Management of Breathing effects in Radiotherapy Planning

放射治疗计划中呼吸效应的管理

• 批准号: 7626808
• 负责人: THOMAS R. BORTFELD
• 金额: $ 31.94万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7626808
• 关键词: 3-Dimensional; Accounting; Acute; Address; Anatomic structures; Archives; Area; Breast; Breathing; Bronchial Tree; Cancer Etiology; Cancer Patient; Characteristics; Chest; Clinical; Clinical Treatment; Clinical Trials; Colon; Communities; Complex; Complication; Computer Simulation; Data; Data Set; Databases; Development; Dose; Dose-Limiting; Economics; Error Sources; Esophagitis; Esophagus; Financial compensation; Fractionation; Future; Goals; Grant; Head and neck structure; Heart; Image; Imaging Device; Intensity-Modulated Radiotherapy; Investigation; Lead; Left; Lesion; Lesion by Stage; Location; Lung; Malignant neoplasm of lung; Maps; Marriage; Methods; Modeling; Morphologic artifacts; Motion; Non-Small-Cell Lung Carcinoma; Normal tissue morphology; Outcome; Patients; Pattern; Phase; Planning Techniques; Plant Leaves; Pneumonia; Positioning Attribute; Probability; Process; Prostate; Radiation; Radiation Oncology; Radiation Pneumonitis; Radiation Therapy Oncology Group; Radiation therapy; Relative (related person); Research; Research Personnel; Resectable; Resistance; Resource Sharing; Risk; Scanning; Shapes; Signal Transduction; Simulate; Software Tools; Solutions; Stream; Structure; Structure of parenchyma of lung; Support System; System; Techniques; Technology; Testing; Time; Tissues; Toxic effect; Translating; Treatment outcome; Uncertainty; University of Texas M D Anderson Cancer Center; Variant; Weight; Woman; Work; X-Ray Computed Tomography; base; cancer radiation therapy; cancer site; cancer therapy; cohort; collaboratory; cost; data mining; data sharing; density; experience; image registration; imaging modality; improved; infancy; innovation; interdisciplinary collaboration; irradiation; lung volume; men; mortality; novel; pre-clinical; process optimization; repository; simulation; tool; treatment planning; treatment strategy; tumor

DESCRIPTION (provided by applicant): Intensity modulated radiation therapy has been shown to improve radiotherapy dose distributions when applied to lung treatments, especially if the delivery can be registered to the patient's breathing cycle. However, many technical issues associated with breathing-registered IMRT treatment planning have not yet been addressed, and comparisons between potential planning and delivery approaches are lacking. The primary goal of this project is to determine the tradeoffs between increased planning and delivery complexity vs. improvements in cumulative patient dose distributions and the expected impact on treatment outcomes. In an interdisciplinary collaboration, a shared cross-platform toolset, techniques, and test data sets will be developed and eventually publicly archived for use by other researchers. Within this framework, planning techniques to simulate a range of potential clinical options, from simple to complex, will be developed, including: simple margins, accounting for tumor motion in a statistical way, gating, and fully synchronizing IMRT delivery with breathing-phase. It is hypothesized that a significant fraction of simulated lung patients (who cannot achieve breath-hold techniques) will have a predicted outcome benefit from the use of breathing-registered planning and delivery. In Specific Aim SA #1 (4-D optimization), temporo-spatial ("4-D") IMRT planning and optimization methods for all relevant delivery techniques will be developed. In SA #2 (Management of uncertainties and daily variations), those methods will be generalized to explicitly account for uncertainties and day-to-day variations. In SA #3 (Clinical impact), the potential impact of the techniques in terms of likely dosimetric and outcome improvements will be estimated for a statistically significant cohort of simulated patient plans. This research will provide, firstly, guidance for understanding the potential outcomes impact of 4-D radiotherapy treatments; secondly, robust solutions to challenging 4-D treatment planning problems; and thirdly, shared data and software tools for other researchers in the area of 4-D planning.

描述（由申请人提供）：在应用于肺部治疗时，强度调节放射治疗已显示可改善放射治疗剂量分布，尤其是如果可以注册到患者的呼吸周期中。但是，尚未解决与呼吸注册的IMRT治疗计划相关的许多技术问题，并且缺乏潜在的计划和交付方法之间的比较。该项目的主要目标是确定计划增加与分娩复杂性与累积患者剂量分布的改善与对治疗结果的预期影响之间的权衡。在跨学科的合作中，将开发共享的跨平台工具集，技术和测试数据集，并最终公开存档以供其他研究人员使用。在此框架内，将开发出一系列潜在的临床选择的计划技术，包括：简单边缘，以统计方式计算肿瘤运动，门控，以及将IMRT与呼吸相完全同步。假设，大量的模拟肺患者（无法实现呼吸含量技术）将获得预测的结果，从而通过使用呼吸注册的计划和分娩。在特定的AIM SA＃1（4-D优化）中，将开发所有相关交付技术的颞型空间（“ 4-D”）IMRT计划和优化方法。在SA＃2（不确定性和每日变化的管理）中，这些方法将被推广，以明确说明不确定性和日常变化。在SA＃3（临床影响）中，将估计该技术在可能的剂量计和结果改善方面的潜在影响，以估计具有统计学意义的模拟患者计划的群体。这项研究将首先为理解4-D放射治疗的潜在结果影响提供指导；其次，挑战4-D治疗计划问题的强大解决方案；第三，为4-D计划领域的其他研究人员共享数据和软件工具。