Image-guided IMRT and Brachytherapy for Pelvic Tumors

图像引导 IMRT 和近距离放射治疗盆腔肿瘤

• 批准号: 8074385
• 负责人: JEFFREY F WILLIAMSON
• 金额: $ 30.64万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-16 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8074385
• 关键词: Anatomy; Biological; Brachytherapy; Cancer Patient; Clinical; Clinical Research; Clinical Trials; Collaborations; Computer Simulation; Computer Systems Development; Disease; Dose; Family; Feedback; Four-dimensional; Goals; Image; Intensity-Modulated Radiotherapy; Label; Magnetic Resonance Imaging; Malignant neoplasm of cervix uteri; Malignant neoplasm of prostate; Maps; Methodology; Methods; Modeling; Modification; Motion; Nodal; Normal tissue morphology; Patients; Pelvis; Performance; Phase; Positron-Emission Tomography; Primary Neoplasm; Process; Protocols documentation; Radiation therapy; Relative (related person); Research Infrastructure; Research Personnel; Risk; Schedule; Simulate; Staging; Techniques; Technology; Testing; Time; Tissues; Toes; Toxic effect; Uncertainty; X-Ray Computed Tomography; base; cost; design; image registration; improved; intraoperative imaging; novel strategies; patient population; prototype; response; tool; treatment duration; treatment planning; tumor; virtual

The survival of patients with locally advanced cervix cancer and intermediate risk prostate cancer is compromised by suboptimal local/regional control. We hypothesize that by integrating brachytherapy primary tumor treatment with highly conformal IMRT that accurately delivers dose-per-fraction escalation to regions of known primary and metastatic nodal disease not adequately treated by brachytherapy will allow overall treatment time to be reduced and biologically effective dose to be increased beyond levels considered safe with current technology. To achieve these goals we will collaborate with Projects 1 and 2 to apply and clinically validate deformable image registration tools for accurately transferring information from biological imaging studies to planning x-ray computed tomography (CT) images (voxel labeling), mapping brachytherapy dose distributions onto IMRT planning images, and constructing 4-dimensional models (4D voxel trajectories) of patient anatomy based upon serial CT imaging. We will investigate a family of image-guided adaptive radiation therapy (IGART) based upon 4D voxel trajectories, probabilistic treatment planning, and off- and on-line plan adaptations to compensate for changes in patient anatomy. The aim of IGART is to minimize geometric delivery uncertainties arising from setup error and internal tissue motion so that dose-per-fraction escalation can be administered to the target tissue with minimum margins and maximum normal tissue avoidance. In Specific Aim 1. we will perform clinical studies in the two patient populations and implement and validate tools for quantifying 3D tissue deformation uncertainties and investigate methods for minimizing systematic errors arising from voxel labeling and brachytherapy dose mapping. Specific Aim 2 will develop approaches for constructing 4D voxel trajectories from serial CT images and assess their uncertainties. Optimal methods for estimating the patient's 4D anatomy configuration prior to each day's treatment will be investigated. Specific Aim 3 will perform simulated virtual clinical trials to identify and optimize the most appropriate form of IGART for maximizing clinical benefit relative to costs. In Specific Aim 4. a prototype of the IGART process selected for clinical implementation will be developed. Clinical studies will be performed to confirm IGART feasibility and dose targeting accuracy.

局部晚期子宫颈癌和中间风险前列腺癌的患者的生存率是 通过次优的局部/区域控制妥协。我们通过整合近距离放射治疗来假设 用高度共形IMRT处理原发性肿瘤，可准确地将剂量升级升级为 已知的原发性和转移性淋巴结疾病的区域未通过近距离放射治疗充分治疗 总体治疗时间减少和生物学上有效的剂量，以增加水平 当前技术被认为是安全的。为了实现这些目标，我们将与项目1和2合作 应用和临床验证可变形的图像注册工具，以准确传输信息 从生物成像研究到计划X射线计算机断层扫描（CT）图像（体素标记）， 将近距离放射治疗剂量分布映射到IMRT计划图像上，并构建4维 基于串行CT成像的患者解剖结构模型（4D体素轨迹）。我们将调查一个家庭 基于4D体素轨迹，概率治疗的图像引导的自适应放射疗法（IGART） 计划以及在线和在线计划的适应，以弥补患者解剖结构的变化。目的 IGART是为了最大程度地减少由设置误差和内部组织运动引起的几何递送不确定性，因此 可以以最小的边缘和 最大的正常组织回避。在特定目标1中。我们将在两名患者中进行临床研究 种群并实施和验证工具，以量化3D组织变形不确定性和 研究方法是为了最大程度地减少体素标记和近距离放射治疗剂量引起的系统误差 映射。特定的目标2将开发从串行CT构建4D体素轨迹的方法 图像并评估他们的不确定性。估计患者4D解剖的最佳方法 将研究在每天治疗之前的配置。特定目标3将执行模拟虚拟 临床试验以识别和优化最合适的IGART形式，以最大化临床益处 相对于成本。在特定目标4中。选择用于临床实施的IGART过程的原型 将开发。将进行临床研究以确认IGART的可行性和剂量靶向 准确性。