Improving the Therapeutic Ratio of Proton Radiation Therapy

提高质子放射治疗的治疗率

• 批准号: 8736216
• 负责人: THOMAS F DELANEY
• 金额: $ 20.41万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-04-01 至 2014-09-24
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8736216
• 关键词: Adult; Adverse effects; Anatomic Sites; Anesthesia procedures; BAY 54-9085; Cancer Patient; Child; Childhood; Childhood Medulloblastomas; Childhood Rhabdomyosarcoma; Clinical; Clinical Research; Clinical Trials; Complex; Correlative Study; Devices; Disease; Dose; Effectiveness; Goals; Hepatic; Investigation; Length; Liver neoplasms; Malignant Childhood Neoplasm; Malignant Neoplasms; Morbidity - disease rate; Neutrons; Non-Small-Cell Lung Carcinoma; Normal tissue morphology; Operative Surgical Procedures; Outcome; Paranasal Sinus Neoplasms; Patients; Phase; Photons; Physics; Positioning Attribute; Protocols documentation; Proton Radiation; Protons; Public Health; Quality-of-Life Assessment; Radiation; Radiation therapy; Relative (related person); Research; Rhabdomyosarcoma; Risk; Scanning; Sinus; Testing; Therapeutic; Therapeutic Studies; Toxic effect; Translating; Tumor Tissue; Unresectable; Vertebral column; X-Ray Computed Tomography; chemoradiation; chemotherapy; clinical research site; cohort; high risk; improved; irradiation; medulloblastoma; phase 2 study; prospective; proton beam; proton therapy; randomized trial; response; sarcoma; skull base; tool; treatment planning; tumor

Protons have a physical dose advantage over photons (x-rays), the most commonly used type of radiation therapy for cancer patients, because they do not exit beyond the tumor target and thus irradiate less normal tissue. Irradiation of normal tissue yields no possible benefit for the patient; it can only increase the risk of treatment related side effects during and long after the end of treatment. While proton radiation therapy has been used in selective clinical sites with significant improvements in clinical outcome, we believe that research into better control of the finite range of the proton in the patient can yield additional clinical gains. The major objective of this project, Improving the Therapeutic Ratio of Proton Radiation Therapy in Challenging Clinical Sites, is to perform clinical trials employing improved control of the proton range in challenging clinical scenarios. We believe that these research advances should translate into further improvement in outcome in not only these particular diseases, but at multiple other anatomic sites where proton radiation therapy is increasingly being employed. The potential impact for public health is higher cancer cure rates and/or reduced treatment side effects, particularly in children, who are at the highest risk of late radiation therapy-induced side effects, which can be reduced with the use of protons. The specific aims are to conduct phase II clinical studies in patients with unresectable liver tumors, pediatric medulloblastoma and rhabdomyosarcoma, spine and skull base sarcomas, and paranasal sinus tumors in which we will (1) use the end of range of the proton more effectively, (2) investigate the clinical use of magnetically scanned proton beams and intensity-modulated proton therapy, (3) confirm the tolerability and effectiveness of hypofractionated radiation dose escalation for unresectable liver tumors, (4) critically assess the importance of an adaptive proton radiation therapy strategy in response to tumor and normal tissue responses to radiation therapy in one anatomic site, and (5) compare treatment-related morbidity with photons and protons in these selected pediatric malignancies and in adult paranasal sinus tumors. The physical tools necessary to achieve these clinical goals will be investigated in Projects 3 and 4. The initial use of many of these physical tools in Project 2 will be important for their later use in Project 1, Proton Dose Escalation and Proton vs. Photon Randomized Trials for Non-Small Cell Lung Cancer.

质子比光子（X射线）具有物理剂量优势，这是最常用的类型的 癌症患者的放射疗法，因为他们没有超出肿瘤靶标的而放射 较不正常的组织。正常组织的照射对患者没有可能的好处。它只能增加 治疗期间和治疗结束后很长时间与治疗相关的副作用的风险。而质子辐射 我们认为，疗法已用于选择性临床部位，临床结局有显着改善。 对更好控制患者质子有限范围的研究可以产生额外的临床 收益。该项目的主要目的是改善质子放射疗法的治疗比率 具有挑战性的临床部位是进行临床试验，以改善对质子范围的控制 具有挑战性的临床情况。我们认为，这些研究的进步应该会进一步转化为 不仅这些特定疾病的结果，而且在其他多个解剖部位的改善 质子辐射疗法越来越多地采用。对公共卫生的潜在影响更高 癌症治愈率和/或降低治疗副作用，特别是在儿童中，他们的风险最高 晚期放射治疗引起的副作用，可以通过使用质子来减少。 具体目的是在无法切除的肝肿瘤患者中进行II期临床研究， 小儿髓母细胞瘤和横纹肌肉瘤，脊柱和颅底肉瘤以及副窦 （1）更有效地使用质子范围的肿瘤，（2）研究临床用途 磁扫描的质子束和强度调节的质子治疗，（3）确认耐受性 低压辐射剂量升级对无法切除的肝肿瘤的有效性，（4）至关重要 评估自适应质子放射治疗策略对肿瘤和正常的重要性 在一个解剖部位中对放射治疗的组织反应，（5）将与治疗相关的发病率与 这些选定的小儿恶性肿瘤和成年旁鼻窦肿瘤中的光子和质子。这 实现这些临床目标所需的物理工具将在项目3和4中进行研究。 项目2中使用许多这些物理工具对于在项目1（质子剂量1）中的后期使用非常重要 非小细胞肺癌的升级和质子与光子随机试验。