A proof-of-concept, personalized shield could protect patients receiving radiation therapy from mouth and gastrointestinal tract injuries.
Cancer patients receiving radiation therapy could soon have a personalized protection shield that could offer an extra level of protection from radiation-induced toxicity.
Injuries to healthy tissue from radiation exposure affect more than 200,000 patients in the United States annually. A good portion of the damage occurs in the mouth and gastrointestinal tract, potentially leading to painful oral mucositis, esophagitis, and proctitis.
In a new study published April 22 in Advanced Science, a team of investigators from Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Massachusetts General Hospital (MGH), and the Massachusetts Institute of Technology (MIT), laid out details of a personalized, 3D-printed device that is intended to shield radiation therapy patients and prevent radiation-induced toxicity.
This work is proof-of-concept, said the multi-disciplinary team led by James Byrne, M.D., Ph.D., a post-doctoral researcher at Brigham and Women’s and MIT, as well as a senior radiation oncology resident physician at Brigham and Women’s, MGH, and Dana-Farber Cancer Institute, but, so far, their testing has shown promising results.
“When we treat patients with radiation, we do our best to minimize the area of healthy tissue that receives radiation and break up treatment into small doses, but it’s a fine balance. We want to administer the most dose we can to shrink the tumor without causing damage to healthy issue,” Byrne said. “Our goal through this project was to find an innovative solution that could offer personalized protection for patients.”
To develop the radio-protective shield, Byrne’s team tested several types of both solid and liquid material, eventually settling on high atomic number (Z) materials. These substances can block gamma and X-rays, as well as other materials, to reduce radiation backscatter.
The team created the individualized designs from CT scans and produced them with 3D printers. Once the shields were printed, Bryne and his colleagues tested them with rats and pigs, specifically focusing on how the devices impacted the mouth and gastrointestinal tracts.
“It’s not uncommon for gastroenterologists to be called in to consult on a case to support a patient who is experiencing side effects of radiation in the esophagus, small intestine, or anywhere else in the gastrointestinal tract,” said corresponding author C. Giovanni Traverso, MB, BChir, Ph.D., a gastroenterologist and biomedical engineer at Brigham and MIT, noting that the team began brainstorming several years back about whether it were possible to create a shield that could protect significant portions of healthy tissue during radiation therapy.
The results of their test so far have been encouraging, they said.
According to their analysis, the 3D shield successfully protects healthy tissue in the mouth and rectum of rats, and they have good feasibility and reproducibility of placement in pigs. The team also estimated that, in human simulations, the device could potentially reduce radiation to the mouth by 30 percent for head and neck cancer patients. Additionally, it could provide a 15-percent drop in radiation exposure to the gastrointestinal tract for prostate cancer patients without any dose reduction to the tumor.
Although these results are promising, Byrne said, there is still much work to be done to determine how best to translate the devices into clinical use.
“Our results support the feasibility of personalized devices for reducing the side effects of radiation therapy,” he said. “This personalized approach could be applicable to a variety of cancers and holds the potential to reduce the burden of radiation injury and toxicity for our patients.”
For more coverage based on industry expert insights and research, subscribe to the Diagnostic Imaging e-Newsletter here.