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Nanoparticules et rayonnement synchrotron pour le traitement des tumeurs cérébrales

Abstract : Gliomas treatment is still a serious challenge in medicine. Available treatments are mainly palliative and patients' survival is increased by a few months only. An original radiotherapy technique consists in increasing the dose delivered to the tumor by loading it with high Z atoms before an irradiation with low energy X-rays (50-100 keV). Preclinical studies have been conducted using iodine contrast agent (CA) (Z=53) and 50 keV X-rays. The increase of the animals' survival leads today to the beginning of clinical trials (phases I and II) at the medical beamline of the European synchrotron, where the available monochromatic and intense photons beam is well suited for this treatment. The use of intravenously injected CA is however insufficient for curing rat's bearing glioma. Indeed, the contrast agent's accumulation is limited by the presence of the BBB and it remains extracellular. Metallic nanoparticles (NPs) appear interesting for improving the treatment efficacy. During this work, three different types of NPs have been studied: GdNPs (3 nm), AuNPs (13 nm) and PtNPs (6 nm). Their toxicity and internalization have been evaluated in vitro on F98 rodent glioma cells. Cells' survival has also been measured after different irradiation conditions in presence of these NPs and with monochromatic photons beams. Several mechanisms implicated in the treatment have been highlighted by the study of the cells' response dependence to the incident particles energy and to the sub cellular NPs distribution during irradiation. For identical concentrations, NPs were more efficient in cells killing than CA, illustrating their microdosimetric potential. The effect was also preferential for low energy X-rays, indicating that photoactivation of heavy atoms plays a role in the cells' death. GdNPs and PtNPs have also lead to an effect in combination to high energy photons (1.25 MeV), indicating that another mechanism may also increase the cell sensitivity to radiations with such NPs. Preclinical trials, performed on rats bearing F98 glioma, have shown that the complete tumor's overlap with NPs is a key point for the success of this treatment. Dual energy computed tomography (CT) has been developed at the synchrotron medical beamline and evaluated during this PhD thesis. The study has allowed quantitatively and simultaneously imaging the tumor (highlighted by iodinated CA) and the GdNPs distribution injected intracerebrally in rodents bearing glioma. The comparison between the CA distribution and the tumor's volume has also been performed using high spatial resolutions imaging methods (MRI, X-rays phase contrast tomography and histology).
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Florence Taupin. Nanoparticules et rayonnement synchrotron pour le traitement des tumeurs cérébrales. Médecine humaine et pathologie. Université de Grenoble, 2013. Français. ⟨NNT : 2013GRENS021⟩. ⟨tel-00949136⟩

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