Retrospective NCI Phantom-Monte Carlo Dosimetry for Late Effects in Wilms Tumor

回顾性 NCI 幻影蒙特卡罗剂量测定对肾母细胞瘤迟发效应的影响

• 批准号: 10224117
• 负责人: John Andrew Kalapurakal
• 金额: $ 54.32万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224117
• 关键词: 3-Dimensional; Abdomen; Address; Adult; Age; Algorithms; Breast; Chest wall structure; Child; Childhood; Cohort Studies; Colon; Congestive Heart Failure; Data; Databases; Dose; End stage renal failure; Exposure to; Family; Female; Fertility; Future; Heart; Heart Ventricle; Height; Hypogonadism; Impairment; Incidence; Infertility; Institution; Kidney; Knowledge; Late Effects; Libraries; Liver; Location; Lung; Lung diseases; Male Infertility; Malignant Neoplasms; Malignant neoplasm of lung; Measurement; Measures; Medical History; Methods; Modeling; Modernization; Myocardium; Nephroblastoma; Normal tissue morphology; Organ; Ovary; Patients; Pelvis; Prevalence; Protocols documentation; Questionnaires; Radiation; Radiation Tolerance; Radiation therapy; Recording of previous events; Records; Reporting; Stomach; Study Subject; Survivors; System; Testis; Thyroid Gland; Time; Toxic effect; Uterus; Weight; adverse pregnancy outcome; base; childhood cancer survivor; design; dosimetry; follow-up; improved; male; ovarian failure; phantom model; prospective; reconstruction; reproductive; reproductive outcome; sex; survivorship; treatment planning

PROJECT SUMMARY Radiation therapy is the most important contributor to late toxicity in children. Unlike in adults, there is not much data on three-dimensional (3D) normal tissue radiation tolerance in children. This retrospective dosimetry study will use the patient-matched NCI computational pediatric phantom model for conducting Monte Carlo dosimetry analysis. This study will be performed on matched phantoms of all 5000 children with Wilms tumor (WT) who received radiation therapy (RT) on five National Wilms Tumor Study (NWTS) protocols during 1969-2002. The high survivorship (90%) of WT and the many advantages of the NWTS late effects database makes this an ideal platform for a detailed dosimetry study of late effects of therapy. One patient-matched phantom based on height, weight, age and sex of each NWTS patient, with already pre-contoured target organs will be selected from the phantom library of Dr. Lee at the NCI. This phantom will be imported into the radiation treatment planning system for reconstruction of NWTS radiation fields. While modern RT treatment planning systems (TPS) are fairly accurate for estimating doses both in-field and near-field locations, this method is not suitable for out-of-field dose measurements. The Monte Carlo (MC) dose calculation algorithm has overcome this deficiency of TPS and measures out-of-field doses more accurately. In this study, both dosimetry models will be used for estimating doses in-field, and MC-based dose calculations will be used for estimating out-of-field doses. For AIM 1 of this study, we will collect target organ 3D dosimetry data for 13 organs including thyroid, heart (total heart, ventricles and myocardium), lungs, kidneys, liver, chest wall, stomach, colon, breasts, uterus, ovaries, pelvis and testicles. For AIM 2 we will review and validate reproductive late effects (hypogonadism and infertility) among males and females recorded in the NWTS database and conduct a prospective questionnaire-based cohort study to determine their prevalence among NWTS survivors. For AIM 3 we will study the association between RT dose to target organs estimated using the NCI Phantom MC dosimetry model and six late effects ascertained by the NWTS including: congestive heart failure (heart, ventricles, myocardium), restrictive pulmonary disease (lungs, chest wall), second malignant neoplasms (lung, thyroid, breasts, liver stomach, colon), end stage renal disease (kidney/s), adverse pregnancy outcomes (ovaries, uterus, pelvis) and additional reproductive outcomes (hypogonadism and infertility – ovaries, uterus in females and testicles in males). A comprehensive knowledge of 3D organ tolerance will help reduce the incidence of RT induced late toxicity and minimize their adverse impact on current and future childhood cancer survivors.

项目概要 放射治疗是导致儿童晚期毒性的最重要因素。与成人不同，没有 有关儿童三维 (3D) 正常组织辐射耐受性的大量数据。此次回顾展 剂量测定研究将使用患者匹配的 NCI 计算儿科体模模型进行 Monte 卡洛剂量测定分析。这项研究将在所有 5000 名维尔姆斯患儿的匹配模型上进行 肿瘤 (WT) 在五项国家肾母细胞瘤研究 (NWTS) 方案中接受放射治疗 (RT) 1969-2002。 WT的高存活率（90%）和NWTS晚效数据库的诸多优势 使其成为对治疗后期效果进行详细剂量测定研究的理想平台。一名患者匹配 基于每位 NWTS 患者的身高、体重、年龄和性别的体模，并已预先勾勒出目标轮廓 器官将从李博士在国家癌症研究所的模型库中挑选。该模型将被导入到 用于重建 NWTS 辐射场的放射治疗计划系统。虽然现代 RT 治疗 规划系统（TPS）对于估计现场和近场位置的剂量相当准确，这 该方法不适用于野外剂量测量。蒙特卡罗 (MC) 剂量计算算法 克服了 TPS 的这一缺陷，可以更准确地测量外场剂量。在这项研究中，两者 剂量测定模型将用于估计现场剂量，基于 MC 的剂量计算将用于 估计场外剂量。对于本研究的 AIM 1，我们将收集 13 个目标器官的 3D 剂量测定数据 器官包括甲状腺、心脏（全心、心室和心肌）、肺、肾、肝、胸壁、 胃、结肠、乳房、子宫、卵巢、骨盆和睾丸。对于 AIM 2，我们将审查和验证 NWTS 中记录的男性和女性生殖后期影响（性腺功能减退症和不育） 数据库并进行一项基于问卷调查的前瞻性队列研究，以确定其患病率 NWTS 幸存者。对于 AIM 3，我们将研究 RT 剂量与目标器官之间的关联，估计使用 NCI Phantom MC 剂量测定模型和 NWTS 确定的六种后期效应包括： 心力衰竭（心脏、心室、心肌）、限制性肺疾病（肺、胸壁）、第二 恶性肿瘤（肺、甲状腺、乳房、肝胃、结肠）、终末期肾病（肾脏）、不良 妊娠结局（卵巢、子宫、骨盆）和其他生殖结局（性腺功能减退症和 不孕症——女性卵巢、子宫和男性睾丸）。全面了解 3D 器官 耐受性将有助于减少放疗引起的迟发毒性的发生率，并最大限度地减少其对健康的不利影响。 当前和未来的儿童癌症幸存者。