RADIATION THERAPY WITH ACTIVE BREATHING CONTROL

主动呼吸控制的放射治疗

• 批准号: 6172739
• 负责人: John W Wong
• 金额: $ 18.85万
• 依托单位: WILLIAM BEAUMONT HOSPITAL RESEARCH INST
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-07-01 至 2002-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6172739
• 关键词: biomedical equipment development; body movement; clinical research; diagnosis design /evaluation; diagnosis quality /standard; human subject; human therapy evaluation; immobilization of body part; liver neoplasms; lung neoplasms; neoplasm /cancer radiation therapy; pulmonary respiration; radiation therapy dosage; radionuclide imaging /scanning

The success of cancer treatment with external beam radiation therapy depends critically on the adequate coverage of the tumor. Treatment variation due to daily setup variation and organ motion must be taken into account. Typically, a treatment margin is added to make allowance for these variations. It is generally desirable to have a small treatment margin. A higher dose can then be prescribed without inflicting serious failure. However, improper reduction of the margin will greatly increase the risk of local failure. The problem of margin reduction is particularly important for treatment of tumors in the lungs and upper abdomen. The dismal prognosis of these diseases compels the use of higher dose for treatment. Yet, attempt to do so is severely hampered by the large margin needed to cover the tumor motion while the patient breathes. The applicants hypothesize that treatment of tumors in the thorax and abdomen is much more effective when breathing motion is minimized. To do so, the approach of active breathing control (ABC) is developed to immobilize breathing motion temporarily and reproducibly. At any pre-selected phase in the breathing cycle, an ABC apparatus temporarily restricts airflow to and from the patient, thereby immobilizing breathing motion. The period of active breath hold is that which can by comfortably maintained by the patient. With ABC, radiation is turned on and off manually, and only, during the period of active breath hold. The need of complex control of the treatment machine is thus avoided. The ABC procedure can be applied for three dimensional (3D) CT scanning and treatment such that the patient information used in planning reproduces that during treatment. In this proposal, an ABC apparatus will be used to acquire 3D CT scans of 40 patients with lung and liver cancer at 8 different phases in the breathing cycle. The merit of treatment with ABC is evaluated by comparing the dosimetry of a 3D treatment plan where breathing motion is immobilized at one respiratory phase with that were 3D organ motion exists, as modeled by the 8 scans. Clinical feasibility of treatment with ABC will also be tested on 25 patients undergoing conventional treatment by studying the reproducibility and acceptance of the procedure by the patients and the treatment personnel.

外束放射治疗癌症治疗的成功 关键取决于肿瘤的充分覆盖。治疗 必须考虑由于日常设置变化和器官运动而产生的变化 考虑到。 通常，会添加治疗余量以留出余量 对于这些变化。 通常希望有一个小的 治疗裕度。 然后可以开出更高的剂量，而无需 造成严重失败。 然而，不恰当地减少保证金 将大大增加局部故障的风险。 保证金问题 减少对于肺部肿瘤的治疗尤为重要 和上腹部。 这些疾病的不良预后迫使 使用较高剂量进行治疗。 然而，这样做的尝试是严重的 由于覆盖肿瘤运动所需的大边缘而受到阻碍，而 病人呼吸。 申请人假设肿瘤的治疗 呼吸运动时，胸部和腹部的效果要好得多 被最小化。 为此，采用主动呼吸控制（ABC）方法 被开发用于暂时固定呼吸运动 可重复地。 在呼吸周期的任何预先选择的阶段，ABC 设备暂时限制进出患者的气流，从而 固定呼吸运动。 主动屏气的时间是 患者可以舒适地维护它。 ABC、辐射 手动打开和关闭，并且仅在活动期间 屏住呼吸。 治疗机复杂控制的需要是 从而避免了。 ABC 程序可应用于三维 (3D) CT 扫描和治疗，以便使用患者信息 在计划中重现治疗期间的情况。 在这个提案中，ABC 设备将用于获取 40 名患有肺部疾病的患者的 3D CT 扫描 和肝癌在呼吸周期的8个不同阶段。 这 通过比较 ABC 治疗的剂量来评估 ABC 治疗的优点 呼吸运动固定在一个位置的 3D 治疗计划 呼吸阶段与存在 3D 器官运动的情况相同，建模如下 8 次扫描。 ABC治疗的临床可行性也将是 通过研究对 25 名接受常规治疗的患者进行了测试 患者和医生对手术的可重复性和接受度 治疗人员。