Bacterial nanocellulose membrane as bolus in radiotherapy: "proof of concept"
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Bacterial nanocellulose membrane as bolus in radiotherapy: ‘‘proof of concept’’ Giulia Cristina Chiozzini . Guilherme Paula˜o Mendes . Fernando Pereira Vanni . Amanda Maria Claro . Creusa Sayuri Tahara Amaral . Nayara Cavichiolli do Amaral . Hernane da Silva Barud . Andre´ Capaldo Amaral
Received: 23 June 2020 / Accepted: 9 November 2020 Ó Springer Nature B.V. 2020
Abstract Boluses characterize materials with an electromagnetic radiation attenuation coefficient similar to biological tissue and used to restrict the penetration of high energy photons and electrons used in radiotherapy for the treatment of superficial tumors. The development of new materials, mainly from sustainable biotechnological routes, will contribute to increase efficiency and expand the use of these technologies. The objective of this research was to develop the ‘‘proof of concept’’ regarding the use of the bacterial nanocellulose membrane (BNCm) as a bolus. For this purpose, BNCm were produced, purified and subjected to the physical–chemical characterization. The radiological density (RD) and radiation attenuation potential (RAP) of the BNCm were
established and compared to a commercial bolus (CB). The moldability of BNCm was established and compared to the virtual bolus of dosimetric planning. The physical–chemical analysis demonstrated the constitution of a pure, highly hydrated, homogeneous and nanostructured network of cellulose fibers. BNCm showed superiority in relation to RD and similar RAP values when compared to CB. Moldability analysis showed a profile identical to a virtual bolus. The results validate the concept of using BNCm as a highly efficient biotechnological device, aligned with the idea of sustainability, as a bolus for use in radiotherapy.
G. C. Chiozzini F. P. Vanni A. M. Claro C. S. T. Amaral N. C. do Amaral H. S. Barud A. C. Amaral (&) Programa de Po´s-Graduac¸a˜o em Biotecnologia da Universidade de Araraquara – UNIARA, Rua Carlos Gomes, 1217, Araraquara, Sa˜o Paulo CEP: 14801-340, Brazil e-mail: [email protected] G. P. Mendes Centro de Oncologia do Hospital Santa Casa de Miserico´rdia de Araraquara, Av. Jose´ Bonifa´cio, 794 Centro, Araraquara, Sa˜o Paulo CEP: 14801-150, Brazil
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Cellulose
Graphic abstract
Keywords Bacterial nanocellulose Cellulose Medical biotechnology Radiotherapy Bolus Superficial tumors
Introduction With estimates of more than 1.2 million cases worldwide (Bray et al. 2018), skin cancer is the most common malignancy today and its incidence is increasing, mainly due to the main risk factor: high exposure to ultraviolet light (Chummun and McLean 2017). This type of cancer can be divided into two major groups: non-melanoma skin cancer, which includes basal and squamous cell carcinomas, and melanoma. The first type has a good prognosis and neoplasms are derived from cells of the epidermis, while the second type is derived from melanocytes and has a much greater risk of metastasis (Craythorne and Al-Niami
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