Investigating the influence of respiratory motion on the radiation induced bystander effect in modulated radiotherapy.
Respiratory motion introduces complex spatio-temporal variations in the dosimetry of radiotherapy and may contribute towards uncertainties in radiotherapy planning. This study investigates the potential radiobiological implications occurring due to tumour motion in areas of geometric miss in lung cancer radiotherapy. A bespoke phantom and motor-driven platform to replicate respiratory motion and study the consequences on tumour cell survival in vitro was constructed. Human non-small-cell lung cancer cell lines H460 and H1299 were irradiated in modulated radiotherapy configurations in the presence and absence of respiratory motion. Clonogenic survival was calculated for irradiated and shielded regions. Direction of motion, replication of dosimetry by multi-leaf collimator (MLC) manipulation and oscillating lead shielding were investigated to confirm differences in cell survival. Respiratory motion was shown to significantly increase survival for out-of-field regions for H460/H1299 cell lines when compared with static irradiation (p < 0.001). Significantly higher survival was found in the in-field region for the H460 cell line (p < 0.030). Oscillating lead shielding also produced these significant differences. Respiratory motion and oscillatory delivery of radiation dose to human tumour cells has a significant impact on in- and out-of-field survival in the presence of non-uniform irradiation in this in vitro set-up. This may have important radiobiological consequences for modulated radiotherapy in lung cancer.
Centre for Cancer Research and Cell Biology, Queen's University Belfast, Lisburn Road, Belfast, BT9 7BL, UK. Clinical Oncology, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Lisburn Road, Belfast, BT9 7AB, UK.
Aidan J
AJ
Cole
Conor K
CK
McGarry
Karl T
KT
Butterworth
Stephen J
SJ
McMahon
Alan R
AR
Hounsell
Kevin M
KM
Prise
Joe M
JM
O'Sullivan
D024201:Bystander Effect / Q000528:radiation effects*; D045744:Cell Line, Tumor; D006801:Humans; D009068:Movement; D019047:Phantoms, Imaging; D011835:Radiation Protection; D011853:Radiobiology; D020266:Radiotherapy, Conformal / Q000379:methods*; D012119:Respiration