4D IMRT: Stereotactic body radiotherapy for lung cancer

4D IMRT：肺癌立体定向放射治疗

• 批准号: 7752825
• 负责人: PAUL J KEALL
• 金额: $ 31.25万
• 依托单位: STANFORD UNIVERSITY
• 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 2010-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7752825
• 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; 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）： 肺癌患者治疗有几种趋势，所有趋势都导致接受立体定向身体放射治疗（SBRT）的患者数量增加。趋势是：（1）通过筛查计划增加肺癌检测； （2）使用当前技术和技术的肺SBRT试验的有希望的结果； （3）SBRT与医学可手术患者的手术相当的结果，导致开放II期和III期试验。肺SBRT是一种利用高精度和大辐射剂量的新兴技术。尽管在大多数研究中，局部控制良好，但使用当前放疗技术的消融辐射剂量的成本是发病率，在某些情况下是死亡率。该赠款提出的研究旨在通过几种技术发展和相关研究大大降低肺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；将通过在优化中加入解剖学变化作为额外的自由度来创建改进的治疗计划。其次，我们将结合两种外部和内部处理成像方式，以在整个辐射处理过程中获得目标运动的实时估计。第三，该位置估计值将用于实时指导强度调节辐射的光束，以实时移动肿瘤，以提供前所未有的治疗保融性和正常的组织剂量降低。第四，将与音乐家和设计专家合作开发呼吸道视听工具。该工具将改善肺SBRT患者的呼吸规律性，从而减少PET/CT伪像，并在PET/CT扫描上靶向描绘误差，并促进辐射递送过程中改善的治疗束肿瘤对齐。这种管理肿瘤运动的全面和多学科的方法将提供辐射肿瘤学团队优质辐射梁肿瘤的靶向和结构化方法，以治疗早期肺癌患者。我们预计这项研究最终将导致治疗结果的可衡量，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存活率，肺立体定向体放疗（SBRT）是一种越来越多地用于早期肺癌的治疗方法。但是，发病率以及在某些情况下使用当前技术导致的死亡率。这项全面的多学科研究计划将制定改进的治疗计划，图像指导和治疗方法，以提供前所未有的辐射梁肿瘤靶向。因此，将降低健康组织辐照和相关治疗毒性的量，从而改善肺癌患者的健康状况。