Toward patient-specific, biologically optimized radiation therapy plans for the treatment of glioblastoma.
Toward patient-specific, biologically optimized radiation therapy plans for the treatment of glioblastoma.
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DOI：
10.1371/journal.pone.0079115
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Swanson KR
中科院分区：
文献类型：
--
作者：
Corwin D;Holdsworth C;Rockne RC;Trister AD;Mrugala MM;Rockhill JK;Stewart RD;Phillips M;Swanson KR
演示一种生成患者特定的、生物引导的放射治疗剂量计划的方法，并将其与护理标准方案进行比较。我们将胶质瘤增殖、侵袭和放射治疗的特定患者的生物数学模型与强度调制放射治疗优化的多目标进化算法相结合，为11名胶质母细胞瘤患者构建了个性化的、生物指导的计划。患者个性化、球对称的护理标准和优化方案的模拟在几个生物学指标方面进行了比较。综合模型产生了空间上不均匀的剂量，与标准护理方案相比，导致正常组织的等效均匀剂量减少了67%至93%，而治疗比率，即肿瘤等效均匀剂量与正常组织的比率，增加了50%至265%。将一种新的治疗反应(获得的天数)指标应用于患者个性化的模拟结果，预测优化的方案将对延缓肿瘤进展产生重大影响，11名患者中有9名从21%增加到105%。使用生物数学模型和放射治疗优化算法相结合的患者个性化模拟产生了生物引导剂量，降低了正常组织的EUD，提高了治疗率，并有可能改善胶质母细胞瘤治疗的生存结果。
To demonstrate a method of generating patient-specific, biologically-guided radiotherapy dose plans and compare them to the standard-of-care protocol. We integrated a patient-specific biomathematical model of glioma proliferation, invasion and radiotherapy with a multiobjective evolutionary algorithm for intensity-modulated radiation therapy optimization to construct individualized, biologically-guided plans for 11 glioblastoma patients. Patient-individualized, spherically-symmetric simulations of the standard-of-care and optimized plans were compared in terms of several biological metrics. The integrated model generated spatially non-uniform doses that, when compared to the standard-of-care protocol, resulted in a 67% to 93% decrease in equivalent uniform dose to normal tissue, while the therapeutic ratio, the ratio of tumor equivalent uniform dose to that of normal tissue, increased between 50% to 265%. Applying a novel metric of treatment response (Days Gained) to the patient-individualized simulation results predicted that the optimized plans would have a significant impact on delaying tumor progression, with increases from 21% to 105% for 9 of 11 patients. Patient-individualized simulations using the combination of a biomathematical model with an optimization algorithm for radiation therapy generated biologically-guided doses that decreased normal tissue EUD and increased therapeutic ratio with the potential to improve survival outcomes for treatment of glioblastoma.
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DOI：
10.1016/s0360-3016(98)00266-1
发表时间：
1999-01-01
影响因子：
7
作者：
Lee, SW;Fraass, BA;Sandler, HM
通讯作者：
Sandler, HM
影响因子：
3.4
作者：
Jena, R;Price, SJ;Burnet, NG
通讯作者：
Burnet, NG
影响因子：
1.9
作者：
Rockne, R.;Alvord, E. C., Jr.;Rockhill, J. K.;Swanson, K. R.
通讯作者：
Swanson, K. R.
影响因子：
3.5
作者：
Rockne R;Rockhill JK;Mrugala M;Spence AM;Kalet I;Hendrickson K;Lai A;Cloughesy T;Alvord EC Jr;Swanson KR
通讯作者：
Swanson KR
影响因子：
51.1
作者：
Stupp, Roger;Hegi, Monika E.;Mirimanoff, Rene-Olivier
通讯作者：
Mirimanoff, Rene-Olivier