cm) Neutron Dose equivalent/ Proton Dose Hall's Paper, HCL (160 MeV) LLUMC Snoopy Neutron Detector (250 MeV) LLUMC CR39 Detectors (250 MeV) Yan's Paper, HCL, Boston Bonner Spheres (160 MeV) MPRI, Neutron Bubble detector (150 Mev) SOI Microdosimeter (225MeV)

  • Expon. (Hall's Paper, HCL (160

MeV))

Courtesy of A. Wroe

  • C. Rossi-LLUMC. ESTRO 2007

Ex : How potential applications and solutions can be suddenly affected: Use of passive delivery systems of proton beams for pediatric treatments Measured Neutron Dose at LLUMC

Status & Perspectives in Particle Therapy – Alejandro Mazal

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Gaboriaud & al, Curie

Electrons + photons

St.Clair & al, MGH

IMXT Photons

Miralbell

PEDIATRICS (medulloblastoma)

  • Issues:

T.control

  • Sequelae

Secondary T Cognigtive …

  • Lomax & al, PSI

Protons (court.Varian)

Status & Perspectives in Particle Therapy – Alejandro Mazal

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Secondary Malignant Neoplasms (SMN) in particle therapy Comparison of relative radiation dose distribution with the corresponding relative risk distribution for radiogenic second cancer incidence and mortality. This 9-year old girl received craniospinal irradiation for medulloblastoma using passively scattered proton beams. The color scale illustrates the difference for absorbed dose, incidence and mortality cancer risk in different

  • rgans.

Radiation Absorbed Dose Risk of SMN Incidence Risk of SMN Mortality

Newhauser & Durante, Nature Rev. Cancer 2011

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In patient dosimetry (uterus dose for a pregnant woman)

Total dose < 0.3 mSv Münter et al., Fertil Steril. 2010 Very low stray radiation reduced risk of secondary cancers or teratogen effects

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We know how to deal with the technology, but is bulky and, mainly, too expensive Protons stops but we do not know exactly where Ions have a strong biological effect, but we do not know exactly the values Thousands of patients have been treated but there are critics on the lack of clinical trials In spite of the experience of the existing centers there are still non realistics business plans CONCLUSIONS Status & Perspectives in Particle Therapy – Alejandro Mazal

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~ 200 shifts/year for reducing uncertainty on cancer risk from 1500% to 50% in 20 years

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Outlook

  • Most of the uncertainty in particle therapy and

space radiation protection is due to biology, not physics

  • Physics can lead to significant technical

improvements and reduced costs but biology can lead to major breakthrough

  • Hot topics are RBE, genetic background,

hypofractionaction, vascular damage, nanotechnologies, adaptive TP, angiogenesis, metastasis, late effects and second cancers

  • Beamtime and easier access to facilities needed
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