title: Heavy element enhanced synchrotron stereotactic radiotherapy as a promising brain tumour treatment.
abstract: Synchrotron stereotactic radiotherapy (SSR) is a treatment that involves selective accumulation of high-Z elements in tumours followed by stereotactic irradiation, in CT mode, with monochromatic X-rays from a synchrotron source, tuned at an optimal energy. The irradiation geometry, characteristic X-rays, photoelectrons, and Auger electrons generated on high-Z atoms by kilovoltage X-rays produce a localized dose enhancement. Two complimentary SSR approaches have been successfully developed in the past 5 years in our team, and may be promising in high-grade glioma management: iodine-enhanced SSR, with an iodinated contrast agent; and Pt-enhanced SSR; a concomitant radio-chemotherapy treatment with locoregional injection of platinated chemotherapy drugs. The results for iodine-enhanced SSR using contrast agents are presented in this paper. IUdR-enhanced SSR was also tested in this study. Up to 15 Gy, intracarotid infusion of iodine significantly improved the rats' survival compared to irradiation alone. SSR provides the most protracted survivals of F98 glioma-bearing rats. The technique is currently transferred to clinical trials. Iodine-enhanced SSR will be implemented first, because of its simplicity; and pave the way for Pt-enhanced SSR, the most efficient technique, but still needing to be improved in terms of intrinsic toxicity.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale, Unite 836, Grenoble Institut des Neurosciences, Equipe 6 Rayonnement Synchrotron et recherche Médicale, ESRF Medical Beamline, BP 220, 38043 Grenoble Cedex 9, France. adam@esrf.fr
authors.forename: J F
authors.initials: JF
authors.lastname: Adam
authors.forename: M C
authors.initials: MC
authors.lastname: Biston
authors.forename: J
authors.initials: J
authors.lastname: Rousseau
authors.forename: C
authors.initials: C
authors.lastname: Boudou
authors.forename: A M
authors.initials: AM
authors.lastname: Charvet
authors.forename: J
authors.initials: J
authors.lastname: Balosso
authors.forename: F
authors.initials: F
authors.lastname: Estève
authors.forename: H
authors.initials: H
authors.lastname: Elleaume
mesh_terms: D000818:Animals; D055592:Biophysical Phenomena; D001703:Biophysics; D001932:Brain Neoplasms / Q000601:surgery*; D003287:Contrast Media / Q000008:administration & dosage; D005910:Glioma / Q000601:surgery; D006801:Humans; D007065:Idoxuridine / Q000008:administration & dosage; D007455:Iodine / Q000008:administration & dosage; D010984:Platinum / Q000008:administration & dosage; D016634:Radiosurgery / Q000379:methods*; D051381:Rats; D011916:Rats, Inbred F344; D017356:Synchrotrons
chemical_list: D003287:Contrast Media; D010984:Platinum; D007455:Iodine; D007065:Idoxuridine