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

基本信息

批准号：
7806513
负责人：
JEFFREY F WILLIAMSON
金额：
$ 37.07万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
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/7806513
关键词：
Anatomy Biological Brachytherapy Cancer Patient Classification 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

项目摘要

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.

局部晚期宫颈癌和中危前列腺癌患者的生存率因当地/区域控制不佳而受到损害。我们假设通过整合近距离放射治疗采用高度适形 IMRT 进行原发性肿瘤治疗，可准确地将每次剂量递增已知原发性和转移性淋巴结疾病未通过近距离放射治疗充分治疗的区域将允许总体治疗时间减少，生物有效剂量增加至超出水平以目前的技术来看是安全的。为了实现这些目标，我们将与项目 1 和 2 合作应用并临床验证可变形图像配准工具以准确传输信息从生物成像研究到规划 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 维基于连续 CT 成像的患者解剖模型（4D 体素轨迹）。我们将调查一个家庭基于 4D 体素轨迹的图像引导自适应放射治疗 (IGART)、概率治疗计划以及离线和在线计划调整以补偿患者解剖结构的变化。的目的 IGART 旨在最大限度地减少因设置误差和内部组织运动而产生的几何传递不确定性，从而可以以最小的余量对目标组织进行逐次剂量递增，并且最大程度地避免正常组织。在具体目标 1 中，我们将对两名患者进行临床研究人群并实施和验证用于量化 3D 组织变形不确定性的工具研究最小化体素标记和近距离放射治疗剂量引起的系统误差的方法映射。具体目标 2 将开发从串行 CT 构建 4D 体素轨迹的方法图像并评估其不确定性。估计患者 4D 解剖结构的最佳方法每天治疗前的配置将被调查。具体目标3将进行模拟虚拟临床试验，以确定和优化最合适的 IGART 形式，以最大限度地提高临床效益相对于成本。在具体目标 4 中，选择用于临床实施的 IGART 流程原型将被开发。将进行临床研究以确认 IGART 的可行性和剂量目标准确性。