论文标题

建模组织氧轮廓和氧耗竭参数不确定性对生物学反应和闪光治疗益处的影响

Modeling the impact of tissue oxygen profiles and oxygen depletion parameter uncertainties on biological response and therapeutic benefit of FLASH

论文作者

Zhu, Hongyu, Schuemann, Jan, Zhang, Qixian, Gerweck, Leo E

论文摘要

据报道,闪光辐射可以有效抑制肿瘤的生长,同时避免正常组织,但是,差异组织隔离效应的机制尚不清楚。长期以来,已知氧气会深刻影响放射生物学的反应,而放射性氧的耗竭被认为是闪光现象的可能原因或促成因素。这项工作研究了组织PO2谱,单位剂量(G)的氧耗竭以及在肿瘤和正常组织中产生半Ximimal放射敏化(K)的影响。我们开发了一个模型,该模型考虑了氧气耗竭与闪光照射期间的放射敏性变化之间的依赖关系。根据LQ-L模型计算细胞存活,并在输送闪光照射的分数剂量时调整了相关的参数。模型复制了已发表的实验数据,并用于分析参数不确定性对放射生物学响应的影响。这项研究将基于临床确定的骨料和个体患者PO2特征扩展到正常的人体组织和肿瘤的氧气耗竭分析。结果表明,PO2轮廓是影响生物学反应和基于中位数PO2而不是完整PO2轮廓的生物学反应和分析的最重要因素,这可能是不可靠和误导的。另外,放射性生物学缺氧阈值的一小部分细胞的存在显着改变了对闪光照射的生物学反应。我们发现,由于肿瘤中PO2较低的频率,K值的增量通常比正常组织更具保护性肿瘤。 G值的变化会影响氧气耗竭会影响反应的剂量,而不会改变剂量依赖性响应趋势,如果G值在肿瘤和正常组织中均相同。

FLASH radiation has been reported to efficiently suppress tumor growth while sparing normal tissue, however, the mechanism of the differential tissue sparing effect is still not known. Oxygen has long been known to profoundly impact radiobiological responses, and radiolytic oxygen depletion has been considered to be a possible cause or contributor to the FLASH phenomenon. This work investigates the impact of tissue pO2 profiles, oxygen depletion per unit dose (g), and the oxygen concentration yielding half-maximal radiosensitization (k) in tumor and normal tissue. We developed a model that considers the dependent relationship between oxygen depletion and change of radiosensitivity during FLASH irradiation. Cell survival was calculated based on the LQ-L model and the radiosensitivity related parameters were adjusted while delivering fractional doses of FLASH irradiation The model reproduced published experimental data and was used to analyze the impact of parameter uncertainties on the radiobiological responses. This study expands the oxygen depletion analysis of FLASH to normal human tissue and tumor based on clinically determined aggregate and individual patient pO2 profiles. The results show that the pO2 profile is the most essential factor that affects biological response and analyses based on the median pO2 rather than the full pO2 profile can be unreliable and misleading. Additionally, the presence of a small fraction of cells on the threshold of radiobiologic hypoxia substantially alters biological response to FLASH irradiation. We found that an increment in the k value is generally more protective of tumor than normal tissue due to a higher frequency of lower pO2 values in tumors. Variation in the g value affects the dose at which oxygen depletion impacts response, but does not alter the dose dependent response trends, if the g value is identical in both tumor and normal tissue.

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