PlanUNC Research Platform for Radiotherapy Simulation

描述(由申请人提供)：在癌症的体外放射治疗期间，不可避免地向附近的放射敏感结构提供的剂量限制了可以安全地向肿瘤目标提供的最大辐射剂量。为了减少不可接受的发病率风险，每个单独的放射治疗疗程都必须仔细地预先计划，以实现高肿瘤剂量，同时尽可能地保留正常组织。放射治疗剂量计划的指导原则已被细化为现代剂量构象的概念--塑造剂量分布以匹配目标m，这是贯穿于大多数现代放射治疗研究的。用于三维(3-D)甚至四维(3-D时间)图像引导的治疗模拟和提供的创新技术、方法和思想已经将这一概念在研究水平上推向了极端，即使在肿瘤和周围正常解剖的空间复杂和时变的几何形状和关系的背景下，基本上将高剂量区域收缩包裹到围绕靶体积的保形手套状配合，同时在保护性低剂量区域包裹敏感组织。这一领域的研究正在从临床试验中获得动力，这些临床试验正在产生的医学证据表明，无论是在剂量递增的情况下还是在没有剂量递增的情况下，高度适形放射治疗都显著增加了在改善肿瘤控制和减少副作用方面的良好临床结果的可能性。图形复杂和分析复杂的软件工具是进行图像引导计算机模拟(虚拟模拟)和优化治疗提供的基本资源，包括高精度的剂量计算。我们的总体目标是满足全国对全面记录和支持、开放和可扩展的治疗计划和虚拟模拟研究平台的需求，以研究图像引导放射治疗模拟和交付的新技术和方法。

DESCRIPTION (provided by applicant): The unavoidable dose delivered to nearby radiosensitive structures limits the maximum radiation dose that can be delivered safely to the tumor target during external beam radiation therapy for the treatment of cancer. To reduce the risk of unacceptable morbidity each individual course of radiation therapy must be carefully preplanned to achieve a high tumor dose while sparing normal tissues as much as possible. This guiding principle of radiation therapy dose planning has been refined to the modern concept of dose conformation--shaping the dose distribution to match the target m that pervades most modern research in radiation therapy. Innovative technologies, methods, and ideas for three-dimensional (3-D) and even four-dimensional (3-D + time) image-guided treatment simulation and delivery have pushed this concept at the research level to the extreme limit of essentially shrink-wrapping the high dose region to a conformal glove-like fit around the target volume while enveloping sensitive tissues in protective lower dose regions, even in the context of spatially complex and time-varying geometrical shapes and relationships of the tumor and surrounding normal anatomy. Research in this area is gaining momentum from clinical trials that are producing medical evidence showing highly conformal radiation therapy, both with and without dose escalation, significantly increases the probability of favorable clinical outcome both in terms of improving tumor control and reducing the occurrence of side effects. Graphically sophisticated and analytically complex software tools are essential resources for conducting image guided computer simulations (virtual simulation) and optimizations of treatment delivery, including highly accurate dose calculations. Our overall aim is to fill a national need for a fully documented and supported, open and extensible treatment planning and virtual simulation research platform for investigating new techniques and methods for image-guided radiotherapy treatment simulation and delivery.