PlanUNC Research Platform for Radiotherapy Simulation

描述（由申请人提供）：在治疗癌症的外部放射治疗过程中，不可避免的辐射剂量限制了可以安全传递到肿瘤靶点的最大辐射剂量。为了降低不可接受的发病率的风险，每个单独的放射治疗过程必须仔细地预先计划，以达到高肿瘤剂量，同时尽可能保留正常组织。放射治疗剂量计划的这一指导原则已被细化为剂量构象的现代概念——塑造剂量分布以匹配目标m，这在大多数现代放射治疗研究中普遍存在。三维（3-D）甚至四维（3-D +时间）图像引导治疗模拟和递送的创新技术、方法和理念，已经将这一概念在研究层面推向了极限，基本上是将高剂量区域收缩包裹到目标体积周围的适形手套，同时将敏感组织包裹在保护性低剂量区域。即使在空间复杂和时变的几何形状和关系的背景下，肿瘤和周围的正常解剖。这一领域的研究正从临床试验中获得动力，这些临床试验产生的医学证据表明，无论是否增加剂量，高度适形的放射治疗在改善肿瘤控制和减少副作用发生方面都显著增加了有利临床结果的可能性。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）和优化治疗递送的必要资源，包括高度精确的剂量计算。我们的总体目标是填补国家对一个完整记录和支持，开放和可扩展的治疗计划和虚拟仿真研究平台的需求，用于研究图像引导放射治疗模拟和传递的新技术和方法。

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.