Jacques Balosso

• Professor
• MD-PhD at Grenoble Alpes University

Background Radiotherapy as a complement or an alternative to neurosurgery has a central role in the treatment of skull base grade I-II meningiomas. Radiotherapy techniques have improved considerably over the last two decades, becoming more effective and sparing more and more the healthy tissue surrounding the tumour. Currently, hypo-fractionated st...

Background Proton therapy (PRT) is an innovative radiotherapeutic modality for the treatment of cancer with unique ballistic properties. The depth-dose distribution of a proton beam reduces exposure of healthy tissues to radiations, compared with photon-therapy (XRT). To date, only few indications for proton-therapy, like pediatric cancers, chordom...

This report describes the general framework, research goals, preliminary technical design, and resources required for a novel accelerator-based research infrastructure for cancer therapy and biomedical sciences with ion beams. The information presented is the result of five years of research and design activities conducted by a wide multinational c...

Some cancers have a poor prognosis and often lead to local recurrence because they are resistant to available treatments, e.g., glioblastoma. Attempts have been made to increase the sensitivity of resistant tumors by targeting pathways involved in the resistance and combining it, for example, with radiotherapy (RT). We have previously reported that...

Synchrotron Microbeam Radiation Therapy (MRT) has repeatedly proven its superiority compared with conventional radiotherapy for glioma control in preclinical research. The clinical transfer phase of MRT has recently gained momentum; seven dogs with suspected glioma were treated under clinical conditions to determine the feasibility and safety of MR...

Background Objective This multicenter study aimed to retrospectively evaluate the impact of high boost simultaneous integrated boost (SIB) to pathologic lymph nodes compared to Sequential boost (Seq) in patients with locally advanced cervical cancer (LACC). Materials and methods 97 patients with pelvic and/or para-aortic (PAo) node-positive LACC...

Skin adnexal carcinomas are rare skin cancer, developing from pilosebaceous, eccrine and apocrine unit. Treatment of localised tumours usually includes surgery and radiotherapy. Indications and modalities of radiotherapy depend on the pathological subtype with a lack of consensus for some histologies. This review summarises the place of radiotherap...

Simple Summary The poor survival of unresectable locally advanced stage non-small cell lung cancer is due to the resistance to chemoradiotherapy and local/distant relapses. However, with the advent of new drugs, it has become possible to improve the prognosis of patients with stage III NSCLC harboring certain genetic mutations. Herein, we review ne...

Background Some cancers such as sarcomas (bone and soft tissue sarcomas) and adenoid cystic carcinomas are considered as radioresistant to low linear energy transfer radiation (including photons and protons) and may therefore beneficiate from a carbon ion therapy. Despite encouraging results obtained in phase I/II trials compared to historical data...

Introduction The high potential of Microbeam Radiation Therapy (MRT) in improving tumor control whilst reducing side effects has been shown by numerous preclinical studies. MRT offers a widened therapeutic window by using the periodical spatial fractionation of synchrotron generated x-rays into an array of intense parallel microbeams. MRT now enter...

Neurofibromatosis type 1 (NF1) is a disease characterized by high occurrence of benign and malignant brain tumours and caused by mutations of the neurofibromin protein. While there is an increasing evidence that NF1 is associated with radiosensitivity and radiosusceptibility, few studies have dealt with the molecular and cellular radiation response...

Radiotherapy for Hodgkin lymphomas has evolved a lot over time, but still plays an important role, almost always in addition to chemotherapy, for the management of the early stages. The major objective is to preserve the quality of life of patients who will be cured from this disease in the vast majority of cases. Also, the personalization of the i...

The RadioTransNet programme launched under the auspices of French societies for radiation oncology (SFRO) and medical physics (SFPM) was approved by the French national cancer institute (INCa) in December 2018 and is dedicated to proposing a relevant national and transversal structure for preclinical research including translational research in rad...

Purpose: This retrospective study aims to assess factors associated with the occurrence of toxicity after brachytherapy (BT), as boost after external beam radiotherapy (EBRT) for treatment of invasive cervix carcinoma. Methods and materials: All consecutive patients diagnosed with cervical carcinoma, and treated with concurrent radiochemotherapy...

Background: Imaging, in radiotherapy, has become a routine tool for repositioning of the target volume at each session. The repositioning precision, currently infracentimetric, evolves along with the irradiation techniques. This retrospective study aimed to identify practices and doses resulting from the use of high energy planar imaging (portal i...

Purpose Proton therapy (PT) can be a good option to achieve tumor control while reducing the probability of radiation induced toxicities compared to X-ray-based radiotherapy. However, there are still uncertainties about the effects of PT on the organs in direct contact with the irradiated volume. The aim of this prospective series was to report 6-m...

Résumé En dehors de l’oncopédiatrie, et des indications dites « indiscutables » de protonthérapie, validées par l’Institut national du cancer (INCa) et de la Haute autorité de santé (HAS) (chordome, chondrosarcome, et mélanome oculaires), les indications potentielles de protonthérapie en population adulte restent très débattues. L’objectif de cet a...

Background and purpose: Brain metastasis impacts greatly on patients' quality of life and survival. The phase I NANO-RAD trial assessed the safety and maximum tolerated dose of systemic administration of a novel gadolinium-based nanoparticle, AGuIX, in combination with whole brain radiotherapy in patients with multiple brain metastases not suitabl...

Delivery of high-radiation doses to brain tumors via multiple arrays of synchrotron X-ray microbeams permits huge therapeutic advantages. Brain tumor (9LGS)-bearing and normal rats were irradiated using a conventional, homogeneous Broad Beam (BB), or Microbeam Radiation Therapy (MRT), then studied by behavioral tests, MRI, and histopathology. A val...

This phase III trial included patients with ultra-low rectal adenocarcinoma that initially required abdominoperineal resection. The surgical decision was based on clinical tumour status after preoperative treatment. The overall sphincter-saving resection rate was 85 per cent, with 72 per cent rate of intersphincteric resection. Long-term results sh...

Purpose Helical Tomotherapy (HT) appears as a valuable technique for total body irradiation (TBI) to create highly homogeneous and conformal dose distributions with more precise repositioning than conventional TBI techniques. The aim of this work is to describe the technique implementation, including treatment preparation, planning and dosimetric m...

Background Rate of abdominoperineal resection (APR) varies from countries and surgeons. Surgical impact of preoperative treatment for ultra‐low rectal carcinoma (ULRC) initially indicated for APR is debated. We report the 10‐year oncological results from a prospective controlled trial (GRECCAR 1) which evaluate the sphincter saving surgery (SSR)....

Background The purpose of this review is to summarize our own experimental studies carried out over a 13-year period of time using the F98 rat glioma as model for high grade gliomas. We evaluated a binary chemo-radiotherapeutic modality that combines either cisplatin (CDDP) or carboplatin, administered intracerebrally (i.c.) by means of convection-...

From surviving fraction to tumour curability, definitions of tumour radioresistance may vary depending on the view angle. Yet, mechanisms of radioresistance have been identified and involve tumour-specific oncogenic signalling pathways, tumour metabolism and proliferation, tumour microenvironment/hypoxia, genomics. Correlations between tumour biolo...

The use of radiosensitizing nanoparticles with both imaging and therapeutic properties on the same nano-object is regarded as a major and promising approach to improve the effectiveness of radiotherapy. Here, we report the MRI findings of a phase 1 clinical trial with a single intravenous administration of Gd-based AGuIX nanoparticles, conducted in...

Imaging is critical to each step of precision radiation therapy, i.e. planning, setup, delivery and assessment of response. Hadrontherapy can be considered to deliver more precise dose distribution that may better spare normal tissues from intermediate low doses of radiation. In addition, hadrontherapy using high linear energy transfer ions may als...

Résumé La prescription de la dose en radiothérapie est actuellement basée sur des abaques qui ne prennent pas en compte la complexité de la relation patient/dose/effet. Leurs performances prédictives tant sur l’efficacité anti-tumorale que sur la toxicité peuvent être améliorées par l’utilisation de modèles radiobiologiques. C’est dans cette optiqu...

Purpose: Synchrotron microbeam radiation therapy (MRT) is based on the spatial fractionation of the incident, highly collimated synchrotron beam into arrays of parallel microbeams depositing several hundred grays. It appears relevant to combine MRT with a conventional treatment course, preparing a treatment scheme for future patients in clinical t...

The resistance of cancer cells to radiotherapy is a major issue in the curative treatment of cancer patients. This resistance can be intrinsic or acquired after irradiation and has various definitions, depending on the endpoint that is chosen in assessing the response to radiation. This phenomenon might be strengthened by the radiosensitivity of su...

At the 2019 annual meeting of the European Network for Light ion Hadron Therapy (ENLIGHT) hosted by the University of Caen (Normandy, France) and the cancer treatment centre, the Centre François Baclesse of Caen, from 1-3 July 2019, experts from all over the world gathered to discuss the hottest topics in radiation oncology. . Session seven covered...

The functional roles of the Caudate nucleus (Cd) are well known. Selective Cd lesions can be found in neurological disorders. However, little is known about the dynamics of the behavioral changes during progressive Cd ablation. Current stereotactic radiosurgery technologies allow the progressive ablation of a brain region with limited adverse effec...

Clinical trials, their results and their implementation were among the hottest topics discussed at of the European Network for Light Ion Hadron Therapy (ENLIGHT), hosted by the University of Caen (Normandy, France) and the cancer treatment centre, the Centre François Baclesse, of Caen in July. An entire session session five – was dedicated to a bro...

A discussion about machine quality assurance (QA) was opened with a presentation by Dr Sairos Safai of the Paul Scherrer Institute (PSI) in Switzerland. His presentation, based on a European Particle Therapy Network (EPTN) survey, showed that daily QA, lasting an average of 44 minutes, was the most time-consuming part of the QA. Different approache...

The ENLIGHT annual meetings have become a unique opportunity for experts to gather and discuss common issues. Since the meetings began 17 years ago, delegates who work on particle therapies for cancer treatment in most of the European medical and research facilities and research institutions have taken time out to attend. This year, the meeting was...

and the centre for cancer treatment at Caen, Centre François Baclesse, from 1-3 July, experts from all over the world gathered to discuss the hottest topics in radiation oncology. While a significant part of the discussion focused on quality assurance issues, a hot topic of the meeting was radiobiology, including the novel FLASH technique. A talk e...

In 2016 the South East European International Institute for Sustainable Technologies (SEEIIST) was proposed by Herwig Schopper and brought to the political level by Sanja Damjanovi´c, Minister of Science of Montenegro. In this framework two design studies have been completed by two groups of European experts: a "4th Generation Synchrotron Light Sou...

Nanomedicine has undergone significant development since the 2000s and it is only very recently that two metallic nanoparticles have emerged in clinical trials. The mechanism of these radiosensitizing agents is based on the presence of atoms with a high atomic number (Z) allowing a higher dose deposition into the tumor during irradiation. The first...

Microbeam radiation therapy (MRT) uses synchrotron arrays of X-ray microbeams to take advantage of the spatial fractionation effect for normal tissue sparing. In this study, radiochromic film dosimetry was performed for a treatment where MRT is introduced as a dose boost in a hypofractionated stereotactic radiotherapy (SRT) scheme. The isocenter do...

Résumé L’ambition du réseau RADIOTRANSNET, labellisé par l’Institut national du cancer (INCa) fin 2018, est de créer un consortium de recherche national dédié à la radiothérapie oncologique préclinique afin de favoriser les interactions scientifiques et cliniques à l’interface de la radiothérapie et de la radiobiologie et de dégager des priorités d...

Résumé Il existe plus de 100 centres de proton thérapie dans le monde, et trois en France. La protonthérapie française est en phase de structuration et de montée en charge, avec l’ouverture récente des centres de Nice (2016) et Caen (2018) en plus du centre d’Orsay (2010) pour les indications corps entier. La prise en charge des enfants et adolesce...

This paper reviews the current state of the art of an emerging form of radiosurgery dedicated to brain tumour treatment and which operates at very high dose rate (kGy·s-1). Microbeam Radiation Therapy uses synchrotron-generated X-rays which triggered normal tissue sparing partially mediated by FLASH effect.

Background: Recurrence and distant metastases remain a significant issue in locally advanced rectal cancer (LARC). Several multimodal strategies are assessed in clinical trials. Patients and methods: Patients with mid/low magnetic resonance imaging-defined high-risk LARC were randomized to arm A (12-week bevacizumab + FOLFOX-4 then bevacizumab-5...

Purpose: Linear energy transfer (LET) plays an important role in radiation response. Recently, the radiation-induced nucleo-shuttling of ATM from cytoplasm to the nucleus was shown to be a major event of the radiation response that permits a normal DNA double-strand break (DSB) recognition and repair. Here, we aimed to verify the relevance of the A...

Background Carbon ion radiotherapy (CIRT) has been delivered to more than 20,000 patients worldwide. International trials have been recommended in order to emphasize the actual benefits. The ULICE program (Union of Light Ion Centers in Europe) addressed the need for harmonization of CIRT practices. A comparative knowledge of the sources and magnitu...

Introduction Occurrence of multiple brain metastases is a critical evolution of many cancers with significant neurological and overall survival consequences, despite new targeted therapy and standard whole brain radiotherapy (WBRT). A gadolinium-based nanoparticle, AGuIX, has recently demonstrated its effectiveness as theranostic and radiosensitise...

Introduction The depth-dose distribution of a proton beam, materialized by the Bragg peak makes it an attractive radiation modality as it reduces exposure of healthy tissues to radiations, compared with photon therapy Prominent indications, based on a long-standing experience are: intraocular melanomas, low-grade skull-base and spinal canal maligna...

Purpose: The Union of Light Ion Centers in Europe (ULICE) program addressed the need for uniting scientific results for carbon-ion radiation therapy obtained by several institutions worldwide in different fields of excellence, and translating them into a real benefit to the community. Particularly, the concepts for dose/volume parameters developed...

AGuIX® are sub-5 nm nanoparticles made of a polysiloxane matrix and gadolinium chelates. This nanoparticle has been recently accepted in clinical trials in association with radiotherapy. This review will summarize the principal preclinical results that have led to first in man administration. No evidence of toxicity has been observed during regulat...

Since the invention of Computed Tomography (CT), many technological advances emerged to improve the image sensitivity and resolution. However, no new source types were developed for clinical use. In this study, for the first time, coherent monochromatic X-rays from a synchrotron radiation source were used to acquire 3D CTs on patients. The aim of t...

Purpose A present challenge in medical physics is to implement the most accurate dose calculation algorithm, close to Monte Carlo simulations, with the highest safety to obtain the expected tumour control probability (TCP) and acceptable normal tissue complication probabilities (NTCP). The purpose is to propose dosimetric and radiobiological criter...

The overarching aim of work package 1 of the European Proton Therapy Network (EPTN) is to create a firm basis for evidence-based particle therapy at the European level. To achieve this, this work package will set up a worldwide unique prospective data registration programme for nine different tumour sites. Such programme will provide more insights...

Under the umbrella of the European Network for Light Ion Therapy (ENLIGHT), the project on Union of Light Ion Centers in Europe (ULICE), which was funded by the European Commission (EC/FP7), was carried out from 2009 to 2014. Besides the two pillars on Transnational Access (TNA) and Networking Activities (NA), six work packages formed the pillar on...

nous proposons une méthode d’assurance qualité avec des critères dosimétriques, radiobiologiques pour évaluer les modifications dosimétriques introduites par un nouvel algorithme de calcul de dose

Purpose: The aim of this study is to evaluate the impact of normal tissue complication probability (NTCP)-based radiobiological models on the estimated risk for late radiation lung damages. The second goal is to propose a medical decision-making approach to select the eligible patient for particle therapy. Materials and methods: 14 pediatric patien...

The use of normal tissue complication probability (NTCP) models to guide medical decisions is impeded by absolute uncertainties and predictive values rather limited to severe complications, beyond the scope of present day’s radiotherapy. Here is tested in-silico the interest of a comprehensive estimation of the biological equivalent dose, EUD, for...

Background: For a given prescribed dose of radiotherapy, with the successive generations of dose calculation algorithms, more monitor units (MUs) are generally needed. This is due to the implementation of successive improvements in dose calculation: better heterogeneity correction and more accurate estimation of secondary electron transport contri...

Proton therapy is a radiotherapy, based on the use of protons, charged subatomic particles that stop at a given depth depending on their initial energy (pristine Bragg peak), avoiding any output beam, unlike the photons used in most of the other modalities of radiotherapy. Proton therapy has been used for 60 years, but has only become ubiquitous in...

To track the dosimetric changes for similar dose prescriptions, when dose calculation algorithms are upgraded in the treatment planning system (TPS). Clinically significant representations of the treatment outcomes are used to provide interpretable data for radiation oncologists, as the equivalent uniform dose (EUD), the tumor control probability (...

Introduction Acuros-XB (AXB) algorithm has been introduced several years ago in order to improve the accuracy of dose calculation in radiotherapy, especially in the presence of tissue heterogeneities. This type (c) algorithm is based on the deterministic resolution of the linear Boltzmann transport equation and offers results close to Monte Carlo s...

Introduction: The normal tissue complication probability (NTCP) models have been proposed to rank radiotherapy plans and to select patients who would benefit from advanced radiotherapy technique. The NTCP value is directly correlated to calculated dose from DVH metrics. In this study, we quantify the uncertainties from dose calculation models on NT...

The first aim of this study is to evaluate the correlation between predicted normal tissue complication probability (NTCP) with dosimetric parameters. Then, the second goal is to evaluate the impact of published radiobiological models on NTCP prediction

Cite this article as: Chaikh A, Bresciani J, Balosso J. The bootstrap method to improve statistical analysis of dosimetric data for radiotherapy outcomes. Int J Cancer Ther Oncol. 2017; 5(1):512. Abstract Purpose: The purpose of this study is to validate a new technique in radiotherapy, the medical physicist needs to evaluate the dosimetric benefit...

Microbeam irradiation is spatially fractionated radiation on a micrometer scale. Microbeam irradiation with therapeutic intent has become known as microbeam radiation therapy (MRT). The basic concept of MRT was developed in the 1980s, but it has not yet been tested in any human clinical trial, even although there is now a large number of animal stu...

France HADRON is a French national collaboration that brings together 26 teams in nine different French cities (Lyon, Caen, Clermont-Ferrand, Paris-Orsay, Nice, Toulouse, Marseille, Strasbourg and Grenoble). This infrastructure was created in 2013 and follows the ETOILE and ARCHADE projects; it is presently funded by public money. Ten teams, from d...

L'utilisation des modèles radiobiologiques appropriés, pour estimer la probabilité de contrôle tumoral (TCP) et le risque de complications des tissus normaux (NTCP), est une étape importante pour classer et comparer les plans de protons et de photons. Les objectifs de cette étude sont d'évaluer et de quantifier les conséquences du choix des modèles...

The use of appropriate radiobiological models to estimate the tumor control probability (TCP) and the normal tissue complication probability NTCP is an important step to rank and compare proton vs photon plans for cost effectiveness. The objectives of this study are to asses and quantify the uncertainties resulting from the choice of radiobiologica...

Background: During the past decades, in radiotherapy, the dose distributions were calculated using density correction methods with pencil beam as type 'a' algorithm. The objectives of this study are to assess and evaluate the impact of dose distribution shift on the predicted secondary cancer risk (SCR), using modern advanced dose calculation algo...

Modern dose calculation algorithms (DCA) are presently being introduced into routine practice to precisely take into account secondary electrons. The Acuros-XB (AXB) as algorithm type (c) provides two dose calculation modes: dose-to-water D(w,m) and dose-to-medium D(m,m). The former algorithms (type (a) or (b)) are considered as D(w,m). The purpose...

Modern dose calculation algorithms in radiotherapy treatment take into account the scattered dose and lateral electrons transport, such as point kernel model. The impact of scattered radiation dose from radiotherapy treatment is more significant for children. In this study, secondary cancer risk (SCR) resulting from scattered dose and the contribut...

The aim of this study is to assess the impact of radiobiological models and their clinical parameters on the medical decisions. This include TCP, NTCP, UTCP (substitute of QALY) and secondary cancer risk estimation in pediatric patients.

Background: To apply the equivalent uniform dose (EUD) radiobiological model to estimate the tumor control probability (TCP) scores for treatment plans using different radiobiological parameter settings, and to evaluate the correlation between TCP and physical quality indices of the treatment plans. Methods: Ten radiotherapy treatment plans for...

The evolution of technology in radiotherapy nowadays allows us to deliver much higher doses to the target volumes, thanks to better absorbed dose distribution accuracy and conformation, while better sparing healthy tissues. In photon radiotherapy, higher precision usually entails employing small and moving beams. This emphasizes the role of in vivo...

Background: The equivalent uniform dose (EUD) radiobiological model can be applied for lung cancer treatment plans to estimate the tumor control probability (TCP) and the normal tissue complication probability (NTCP) using different dose calculation models. Then, based on the different calculated doses, the quality adjusted life years (QALY) score...

The dose calculation algorithms, integrated in a radiotherapy treatment planning system, use different approximations to swiftly compute the dose distributions. Any biological effect is somehow related to the dose delivered to the tissues. Thus, the optimization of treatment planning in radiation oncology requires, as a basis, the most accurate dos...

Background: To apply the statistical bootstrap analysis and dosimetric criteria’s to assess the change of prescribed dose (PD) for lung cancer to maintain the same clinical results when using new generations of dose calculation algorithms. Methods: Nine lung cancer cases were studied. For each patient, three treatment plans were generated using ex...

Purpose: This study investigates the use of gamma indices (γ) criteria and the digital imaging and communications in medicine (DICOM) images in order to compare dose distribution and readjust the prescription dose due to the change in dose calculation engine, to maintain the same clinical results when changing the dose calculation algorithm in a ra...