Image Guided Integrated Active Breath Hold Radiotherapy

图像引导综合主动屏气放射治疗

• 批准号: 7230450
• 负责人: Geoffrey D Hugo
• 金额: $ 19.37万
• 依托单位: WILLIAM BEAUMONT HOSPITAL RESEARCH INST
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-01 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7230450
• 关键词: Address; Breathing; Cancer Patient; Classification; Daily; Data; Depth; Dose; Financial compensation; Fluoroscopy; Glossary; Goals; Heart; Image; Immobilization; Lung; Lung Neoplasms; Malignant neoplasm of lung; Measures; Methods; Modeling; Motion; Normal tissue morphology; Organ; Participant; Patients; Population; Positioning Attribute; Primary Neoplasm; Radiation therapy; Research; Residual state; Respiratory physiology; Slice; Structure; System; Techniques; Testing; Uncertainty; Variant; base; cancer therapy; compliance behavior; cone-beam computed tomography; design; improved; irradiation; malignant breast neoplasm; new technology; prevent; pulmonary function; respiratory; soft tissue; tumor

DESCRIPTION (provided by applicant): Control of the primary tumor is a major goal of radiotherapy for cancer. Escalating the dose delivered to the tumor provides a method to improve local control. For lung cancer patients in particular, respiratory-induced organ motion has impeded safe dose escalation. Methods to compensate for this motion or to immobilize the tumor have been developed in recent years. However, these new technologies have not been applied in concert with reduced margins that would enable dose escalation due to the lack of data characterizing uncertainty in respiratory-induced organ motion. It is critical to characterize the uncertainties associated with tumor immobilization to enable the use of appropriate margins. It is our hypothesis that the combination of image guidance techniques and integrated active breath hold radiotherapy will enable characterization and reduction of the geometric uncertainties due to respiratory-induced organ motion. Active breathing control (ABC) has been shown to be a safe and effective means of tumor immobilization for breast cancer patients which allows for the reduction of the dose to normal tissue structures such as the heart and lungs. For lung cancer patients, however, the ABC technique must be adapted to increase compliance for patients with pulmonary compliance issues. Furthermore, the integration of image guidance techniques with ABC radiotherapy enables the characterization and reduction of daily setup variation and immobilization uncertainty. The specific aims of this project are to (1) Measure the random and systematic uncertainties of tumor immobilization for integrated active breath hold radiotherapy. (2) Evaluate a model image-guidance strategy with respect to the presence of these uncertainties and to design a treatment margin to compensate for these uncertainties. (3) Quantify residual setup error in a small population of patients.

描述（由申请人提供）：控制原发肿瘤是癌症放射治疗的主要目标。增加递送至肿瘤的剂量提供了一种改善局部控制的方法。特别是对于肺癌患者，呼吸引起的器官运动阻碍了安全剂量递增。近年来已经开发出补偿这种运动或固定肿瘤的方法。然而，由于缺乏表征呼吸引起的器官运动不确定性的数据，这些新技术并未与减少的余量一起应用，从而导致剂量递增。表征与肿瘤固定相关的不确定性至关重要，以便能够使用适当的边缘。我们的假设是，图像引导技术和集成主动屏气放射治疗的结合将能够表征和减少由于呼吸引起的器官运动引起的几何不确定性。主动呼吸控制（ABC）已被证明是乳腺癌患者安全有效的肿瘤固定方法，可以减少对心脏和肺部等正常组织结构的剂量。然而，对于肺癌患者，必须调整 ABC 技术以提高有肺部顺应性问题的患者的顺应性。此外，图像引导技术与 ABC 放射治疗的集成能够表征和减少日常设置变化和固定不确定性。该项目的具体目标是（1）测量集成主动屏气放疗的肿瘤固定的随机和系统不确定性。 (2) 针对这些不确定性的存在评估模型图像引导策略，并设计治疗裕度以补偿这些不确定性。 (3) 量化一小部分患者的残余设置误差。