Dose- and Volume-Limiting Late Toxicity of FLASH Radiotherapy in Cats with Squamous Cell Carcinoma of the Nasal Planum and in Mini Pigs.

Details

Serval ID
serval:BIB_83A4D24300BD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Dose- and Volume-Limiting Late Toxicity of FLASH Radiotherapy in Cats with Squamous Cell Carcinoma of the Nasal Planum and in Mini Pigs.
Journal
Clinical cancer research
Author(s)
Rohrer Bley C., Wolf F., Gonçalves Jorge P., Grilj V., Petridis I., Petit B., Böhlen T.T., Moeckli R., Limoli C., Bourhis J., Meier V., Vozenin M.C.
ISSN
1557-3265 (Electronic)
ISSN-L
1078-0432
Publication state
Published
Issued date
01/09/2022
Peer-reviewed
Oui
Volume
28
Number
17
Pages
3814-3823
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
Publication Status: ppublish
Abstract
The FLASH effect is characterized by normal tissue sparing without compromising tumor control. Although demonstrated in various preclinical models, safe translation of FLASH-radiotherapy stands to benefit from larger vertebrate animal models. Based on prior results, we designed a randomized phase III trial to investigate the FLASH effect in cat patients with spontaneous tumors. In parallel, the sparing capacity of FLASH-radiotherapy was studied on mini pigs by using large field irradiation.
Cats with T1-T2, N0 carcinomas of the nasal planum were randomly assigned to two arms of electron irradiation: arm 1 was the standard of care (SoC) and used 10 × 4.8 Gy (90% isodose); arm 2 used 1 × 30 Gy (90% isodose) FLASH. Mini pigs were irradiated using applicators of increasing size and a single surface dose of 31 Gy FLASH.
In cats, acute side effects were mild and similar in both arms. The trial was prematurely interrupted due to maxillary bone necrosis, which occurred 9 to 15 months after radiotherapy in 3 of 7 cats treated with FLASH-radiotherapy (43%), as compared with 0 of 9 cats treated with SoC. All cats were tumor-free at 1 year in both arms, with one cat progressing later in each arm. In pigs, no acute toxicity was recorded, but severe late skin necrosis occurred in a volume-dependent manner (7-9 months), which later resolved.
The reported outcomes point to the caveats of translating single-high-dose FLASH-radiotherapy and emphasizes the need for caution and further investigations. See related commentary by Maity and Koumenis, p. 3636.
Keywords
Animals, Carcinoma, Squamous Cell/pathology, Cats, Necrosis, Nose Neoplasms/pathology, Nose Neoplasms/radiotherapy, Nose Neoplasms/veterinary, Radiotherapy Dosage, Swine, Swine, Miniature
Pubmed
Open Access
Yes
Create date
25/04/2022 11:51
Last modification date
22/09/2022 6:38
Usage data