Commissioning parameters met the requirements of TSET treatments and the matching of AAPM guidelines with the IAEA code of practice was successful. Frequent beam performance controls can be easily performed through the presented quality assurance tests. Radiochromic dosimetry facilitated the TSET commissioning and played a major role to validate the application of TRS-398.
The aim of this work was to evaluate the performance of the voxel-based Monte Carlo algorithm implemented in the commercial treatment planning system ONCENTRA MASTERPLAN for a 9 MeV electron beam produced by a linear accelerator Varian Clinac 2100 C/D. In order to realize an experimental verification of the computed data, three different groups of tests were planned. The first set was performed in a water phantom to investigate standard fields, custom inserts, and extended treatment distances. The second one concerned standard field, irregular entrance surface, and oblique incidence in a homogeneous PMMA phantom. The last group involved the introduction of inhomogeneities in a PMMA phantom to simulate high and low density materials such as bone and lung. Measurements in water were performed by means of cylindrical and plane-parallel ionization chambers, whereas measurements in PMMA were carried out by the use of radiochromic films. Point dose values were compared in terms of percentage difference, whereas the gamma index tool was used to perform the comparison between computed and measured dose profiles, considering different tolerances according to the test complexity. In the case of transverse scans, the agreement was searched in the plane formed by the intersection of beam axis and the profile (2D analysis), while for percentage depth dose curves, only the beam axis was explored (1D analysis). An excellent agreement was found for point dose evaluation in water (discrepancies smaller than 2%). Also the comparison between planned and measured dose profiles in homogeneous water and PMMA phantoms showed good results (agreement within 2%-2 mm). Profile evaluation in phantoms with internal inhomogeneities showed a good agreement in the case of "lung" insert, while in tests concerning a small "bone" inhomogeneity, a discrepancy was particularly evidenced in dose values on the beam axis. This is due to the inaccurate geometrical description of the phantom that is linked to the calculation voxel size, a feature over which the user has no control.
Background
Meningiomas are mainly benign brain tumors, although about 20% of histologically benign cases are clinically aggressive and recur after resection. We hypothesize that meningioma brain invasiveness and recurrence may be related to the presence of cancer stem cells and their high responsiveness to the CXCL12-CXCR4/CXCR7 chemokine axis. The aim of this study was to isolate meningioma stem cells from human samples, characterize them for biological features related to malignant behavior, and to identify the role of CXCR4/CXCR7 in these processes.
Methods
Meningioma stem cells were isolated from patient-derived primary cultures in stem cell-permissive conditions, and characterized for phenotype, self-renewal, proliferation and migration rates, vasculogenic mimicry, and in vivo tumorigenesis, in comparison with differentiated meningioma cells and stem-like cells isolated from normal meninges. These cell populations were challenged with CXCL12 and CXCL11 and receptor antagonists to define the chemokine role in stem cell-related functions.
Results
Stem-like cells isolated from meningioma cultures display higher proliferation and migration rates, vasculogenic mimicry, as compared to meningioma non-stem cells or cells isolated from normal meninges and were the only tumorigenic population in vivo. In meningioma cells, these stem-like functions were under the control of the CXCR4/CXCR7 chemokine axis.
Conclusions
We report a role for CXCL11 and CXCL12 in the control of malignant features in stem-like cells isolated from human meningioma, providing a possible basis for the aggressive clinical behavior observed in subsets of these tumors. CXCR4/CXCR7 antagonists might represent a useful approach for meningioma at high risk of recurrence and malignant progression.
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