4D IMRT: Stereotactic body radiotherapy for lung cancer

4D IMRT：肺癌立体定向放射治疗

• 批准号: 8205647
• 负责人: PAUL J KEALL
• 金额: $ 26万
• 依托单位: UNIVERSITY OF SYDNEY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-15 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8205647
• 关键词: Address; Affect; Algorithms; Anatomy; Applications Grants; Biofeedback; Breast; Breathing; Cancer Detection; Cancer Patient; Collaborations; Collimator; Complex; Controlled Clinical Trials; Data; Development; Devices; Diagnostic radiologic examination; Dose; Early treatment; Esophagus; Failure; Feedback; Four-dimensional; Freedom; Frequencies; Future; Goals; Grant; Health; Image; Intensity-Modulated Radiotherapy; Interdisciplinary Study; Investigation; Laboratories; Linear Accelerator Radiotherapy Systems; Link; Liver; Lung; Lung Lymphoma; Lung Neoplasms; Malignant neoplasm of lung; Maps; Measurable; Mechanics; Methods; Modeling; Monitor; Morbidity - disease rate; Morphologic artifacts; Motion; Normal tissue morphology; Operative Surgical Procedures; Optics; Outcome; PET/CT scan; Patients; Performance; Phase II/III Trial; Planning Techniques; Plant Leaves; Positioning Attribute; Positron-Emission Tomography; Procedures; Process; Prostate; Radiation; Radiation Oncology; Radiation therapy; Research; Residual state; Scanning; Scheme; Screening procedure; Series; Staging; Stream; Survival Rate; System; Techniques; Technology; Testing; Time; Tissues; Toxic effect; Training; Treatment outcome; Tumor Tissue; Visual; Width; base; cost; design; imaging modality; improved; interdisciplinary approach; irradiation; millimeter; mortality; multidisciplinary; musician; next generation; novel; optical imaging; pancreatic neoplasm; programs; public health relevance; respiratory; stereoscopic; technology/technique; tool; treatment planning; trend; tumor

DESCRIPTION (provided by applicant): There are several trends in lung cancer patient management, all leading to an increase in the number of patients being treated with stereotactic body radiotherapy (SBRT). The trends are: (1) increased lung cancer detection through screening programs; (2) promising results of lung SBRT trials using current techniques and technology; and (3) comparable results of SBRT to surgery for medically operable patients leading to open phase II and III trials. Lung SBRT is an emerging technique utilizing high precision and large radiation doses to ablate lung tumor tissue. Despite excellent local control in most studies, the cost of using ablative radiation doses with current radiotherapy technology is morbidity, and in some cases mortality. The research proposed for this grant aims to significantly reduce the toxicity of lung SBRT through several technological developments and associated investigations. First we will solve the four-dimensional constrained treatment planning problem in collaboration with optimization experts; improved treatment plans will be created by including anatomic changes with time as an additional degree of freedom in the optimization. Second, we will combine two intra-treatment imaging modalities, external and internal, to obtain a real-time estimate of the target motion throughout the radiation treatment. Third, this position estimate will be used to direct beams of intensity modulated radiation to moving tumors in real time to offer unprecedented treatment conformality and normal tissue dose reduction. Fourth, a respiratory audiovisual biofeedback tool will be developed in collaboration with a musician and design expert. This tool will improve respiratory regularity for lung SBRT patients and thus decreasing PET/CT artifacts and target delineation errors on PET/CT scans and facilitating improved treatment beam-tumor alignment during radiation delivery. Such a comprehensive and multidisciplinary approach to manage tumor motion will offer the radiation oncology team superior radiation beam-tumor targeting and conformality methods to treat early stage lung cancer patients. We expect the research will ultimately result in a measurable improvement in treatment outcome and have a widespread impact on lung cancer management. PUBLIC HEALTH RELEVANCE: Lung stereotactic body radiotherapy (SBRT) is an increasingly used treatment for early stage lung cancer due to promising local control and survival rates. However, morbidity, and in some cases mortality, result using current technology. This comprehensive, multidisciplinary research program will develop improved treatment planning, image guidance and treatment delivery methods to offer unprecedented radiation beam-tumor targeting. Consequently the amount of healthy tissue irradiated and associated treatment toxicity will be reduced, resulting in improved health of lung cancer patients.

描述（由申请人提供）： 肺癌患者管理有多种趋势，所有这些都导致接受立体定向全身放射治疗 (SBRT) 治疗的患者数量增加。趋势是：（1）通过筛查计划增加肺癌检出率； (2) 使用现有技术和技术进行肺部 SBRT 试验的有希望的结果； (3) 对于可进行手术的患者，SBRT 与手术的结果可比较，从而进行开放式 II 期和 III 期试验。肺部SBRT是一种新兴技术，利用高精度和大辐射剂量消融肺部肿瘤组织。尽管大多数研究都取得了良好的局部控制，但使用当前放射治疗技术的消融辐射剂量的成本是发病率，在某些情况下甚至是死亡率。此项资助提出的研究旨在通过多项技术开发和相关研究显着降低肺部 SBRT 的毒性。首先我们将与优化专家合作解决四维约束治疗计划问题；通过将解剖结构随时间的变化作为优化中的额外自由度，将创建改进的治疗计划。其次，我们将结合两种治疗内成像方式（外部和内部），以获得整个放射治疗过程中目标运动的实时估计。第三，这种位置估计将用于将强度调制辐射束实时引导到移动的肿瘤，以提供前所未有的治疗适形性和正常组织剂量减少。第四，将与音乐家和设计专家合作开发呼吸视听生物反馈工具。该工具将改善肺部 SBRT 患者的呼吸规律，从而减少 PET/CT 伪影和 PET/CT 扫描的目标描绘错误，并有助于改善放射治疗期间的治疗射束与肿瘤的对准。这种全面、多学科的肿瘤运动管理方法将为放射肿瘤学团队提供卓越的放射束肿瘤靶向和适形方法来治疗早期肺癌患者。我们预计这项研究最终将显着改善治疗结果，并对肺癌管理产生广泛影响。 公共卫生相关性： 由于有希望的局部控制和生存率，肺立体定向放射治疗（SBRT）越来越多地用于早期肺癌的治疗。然而，使用当前技术会导致发病率和某些情况下的死亡率。这项综合性、多学科的研究计划将开发改进的治疗计划、图像引导和治疗实施方法，以提供前所未有的放射束肿瘤靶向治疗。因此，受照射的健康组织的数量和相关的治疗毒性将减少，从而改善肺癌患者的健康状况。