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The interaction between human recombinant tumor necrosis factor — alpha and radiation in human carcinoma and sarcoma cell lines
160
Radiation
Oncology, Biology,
Physics
October
1989, Volume
17, Supplement
1
were obtained by placing film in the cassette with the storage phosphor plates prior to exposure.
Four radiation oncologists rated the storage phosphor and conventional films from 45 cases for perceptibility of anatomical detail needed to verify the placement of the treatment field. For each case, the reader was shown a simulation film and a portal film side by side. The selection of reading order and type of portal film to be viewed for each case was randomized. Each reader looked at all 45 cases in one session, requiring 3 separate sessions in order to view the 3 types of portal films (contrast enhanced, contrast/edge enhanced, or unprocessed conventional) for each case. Contrast enhancement alone did not result in a significant improvement in perceptibility over unprocessed conventional film (p=O.ll). However, the combination of contrast and edge enhancement did result in a significant improvement over conventional film (p
87 CLINICAL
APPLICATIONS
David Gur, Sc.D., Departments
OF ELECTRON
John C. Weiser,
of Diagnostic
TREATMENT M.S.,
Radiology
PORTAL
IMAGES
Elmer R. Cane, M.D.,
and Therapeutic
Melvin
Deutsch,
University
Radiology,
M.D.
of Pittsburgh,
Pittsburgh,
PA 15261
Although the ability to use the Bremsstrahlung contamination in high-energy electron beams to obtain verification portal films of electron treatments was reported over 10 years ago, a review of the literature indicates One possible that there have been no subsequent reports on clinical application of this verification technique. reason for this lack of emphasis on electron field verification is the superficial nature of many of these treatAlso, the wide ments, which renders an image of the field relative to underlying anatomy of little or no value. The standard variation in dose prescribed for these treatments requires the use of a film with a wide latitude. verification film used in high energy photon treatments meets the requirement for wide latitude, but the speed is much too slow for recording of electron verification images where the x-ray contamination dose is less than one The film used for localization portal images is of appropriate speed but tenth of the prescribed treatment dose. lacks the latitude needed for verification imaging. Thus, a second possible reason for the lack of emphasis on electron treatment verification portal images is the inability to consistently obtain images of acceptable quality using film as the image receptor. The increased use of electron fields in combination with high-energy photon fields in abutting oroverlapping geometry, and the availability of accelerators capable of producing more penetrating (lo-20 MeV)electrons,reopen: The wide exposure latithe question of the clinical utility of verification of the placement of these fields. tude of storage phosphor image receptors and the ability to improve image quality by analog and digital image processing introduces new possibilities for exploring the use of electron treatment verification portal images. In this study, an experimental high-contrast sensitivity storage phosphor system is used to investigate the feasDaily ibility and utility of obtaining verification images of various high-energy electron treatment fields. The images were processed for verification images were obtained during the course of treatment of 15 patients. The films were then used to compare the actual treatoptimum contrast and density and laser printed onto film. Errors on ment to the planned treatment and to monitor the frequency and magnitude of field placement error. The errors were corrected and proper placement was docuinitial set-up were detected on 2 of the cases (13%). The use of verification films aided treatment management by documenting proper/ mented on subsequent treatments. improper placement of the electron beam.
88 THE INTERACTION BETWEEN AND SARCOMA CELL LINES Dennis
E. Hallahan,
Center for Radiation Boston, MA
HUMAN
Michael
RECOMBINANT
A. Beckett,
Therapy,
University
TUMOR NECROSIS
David Spriggs, of Chicago,
FACTOR
Donald
Chicago,
- ALPHA
AND RADIATION
IN HUMAN CARCINOMA
Kufe, and Ralph R. Weichselbaum Illinois
and Dana Farber Cancer
Institute
shown to cause DNA fragmentation and microtubule destruction Tumor necrosis factor (TNF) has been in sensitive human cancer cell lines. We examined the interaction between TNF and radiation in human carcinoma and sarcoma cell lines. TNF was cytolytic or cytostatic in 3 squamous cell carcinoma and 2 sarcoma cell lines (SCC 25, 61, HNSCC 19, SQ20B, STSAR 90). Growth promotion was observed in 2 carcinomas and 2 human fibroblast cell lines (HNSCC 68, 181, STSAR 255, GM 1522). TNF had no effect on 1 carcinoma and 5 sarcomas (HNSCC 151, STSAR 33, 13, 198, 91, 48). Cells were incubated with TNF (10 to 1000 units/ml) for 24 hours prior to irradiation. Exponentially growing and plateau phase cells were irradiated during survival and PLDR experiments respectively. Cells were plated in fresh media and colony formation was assessed. Delayed plating was used to evaluate PLDR. In cell lines in which TNF was cytolytic (SCC 61, 25, 19, 25, and SQ2OB), the interaction between TNF and radiation was additive or synergistic. PLDR was diminished in these cell lines. TNF was cytostatic in STSAR 90. An additive effect in radiation survival and enhancement of PLDR were observed in this cell line. TNF promoted growth in HNSCC 68. An additive effect in radiation survival and diminished PLDR were observed in HNSCC 68. Mechanisms of interaction between radiation and TNF will be discussed.
Radiation
Oncology, Biology,
Physics
October
1989, Volume
17, Supplement
1
were obtained by placing film in the cassette with the storage phosphor plates prior to exposure.
Four radiation oncologists rated the storage phosphor and conventional films from 45 cases for perceptibility of anatomical detail needed to verify the placement of the treatment field. For each case, the reader was shown a simulation film and a portal film side by side. The selection of reading order and type of portal film to be viewed for each case was randomized. Each reader looked at all 45 cases in one session, requiring 3 separate sessions in order to view the 3 types of portal films (contrast enhanced, contrast/edge enhanced, or unprocessed conventional) for each case. Contrast enhancement alone did not result in a significant improvement in perceptibility over unprocessed conventional film (p=O.ll). However, the combination of contrast and edge enhancement did result in a significant improvement over conventional film (p
87 CLINICAL
APPLICATIONS
David Gur, Sc.D., Departments
OF ELECTRON
John C. Weiser,
of Diagnostic
TREATMENT M.S.,
Radiology
PORTAL
IMAGES
Elmer R. Cane, M.D.,
and Therapeutic
Melvin
Deutsch,
University
Radiology,
M.D.
of Pittsburgh,
Pittsburgh,
PA 15261
Although the ability to use the Bremsstrahlung contamination in high-energy electron beams to obtain verification portal films of electron treatments was reported over 10 years ago, a review of the literature indicates One possible that there have been no subsequent reports on clinical application of this verification technique. reason for this lack of emphasis on electron field verification is the superficial nature of many of these treatAlso, the wide ments, which renders an image of the field relative to underlying anatomy of little or no value. The standard variation in dose prescribed for these treatments requires the use of a film with a wide latitude. verification film used in high energy photon treatments meets the requirement for wide latitude, but the speed is much too slow for recording of electron verification images where the x-ray contamination dose is less than one The film used for localization portal images is of appropriate speed but tenth of the prescribed treatment dose. lacks the latitude needed for verification imaging. Thus, a second possible reason for the lack of emphasis on electron treatment verification portal images is the inability to consistently obtain images of acceptable quality using film as the image receptor. The increased use of electron fields in combination with high-energy photon fields in abutting oroverlapping geometry, and the availability of accelerators capable of producing more penetrating (lo-20 MeV)electrons,reopen: The wide exposure latithe question of the clinical utility of verification of the placement of these fields. tude of storage phosphor image receptors and the ability to improve image quality by analog and digital image processing introduces new possibilities for exploring the use of electron treatment verification portal images. In this study, an experimental high-contrast sensitivity storage phosphor system is used to investigate the feasDaily ibility and utility of obtaining verification images of various high-energy electron treatment fields. The images were processed for verification images were obtained during the course of treatment of 15 patients. The films were then used to compare the actual treatoptimum contrast and density and laser printed onto film. Errors on ment to the planned treatment and to monitor the frequency and magnitude of field placement error. The errors were corrected and proper placement was docuinitial set-up were detected on 2 of the cases (13%). The use of verification films aided treatment management by documenting proper/ mented on subsequent treatments. improper placement of the electron beam.
88 THE INTERACTION BETWEEN AND SARCOMA CELL LINES Dennis
E. Hallahan,
Center for Radiation Boston, MA
HUMAN
Michael
RECOMBINANT
A. Beckett,
Therapy,
University
TUMOR NECROSIS
David Spriggs, of Chicago,
FACTOR
Donald
Chicago,
- ALPHA
AND RADIATION
IN HUMAN CARCINOMA
Kufe, and Ralph R. Weichselbaum Illinois
and Dana Farber Cancer
Institute
shown to cause DNA fragmentation and microtubule destruction Tumor necrosis factor (TNF) has been in sensitive human cancer cell lines. We examined the interaction between TNF and radiation in human carcinoma and sarcoma cell lines. TNF was cytolytic or cytostatic in 3 squamous cell carcinoma and 2 sarcoma cell lines (SCC 25, 61, HNSCC 19, SQ20B, STSAR 90). Growth promotion was observed in 2 carcinomas and 2 human fibroblast cell lines (HNSCC 68, 181, STSAR 255, GM 1522). TNF had no effect on 1 carcinoma and 5 sarcomas (HNSCC 151, STSAR 33, 13, 198, 91, 48). Cells were incubated with TNF (10 to 1000 units/ml) for 24 hours prior to irradiation. Exponentially growing and plateau phase cells were irradiated during survival and PLDR experiments respectively. Cells were plated in fresh media and colony formation was assessed. Delayed plating was used to evaluate PLDR. In cell lines in which TNF was cytolytic (SCC 61, 25, 19, 25, and SQ2OB), the interaction between TNF and radiation was additive or synergistic. PLDR was diminished in these cell lines. TNF was cytostatic in STSAR 90. An additive effect in radiation survival and enhancement of PLDR were observed in this cell line. TNF promoted growth in HNSCC 68. An additive effect in radiation survival and diminished PLDR were observed in HNSCC 68. Mechanisms of interaction between radiation and TNF will be discussed.