Who Will Benefit from Charged-Particle Therapy?

Kim, Kyung Soo; Wu, Hong Gyun

doi:10.4143/crt.2021.299

Cited by 5 publications

(3 citation statements)

References 159 publications

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“…Over the past two decades, particle therapy, mainly comprising carbon-ion radiotherapy (CIRT) and proton beam therapy (PBT), has been utilized for the treatment of various cancers, including lung cancer, and has shown encouraging clinical outcomes and acceptable toxicity [ 13 – 16 ]. It was estimated that approximately 13% of patients receiving curative radiotherapy might benefit from PBT [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of particle therapy for inoperable stage II-III non-small cell lung cancer: a systematic review and meta-analysis

Chen,

Luo,

Liu

et al. 2023

Radiat Oncol

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Background and purpose Particle therapy, mainly including carbon-ion radiotherapy (CIRT) and proton beam therapy (PBT), has dose distribution advantages compared to photon radiotherapy. It has been widely reported as a promising treatment method for early non-small cell lung cancer (NSCLC). However, its application in locally advanced non-small cell lung cancer (LA-NSCLC) is relatively rare, and its efficacy and safety are inconclusive. This study aimed to provide systematic evidence for evaluating the efficacy and safety of particle therapy for inoperable LA-NSCLC. Methods To retrieve published literature, a systematic search was conducted in PubMed, Web of Science, Embase, and Cochrane Library until September 4, 2022. The primary endpoints were local control (LC) rate, overall survival (OS) rate, and progression-free survival (PFS) rate at 2 and 5 years. The secondary endpoint was treatment-related toxicity. The pooled clinical outcomes and 95% confidence intervals (CIs) were calculated by using STATA 15.1. Results Nineteen eligible studies with a total sample size of 851 patients were included. The pooled data demonstrated that the OS, PFS, and LC rates at 2 years of LA-NSCLC treated by particle therapy were 61.3% (95% CI = 54.7-68.7%), 37.9% (95% CI = 33.8-42.6%) and 82.2% (95% CI = 78.7-85.9%), respectively. The pooled 5-year OS, PFS, and LC rates were 41.3% (95% CI = 27.1-63.1%), 25.3% (95% CI = 16.3-39.4%), and 61.5% (95% CI = 50.7-74.6%), respectively. Subgroup analysis stratified by treatment type showed that the concurrent chemoradiotherapy (CCRT, PBT combined with concurrent chemotherapy) group had better survival benefits than the PBT and CIRT groups. The incidence rates of grade 3/4 esophagitis, dermatitis, and pneumonia in LA-NSCLC patients after particle therapy were 2.6% (95% CI = 0.4-6.0%), 2.6% (95% CI = 0.5-5.7%) and 3.4% (95% CI = 1.4-6.0%), respectively. Conclusions Particle therapy demonstrated promising efficacy and acceptable toxicity in LA-NSCLC patients.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of particle therapy for inoperable stage II-III non-small cell lung cancer: a systematic review and meta-analysis

Chen,

Luo,

Liu

et al. 2023

Radiat Oncol

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“…The radiobiology of ion beams has been the subject of intense investigation in view of its relevance to advanced forms of cancer therapy, where ion beams allow precise dose deposition within the tumour volume by exploiting the Bragg peak profile (DeLaney 2018, Durante and Flanz 2019, Kim and Wu 2021). This precise dose delivery offers significant normal tissue sparing thus widening the therapeutic window, and resulting in effective treatment of tumours in the close vicinity of critical organs Wu 2021, Park et al 2021).…”

Section: Introductionmentioning

confidence: 99%

Cellular irradiations with laser-driven carbon ions at ultra-high dose rates

et al. 2023

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Objective. Carbon is an ion species of significant radiobiological interest, particularly in view of its use in cancer radiotherapy, where its large Relative Biological Efficiency is often exploited to overcome radio resistance. A growing interest in highly pulsed carbon delivery has arisen in the context of the development of the FLASH radiotherapy approach, with recent studies carried out at dose rates of 40 Gy s−1. Laser acceleration methods, producing ultrashort ion bursts, can now enable the delivery of Gy-level doses of carbon ions at ultra-high dose rates (UHDRs), exceeding 109 Gy s−1. While studies at such extreme dose rate have been carried out so far using low LET particles such as electrons and protons, the radiobiology of high-LET, UHDR ions has not yet been explored. Here, we report the first application of laser-accelerated carbon ions generated by focussing 1020 W cm−2 intense lasers on 10–25 nm carbon targets, to irradiate radioresistant patient-derived Glioblastoma stem like cells (GSCs). Approach. We exposed GSCs to 1 Gy of 9.5 ± 0.5 MeV/n carbon ions delivered in a single ultra-short (∼400-picosecond) pulse, at a dose rate of 2 × 109 Gy s−1, generated using the ASTRA GEMINI laser of the Central Laser Facility at the Rutherford Appleton Laboratory, Didcot, Oxfordshire, UK. We quantified carbon ion-induced DNA double strand break (DSB) damage using the 53BP1 foci formation assay and used 225 kVp x-rays as a reference radiation. Main Results. Laser-accelerated carbon ions induced complex DNA DSB damage, as seen through persistent 53BP1 foci (11.5 ± 0.4 foci/cell/Gy) at 24 h and significantly larger foci (1.69 ± 0.07 μm2) than x-rays induced ones (0.63 ± 0.02 μm2). The relative foci induction value for laser-driven carbon ions relative to conventional x-rays was 3.2 ± 0.3 at 24 h post-irradiation also confirming the complex nature of the induced damage. Significance. Our study demonstrates the feasibility of radiobiology investigations at unprecedented dose rates using laser-accelerated high-LET carbon ions in clinically relevant models.

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“…In this context, we would sincerely wish that three special articles in the current issue of Cancer Research and Treatment (by Koom et al [ 6 ], Kim et al [ 7 ], and Park et al [ 8 ], respectively) could provide the up-to-date and balanced insights on particle beam therapy, from the basic to the practical issues, to the interested readers who major in various oncology fields but may not be very familiar with this topic. Also we would wish these special articles to assist the Korean National Health Insurance Service in establishing the optimal reimbursement policy.…”

mentioning

confidence: 99%