Low-energy X-ray sources that operate in the kilovoltage energy range have been shown to induce more cellular damage when compared to their megavoltage counterparts. However, low-energy X-ray sources are more susceptible to the effects of filtration on the beam spectrum. This work sought to characterize the biological effects of the Xoft Axxent® source, a low-energy therapeutic X-ray source, both with and without the titanium vaginal applicator in place. It was hypothesized that there would be an increase in relative biological effectiveness (RBE) of the Axxent® source compared to 60Co and that the source in the titanium vaginal applicator (SIA) would have decreased biological effects compared to the bare source (BS). This hypothesis was drawn from linear energy transfer (LET) simulations performed using the TOPAS Monte Carlo user code as well a reduction in dose rate of the SIA compared to the BS. A HeLa cell line was maintained and used to evaluate these effects. Clonogenic survival assays were performed to evaluate differences in the RBE between the BS and SIA using 60Co as the reference beam quality. Neutral comet assay was used to assess induction of DNA strand damage by each beam to estimate differences in RBE. Quantification of mitotic errors was used to evaluate differences in chromosomal instability (CIN) induced by the three beam qualities. The BS was responsible for the greatest quantity of cell death due to a greater number of DNA double strand breaks (DSB) and CIN observed in the cells. The differences observed in the BS and SIA surviving fractions and RBE values were consistent with the 13% difference in LET as well as the factor of 3.5 reduction in dose rate of the SIA. Results from the comet and CIN assays were consistent with these results as well. The use of the titanium applicator results in a reduction in the biological effects observed with these sources, but still provides an advantage over megavoltage beam qualities. © 2023 by Radiation Research Society
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May 2023
RESEARCH ARTICLES|
April 04 2023
Biological Characterization of the Effects of Filtration on the Xoft Axxent® Electronic Brachytherapy Source for Cervical Cancer Applications
Autumn E. Walter;
Autumn E. Walter
1
a Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
1 Corresponding author: Autumn E. Walter, PhD, 1111 Highland Avenue, Madison, WI 53705; email: aewalter2@wisc.edu.
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Pippa F. Cosper;
Pippa F. Cosper
b Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
c University of Wisconsin, Carbone Cancer Center, Madison, Wisconsin
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Kwangok P. Nickel;
Kwangok P. Nickel
b Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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Shrey Ramesh;
Shrey Ramesh
b Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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Ahtesham U. Khan;
Ahtesham U. Khan
a Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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Larry A. DeWerd;
Larry A. DeWerd
a Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
c University of Wisconsin, Carbone Cancer Center, Madison, Wisconsin
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Randall J. Kimple
Randall J. Kimple
a Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
b Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
c University of Wisconsin, Carbone Cancer Center, Madison, Wisconsin
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Radiat Res (2023) 199 (5): 429–438.
Article history
Received:
June 29 2022
Accepted:
March 10 2023
Citation
Autumn E. Walter, Pippa F. Cosper, Kwangok P. Nickel, Shrey Ramesh, Ahtesham U. Khan, Larry A. DeWerd, Randall J. Kimple; Biological Characterization of the Effects of Filtration on the Xoft Axxent® Electronic Brachytherapy Source for Cervical Cancer Applications. Radiat Res 1 May 2023; 199 (5): 429–438. doi: https://doi.org/10.1667/RADE-22-00112.1
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