Image-Guided Laser Therapy for Barrett's Esophagus

描述（由申请人提供）：激光消融疗法已用于治疗食道癌前病变，目的是防止进展为腺癌。然而，现有的激光消融方法缺乏仅靶向病理组织而不影响邻近健康组织所需的精度，导致严重的并发症和降低的功效。该K25应用的研究重点是开发和体内测试一种新型内窥镜激光治疗系统，该系统能够使局部治疗符合局部解剖学和生理学的原位测量。这项研究的广度将提供出色的背景培训经验，突出生物医学和临床研究的方法和行为，这将补充候选人在物理和光学技术方面的现有专业知识。研究培训部分将在马萨诸塞州总医院的Wellman光医学中心进行，由生物医学光学和转化临床研究领域的领导者Bouma博士进行主要指导。研究最初将侧重于系统能力的体外测试，这将提供组织病理学方法和解释以及生物组织处理方面的培训。随后对该系统的技术能力和安全性进行的体内研究将提供活体动物和人体研究的伦理和行为方面的培训。哈佛医学院和哈佛-麻省理工学院健康科学与技术部提供的补充课程将使候选人在癌症生物学，癌症治疗和生物统计学方面具有坚实的背景。本提案中提供的培训和初步数据将使候选人能够准备资金申请，从而能够过渡到独立研究，重点是将新技术转化为临床实践。 拟议研究的直接重点是开发能够在腺癌发作之前精确和全面治疗食管病理的新方法。由于食管腺癌是一种与高发病率和低生存率相关的流行疾病，因此解决现有治疗缺点的改进治疗方法将产生重大影响。

DESCRIPTION (provided by applicant): Laser ablation therapy has been used to treat pre-malignant lesions of the esophagus with the goal of preventing progression to adenocarcinoma. Existing laser ablation approaches, however, lack the precision necessary to target only the pathologic tissue while sparing neighboring healthy tissue, resulting in significant complications and reduced efficacy. The research focus of this K25 application is to develop and test in vivo a novel endoscopic laser therapy system capable of conforming local therapy to in situ measurements of local anatomy and physiology. The breadth of this research will provide an outstanding contextual training experience, highlighting the methods and conduct of biomedical and clinical research that will complement the candidate's existing expertise in physics and optical technologies. The research training component will occur within the Wellman Center for Photomedicine at the Massachusetts General Hospital under the primary mentorship of Dr. Bouma, a leader in the field of biomedical optics and translational clinical research. Research will initially focus on the in vitro testing of the system capabilities, which will provide training in the methods and interpretation of histopathology as well as the handling of biological tissues. Subsequent in vivo studies of the technical capabilities and safety of the system will provide training in the ethics and conduct of live animal and human studies. Complementary coursework offered at the Harvard Medical School and the Harvard-MIT Division of Health Sciences and Technology will enable the candidate to develop a solid background in cancer biology, cancer treatment, and biostatistics. The training and preliminary data provided in this proposal will enable the candidate to prepare applications for funding that will enable a transition to independent research focusing on the translation of novel technologies to clinical practice. The immediate focus of the proposed research is to develop new methods capable of precise and comprehensive treatment of esophageal pathology prior to the onset of adenocarcinoma. Since esophageal adenocarcinoma is a prevalent disease associated with high morbidity and dismal survival, an improved therapeutic approach that addresses the shortcomings of currently available therapies will make a significant impact.