Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patients
BackgroundFLASH radiotherapy (RT) is a novel method for delivering ionizing radiation, which has been shown in preclinical studies to have a normal tissue sparing effect and to maintain anticancer efficacy as compared to conventional RT. Treatment of head and neck tumors with conventional RT is comm...
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| Format: | Article |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1256760/full |
| _version_ | 1827820885644410880 |
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| author | Betina Børresen Maja L. Arendt Elise Konradsson Kristine Bastholm Jensen Sven ÅJ. Bäck Per Munck af Rosenschöld Crister Ceberg Kristoffer Petersson Kristoffer Petersson |
| author_facet | Betina Børresen Maja L. Arendt Elise Konradsson Kristine Bastholm Jensen Sven ÅJ. Bäck Per Munck af Rosenschöld Crister Ceberg Kristoffer Petersson Kristoffer Petersson |
| author_sort | Betina Børresen |
| collection | DOAJ |
| description | BackgroundFLASH radiotherapy (RT) is a novel method for delivering ionizing radiation, which has been shown in preclinical studies to have a normal tissue sparing effect and to maintain anticancer efficacy as compared to conventional RT. Treatment of head and neck tumors with conventional RT is commonly associated with severe toxicity, hence the normal tissue sparing effect of FLASH RT potentially makes it especially advantageous for treating oral tumors. In this work, the objective was to study the adverse effects of dogs with spontaneous oral tumors treated with FLASH RT.MethodsPrivately-owned dogs with macroscopic malignant tumors of the oral cavity were treated with a single fraction of ≥30Gy electron FLASH RT and subsequently followed for 12 months. A modified conventional linear accelerator was used to deliver the FLASH RT.ResultsEleven dogs were enrolled in this prospective study. High grade adverse effects were common, especially if bone was included in the treatment field. Four out of six dogs, who had bone in their treatment field and lived at least 5 months after RT, developed osteoradionecrosis at 3-12 months post treatment. The treatment was overall effective with 8/11 complete clinical responses and 3/11 partial responses.ConclusionThis study shows that single-fraction high dose FLASH RT was generally effective in this mixed group of malignant oral tumors, but the risk of osteoradionecrosis is a serious clinical concern. It is possible that the risk of osteonecrosis can be mitigated through fractionation and improved dose conformity, which needs to be addressed before moving forward with clinical trials in human cancer patients. |
| first_indexed | 2024-03-12T01:34:22Z |
| format | Article |
| id | doaj.art-98da175dc7d74a7b9d3b581169f61e4a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-12T01:34:22Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-98da175dc7d74a7b9d3b581169f61e4a2023-09-11T12:15:59ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-09-011310.3389/fonc.2023.12567601256760Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patientsBetina Børresen0Maja L. Arendt1Elise Konradsson2Kristine Bastholm Jensen3Sven ÅJ. Bäck4Per Munck af Rosenschöld5Crister Ceberg6Kristoffer Petersson7Kristoffer Petersson8Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, DenmarkDepartment of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg, DenmarkMedical Radiation Physics, Department of Clinical Sciences, Lund University, Lund, SwedenVeterinärhuset Öresund, Limhamn, SwedenRadiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, SwedenRadiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, SwedenMedical Radiation Physics, Department of Clinical Sciences, Lund University, Lund, SwedenRadiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, SwedenDepartment of Oncology, Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United KingdomBackgroundFLASH radiotherapy (RT) is a novel method for delivering ionizing radiation, which has been shown in preclinical studies to have a normal tissue sparing effect and to maintain anticancer efficacy as compared to conventional RT. Treatment of head and neck tumors with conventional RT is commonly associated with severe toxicity, hence the normal tissue sparing effect of FLASH RT potentially makes it especially advantageous for treating oral tumors. In this work, the objective was to study the adverse effects of dogs with spontaneous oral tumors treated with FLASH RT.MethodsPrivately-owned dogs with macroscopic malignant tumors of the oral cavity were treated with a single fraction of ≥30Gy electron FLASH RT and subsequently followed for 12 months. A modified conventional linear accelerator was used to deliver the FLASH RT.ResultsEleven dogs were enrolled in this prospective study. High grade adverse effects were common, especially if bone was included in the treatment field. Four out of six dogs, who had bone in their treatment field and lived at least 5 months after RT, developed osteoradionecrosis at 3-12 months post treatment. The treatment was overall effective with 8/11 complete clinical responses and 3/11 partial responses.ConclusionThis study shows that single-fraction high dose FLASH RT was generally effective in this mixed group of malignant oral tumors, but the risk of osteoradionecrosis is a serious clinical concern. It is possible that the risk of osteonecrosis can be mitigated through fractionation and improved dose conformity, which needs to be addressed before moving forward with clinical trials in human cancer patients.https://www.frontiersin.org/articles/10.3389/fonc.2023.1256760/fullradiotherapyFLASH radiotherapyosteoradionecrosislate toxicitycanine cancertranslational research |
| spellingShingle | Betina Børresen Maja L. Arendt Elise Konradsson Kristine Bastholm Jensen Sven ÅJ. Bäck Per Munck af Rosenschöld Crister Ceberg Kristoffer Petersson Kristoffer Petersson Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patients Frontiers in Oncology radiotherapy FLASH radiotherapy osteoradionecrosis late toxicity canine cancer translational research |
| title | Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patients |
| title_full | Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patients |
| title_fullStr | Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patients |
| title_full_unstemmed | Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patients |
| title_short | Evaluation of single-fraction high dose FLASH radiotherapy in a cohort of canine oral cancer patients |
| title_sort | evaluation of single fraction high dose flash radiotherapy in a cohort of canine oral cancer patients |
| topic | radiotherapy FLASH radiotherapy osteoradionecrosis late toxicity canine cancer translational research |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1256760/full |
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