Optimization studies of eye tumor - brachytherapy taking into account the position and dimensions of the tumor and the design, dosimetry and positioning of the radioactive eye plaque

眼肿瘤近距离放射治疗的优化研究，考虑肿瘤的位置和尺寸以及放射性眼斑的设计、剂量测定和定位

• 批准号: 183034716
• 负责人: Dr. Marion Eichmann
• 金额: --
• 依托单位: Lehrstuhl für Experimentelle Physik V
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2010
• 资助国家: 德国
• 起止时间: 2009-12-31 至 2016-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/183034716?language=en
• 关键词: Optimization; studies; eye; tumor; brachytherapy

The project is aimed at an improvement of the ophthalmic plaque therapy ofocular tumors, taking a more precise diagnostics into consideration.Brachytherapy is the most frequently used treatment modality forintraocular tumors. Its success highly depends on the exact dosedistribution applied to the tumor and to organs at risk.As an achievement of the DFG project EI869/1-1 at Technical UniversityDortmund, a very precise knowledge of spatial dose distributions of allcommonly used Ru-106 coated eye-plaques was gained by Monte Carlosimulations and measurements. Furthermore, a collaboration with theUniversitätsklinikum Essen resulted in a new and very compact design for abi-nuclide plaque (a plaque using a combination of the radionuclidesRu-106 and I-125). Compared to Ru-106 plaques bi-nuclide plaques extendthe range of treatable tumor sizes (up to 7 to 10 mm height), sparing asmuch normal tissue as possible at the same time. The exact dosedistribution for this type of plaque will be determined as well.While the gained dosimetric precision exceeds current standards, only acombination with a more precise clinical diagnostics will optimizetherapeutic outcomes. The introduction of a plenoptic camera shall enhanceand improve the possibilities of diagnostic features. This camera willfacilitate the three-dimensional reconstruction of the interior bulbusgeometry from a funduscopy, along with a detailed view of interestingstructures, such as the tumor and papilla. This will offer thedetermination of the position and topology of the tumor in relation toplaque position, precisely and, for the first time, by sole usage of anoptical method. In such a fundus view, the plaque position will be markedwith LEDs fixed to the rim of the plaque and visible through the scleraduring and after surgery.This project shall result in a treatment planning system that combines thedosimetric anddiagnostic data. These results shall be achieved in collaboration with theUniversitätsklinikum Essen, one of the worldwide leading centers for thetreatment of eye cancer. A separate clinical trial in Essen is planned toascertain feasibility. Combined consideration of dosimetric and diagnosticdata shall help to better adapt safety margins to the actual clinicalsituation. The possibility for a dose de-escalation, while maintainingtumor control rate, will be discussed with the objective to minimize sideeffects.

该项目旨在改进眼部肿瘤的眼斑治疗，考虑到更精确的诊断。近距离放射治疗是眼内肿瘤最常用的治疗方式。它的成功在很大程度上取决于应用于肿瘤和危险器官的精确剂量分布。作为多特蒙德技术大学的DFG项目EI869/1-1的成果，通过蒙特卡罗模拟和测量获得了所有常用的Ru-106涂层眼斑的空间剂量分布的非常精确的知识。此外，与theUniversitätsklinikum Essen的合作导致了一种新的非常紧凑的阿比核素斑块设计（一种使用放射性核素ru -106和I-125组合的斑块）。与Ru-106斑块相比，双核素斑块扩大了可治疗肿瘤大小的范围（高达7至10毫米高度），同时尽可能多地保留正常组织。这类斑块的确切剂量分布也将被确定。虽然获得的剂量学精度超过了目前的标准，但只有结合更精确的临床诊断才能优化治疗结果。全光学相机的引入将增强和改善诊断特征的可能性。该相机将有助于眼底镜对内部球根几何形状的三维重建，以及对有趣结构（如肿瘤和乳头）的详细视图。这将提供与斑块位置相关的肿瘤位置和拓扑结构的精确测定，并且首次通过单独使用光学方法。在这种眼底视图中，斑块的位置将用固定在斑块边缘的led标记出来，通过巩膜和手术后都可以看到。该项目应形成一个结合剂量学和诊断数据的治疗计划系统。这些结果将与世界领先的眼癌治疗中心之一theUniversitätsklinikum Essen合作实现。计划在埃森进行一项单独的临床试验以确定其可行性。综合考虑剂量学和诊断数据将有助于更好地使安全裕度适应实际临床情况。在保持肿瘤控制率的情况下，我们将讨论剂量递减的可能性，目的是尽量减少副作用。