Abstract
Interstitial brachytherapy (BT) is generally used for the treatment of well-confined solid tumors. One example of this is in the treatment of prostate tumors by permanent placement of radioactive seeds within the prostate gland, where low doses of radiation are delivered for several months. However, successful implementation of this technique is hampered due to several posttreatment adverse effects or symptoms and operational and logistical complications associated with it. Recently, with the advancements in nanotechnology, radioactive nanoparticles (radio-NPs) functionalized with tumor-specific biomolecules, injected intratumorally, have been reported as an alternative to seed-based BT. Successful treatment of solid tumors using radio-NPs has been reported in several preclinical studies, on both mice and canine models. In this article, we review the recent advancements in the synthesis and use of radio-NPs as a substitute to seed-based BT. Here, we discuss the limitations of current seed-based BT and advantages of radio-NPs for BT applications. Recent progress on the types of radio-NPs, their features, synthesis methods, and delivery techniques are discussed. The last part of the review focuses on the currently used dosimetry protocols and studies on the dosimetry of nanobrachytherapy applications using radio-NPs. The current challenges and future research directions on the role of radio-NPs in BT treatments are also discussed.
Highlights
Cancer is one of the main causes of human death worldwide [1]
In external beam RT (EBRT), highenergy photon or electron or ion beams are employed to deliver radiation to the tumor volume by placing radiation source outside the patient’s body [2]. Systemic radiation therapies such as targeted RT deliver radioisotopes labeled with carrier molecules with high affinity towards receptors overexpressed by the cancer cells, e.g., monoclonal antibodies, through ingestion, infusion using catheter, or intravenous injection
We review the recent advancements in the synthesis and use of radio-NPs as nanobrachytherapeutic agents
Summary
Cancer is one of the main causes of human death worldwide [1]. Along with chemotherapy and surgery, radiotherapy (RT), termed as radiation therapy, is a well-established method of treating non-metastatic cancers [2,3,4]. Such nanoparticle-based systems i) conserve the characteristics of BT, i.e., precise and targeted dose delivery; ii) can be administered through injection; and iii) have the ability to provide patient-specific treatment, as radiation dose can be divided into several fractions These radiopharmaceuticals do not need seed removal; they can be handled and can be extremely useful. The nanometer size of these radiopharmaceuticals allows local diffusion from the site of injection and may result in homogeneous dose distribution within the tumor volume These nanomaterials ( high Z nanoparticles) can be used as multifunctional carriers to deliver radioisotopes to provide imaging and RT capabilities. In the succeeding section, the essential characteristics of radionuclide– nanoparticle complexes, which are vital to qualifying them as nanobrachytherapeutic agents, are discussed After intratumoral injection, these radio-NPs diffuse 1–2 mm within the extracellular medium, from the site of injection [15], and are internalized by the tumor cells. Current challenges and future research directions on the role of radioNPs in BT treatments are discussed
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