In:
Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, Vol. 109, No. 38 ( 2012-09-18)
Abstract:
We showed here that the radiochemical and radiobiological mechanisms and outcomes of fs IR laser-induced filamentation are equivalent to conventional ionizing radiation. Moreover, we have shown here that this (to our knowledge) conceptually unique approach to cancer therapy ( 5 ) may bring us one step closer to achieving the ultimate goal of radiation therapy: maximizing the energy dose inside the tumor volume while not exposing healthy tissue. Our IR laser pulses produce high-density avalanches of low-energy electrons via laser filamentation ( 3 , 4 ), a phenomenon that results in a spatial energy density and temporal dose rate that both exceed by several orders of magnitude any values previously reported even for the most intense clinical radiotherapy systems. We compared the effect of the laser filamentation with those of gamma radiation on thymidine decomposition, DNA damage, and a tumor in vivo. Our results show that ( a ) the type of final damage and its mechanisms in aqueous media are comparable to those of conventional ionizing radiation, and ( b ) laser irradiation method was more effective in treating tumors with respect to reducing their size and even eliminating them. Femtosecond laser filamentation paves the way for new applications of photonic processes in radiotherapy. By using intense ultra-short infrared (IR) laser pulses, a very large energy dose can now be deposited at unprecedented microscopic dose rates (up to 10 11 Gy/s) deep inside an adjustable, well-controlled macroscopic volume, without any dose deposit in front or behind the target volume. The macroscopic dose rate of the laser-induced filamentation process was determined here using two different chemical dosimeters. The spatial dose distribution, and hence the microscopic energy density and dose rate, of the laser-induced filamentation process was captured by a polymer gel dosimeter and visualized by magnetic resonance imaging (MRI). Our results clearly show that changing the duration of the laser pulse enables precise control of the distance in the medium over which the entrance dose is zero. The two counterbalanced processes keep the filament core intensity almost constant below the optical breakdown threshold, yielding a self-regulated generation of spatially homogenous low-density plasma spots along the propagation axis of the laser beam. This plasma makes it possible to produce a high rate of ionizations in the heart of such filaments while minimizing thermo-mechanical effects related to “hot” high-density plasmas. We propose that these ionizing properties of laser-induced filamentation give rise to changes in the medium that are equivalent to conventional therapeutic ionizing radiation. More importantly, the filamentation process deposits a large dose of energy localized deep inside a well-controlled macroscopic volume, because the depth at which filamentation begins and ends is regulated by operator-controlled laser pulse parameters. This process is related to the self-focusing of an intense laser pulse induced by the Kerr effect that is counterbalanced by the induction of self-defocusing induced by subsequent laser-plasma interactions. The Kerr effect is characterized by a nonlinear change in the refractive index of a medium such as water, which varies proportionately with the square of the electric field strength. Applied to intense laser pulses with Gaussian intensity profiles, this local, nonlinear change of refractive index acts as a convex lens and results in intense self-focusing of the laser beam along its propagation axis. Thus, after some propagation distance, the laser intensity becomes so high that it overcomes the thresholds for nonlinear ionization, generating local plasma. The interaction of the laser light with the highly defocusing environment created by this plasma will now diverge the laser beam, such that the resulting decrease in light intensity will arrest the process of plasma generation, thus allowing the laser pulse to undergo self-focusing again at a slightly deeper position along the laser pulse propagation axis. This dynamic equilibrium continues as long as the magnitude of the laser pulse intensity, which slowly decreases due to such energy transfers to the medium, allows nonlinear processes, such as the Kerr effect. Numerous biophotonics applications of ultra-fast lasers are available; however, they are not used for radiotherapy of tumors that reside within macroscopic distances inside human tissue. This is of interest, because many of the modern, long-wavelength, high-power lasers can deliver high-energy-density pulses (doses and dose rates), which, in principle, surpass those of any clinical radiation source. This raises fundamental questions: ( i ) Can lasers, non-linear optics, and near-visible photons (IR, visible) generate a true radiotherapeutic effect, not upon entry in the tissue, but at a macroscopic distance within a tissue? and (ii) Can IR lasers, in particular, which emit non-ionizing radiation, replace ionizing radiation (viz radioactive materials) in certain cancer treatments? Nonlinear energy deposition can occur during the propagation of a powerful femtosecond (fs) laser pulse in a medium such as water, when the intensity of the light is sufficiently high so that its electromagnetic field will strongly perturb and change the optical properties of the medium. Here, we propose that a nonlinear photonic process called filamentation ( Fig. P1 ) ( 3 , 4 ) can solve the main problem of radiotherapy, which is the undesirable dose distribution upon tissue entry. Fig. P1. Photographic illustration of the femtosecond laser pulses filamentation in water. Here, a scattering product (milk) was diluted at a weak concentration in water to visualize multiple filamentation, which results in an elongated sparkly glowing region in the figure. Scientifically speaking, due to the presence of the scattering product, multiple filamentation can be observed through the scattering of the supercontinuum white light generated by self-phase modulation and self-steepening of the laser pulses. The direction of laser beam propagation is from top to bottom. The camera was positioned at an angle of elevation of approximately 45° from the on-axis direction in order to capture both the filaments and the transmission of the supercontinuum strong spectral broadening at the rear side of a screen oriented perpendicularly across the laser propagation axis (circular spectral pattern at the bottom of the picture). Since the invention of cancer radiotherapy, its primary goal has been to maximize lethal radiation doses to the tumor volume while keeping the dose to surrounding healthy tissues at zero. Sadly, conventional radiation sources (γ- or X-rays, electrons) and methods used over the decades, including multiple or modulated beams, inevitably deposit the majority of their dose in front of or behind the tumor, thus damaging healthy tissue and causing secondary cancers years after treatment ( 1 ). Even the most recent pioneering advances in costly proton or carbon ion therapies can not completely avoid dose buildup in front of the tumor volume ( 2 ).
Type of Medium:
Online Resource
ISSN:
0027-8424
,
1091-6490
DOI:
10.1073/pnas.1116286109
Language:
English
Publisher:
Proceedings of the National Academy of Sciences
Publication Date:
2012
detail.hit.zdb_id:
209104-5
detail.hit.zdb_id:
1461794-8
SSG:
11
SSG:
12
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