title: Smart Radiation Therapy Biomaterials.
abstract: Radiation therapy (RT) is a crucial component of cancer care, used in the treatment of over 50% of cancer patients. Patients undergoing image guided RT or brachytherapy routinely have inert RT biomaterials implanted into their tumors. The single function of these RT biomaterials is to ensure geometric accuracy during treatment. Recent studies have proposed that the inert biomaterials could be upgraded to "smart" RT biomaterials, designed to do more than 1 function. Such smart biomaterials include next-generation fiducial markers, brachytherapy spacers, and balloon applicators, designed to respond to stimuli and perform additional desirable functions like controlled delivery of therapy-enhancing payloads directly into the tumor subvolume while minimizing normal tissue toxicities. More broadly, smart RT biomaterials may include functionalized nanoparticles that can be activated to boost RT efficacy. This work reviews the rationale for smart RT biomaterials, the state of the art in this emerging cross-disciplinary research area, challenges and opportunities for further research and development, and a purview of potential clinical applications. Applications covered include using smart RT biomaterials for boosting cancer therapy with minimal side effects, combining RT with immunotherapy or chemotherapy, reducing treatment time or health care costs, and other incipient applications.
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Physics and Applied Physics, University of Massachusetts, Lowell, Massachusetts. Electronic address: wngwa@lroc.harvard.edu.
authors.forename: Wilfred
authors.initials: W
authors.lastname: Ngwa
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Francis
authors.initials: F
authors.lastname: Boateng
authors.affiliation: Department of Physics, Northeastern University, Dana-Farber Cancer Institute, Massachusetts.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts.
authors.forename: Darrell J
authors.initials: DJ
authors.lastname: Irvine
authors.affiliation: Department of Radiation Oncology, Cornell University, Ithaca, New York.
authors.forename: Silvia
authors.initials: S
authors.lastname: Formenti
authors.affiliation: Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Twalib
authors.initials: T
authors.lastname: Ngoma
authors.affiliation: University Medical Center Mannheim, University of Heidelberg, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Herskind
authors.affiliation: University Medical Center Mannheim, University of Heidelberg, Germany.
authors.forename: Marlon R
authors.initials: MR
authors.lastname: Veldwijk
authors.affiliation: University Medical Center Mannheim, University of Heidelberg, Germany.
authors.forename: Georg Lars
authors.initials: GL
authors.lastname: Hildenbrand
authors.affiliation: Kirchhoff-Institute for Physics, University of Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hausmann
authors.affiliation: University Medical Center Mannheim, University of Heidelberg, Germany.
authors.forename: Frederik
authors.initials: F
authors.lastname: Wenz
authors.affiliation: University Medical Center Mannheim, University of Heidelberg, Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Hesser
mesh_terms: D001185:Artificial Intelligence; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001918:Brachytherapy / Q000379:methods*; D057918:Fiducial Markers; D006801:Humans; D053758:Nanoparticles; D061089:Radiotherapy, Image-Guided / Q000379:methods*
chemical_list: D001672:Biocompatible Materials