Improving the Therapeutic Ratio of Proton Radiation Therapy

提高质子放射治疗的治疗率

• 批准号: 8736216
• 负责人: THOMAS F DELANEY
• 金额: $ 20.41万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-04-01 至 2014-09-24
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8736216
• 关键词: Adult; Adverse effects; Anatomic Sites; Anesthesia procedures; BAY 54-9085; Cancer Patient; Child; Childhood; Childhood Medulloblastomas; Childhood Rhabdomyosarcoma; Clinical; Clinical Research; Clinical Trials; Complex; Correlative Study; Devices; Disease; Dose; Effectiveness; Goals; Hepatic; Investigation; Length; Liver neoplasms; Malignant Childhood Neoplasm; Malignant Neoplasms; Morbidity - disease rate; Neutrons; Non-Small-Cell Lung Carcinoma; Normal tissue morphology; Operative Surgical Procedures; Outcome; Paranasal Sinus Neoplasms; Patients; Phase; Photons; Physics; Positioning Attribute; Protocols documentation; Proton Radiation; Protons; Public Health; Quality-of-Life Assessment; Radiation; Radiation therapy; Relative (related person); Research; Rhabdomyosarcoma; Risk; Scanning; Sinus; Testing; Therapeutic; Therapeutic Studies; Toxic effect; Translating; Tumor Tissue; Unresectable; Vertebral column; X-Ray Computed Tomography; chemoradiation; chemotherapy; clinical research site; cohort; high risk; improved; irradiation; medulloblastoma; phase 2 study; prospective; proton beam; proton therapy; randomized trial; response; sarcoma; skull base; tool; treatment planning; tumor

Protons have a physical dose advantage over photons (x-rays), the most commonly used type of radiation therapy for cancer patients, because they do not exit beyond the tumor target and thus irradiate less normal tissue. Irradiation of normal tissue yields no possible benefit for the patient; it can only increase the risk of treatment related side effects during and long after the end of treatment. While proton radiation therapy has been used in selective clinical sites with significant improvements in clinical outcome, we believe that research into better control of the finite range of the proton in the patient can yield additional clinical gains. The major objective of this project, Improving the Therapeutic Ratio of Proton Radiation Therapy in Challenging Clinical Sites, is to perform clinical trials employing improved control of the proton range in challenging clinical scenarios. We believe that these research advances should translate into further improvement in outcome in not only these particular diseases, but at multiple other anatomic sites where proton radiation therapy is increasingly being employed. The potential impact for public health is higher cancer cure rates and/or reduced treatment side effects, particularly in children, who are at the highest risk of late radiation therapy-induced side effects, which can be reduced with the use of protons. The specific aims are to conduct phase II clinical studies in patients with unresectable liver tumors, pediatric medulloblastoma and rhabdomyosarcoma, spine and skull base sarcomas, and paranasal sinus tumors in which we will (1) use the end of range of the proton more effectively, (2) investigate the clinical use of magnetically scanned proton beams and intensity-modulated proton therapy, (3) confirm the tolerability and effectiveness of hypofractionated radiation dose escalation for unresectable liver tumors, (4) critically assess the importance of an adaptive proton radiation therapy strategy in response to tumor and normal tissue responses to radiation therapy in one anatomic site, and (5) compare treatment-related morbidity with photons and protons in these selected pediatric malignancies and in adult paranasal sinus tumors. The physical tools necessary to achieve these clinical goals will be investigated in Projects 3 and 4. The initial use of many of these physical tools in Project 2 will be important for their later use in Project 1, Proton Dose Escalation and Proton vs. Photon Randomized Trials for Non-Small Cell Lung Cancer.

质子比光子（X 射线）具有物理剂量优势，光子是最常用的类型 对癌症患者进行放射治疗，因为它们不会超出肿瘤靶标，因此不会受到照射 正常组织较少。正常组织的照射不会给患者带来任何好处；它只能增加 治疗期间和治疗结束后很长时间内出现治疗相关副作用的风险。当质子辐射 我们相信，该疗法已在选择性临床场所使用，临床结果显着改善 更好地控制患者体内质子有限范围的研究可以产生额外的临床效果 收益。该项目的主要目标是提高质子放射治疗的治疗率 具有挑战性的临床地点，是通过改进质子范围的控制来进行临床试验 具有挑战性的临床场景。我们相信这些研究进展应该转化为进一步的 不仅改善了这些特定疾病的结果，还改善了多个其他解剖部位的结果 质子放射治疗的应用越来越广泛。对公共健康的潜在影响更大 癌症治愈率和/或减少治疗副作用，尤其是儿童，他们是癌症风险最高的人 晚期放射治疗引起的副作用，可以通过使用质子来减少。 具体目标是对无法切除的肝脏肿瘤患者进行 II 期临床研究， 儿童髓母细胞瘤和横纹肌肉瘤、脊柱和颅底肉瘤以及鼻旁窦 我们将（1）更有效地使用质子射程末端的肿瘤，（2）研究临床应用 磁扫描质子束和强度调制质子治疗，(3) 确认耐受性 以及大分割放射剂量递增对不可切除肝脏肿瘤的有效性，(4) 关键 评估适应性质子放射治疗策略对肿瘤和正常人的反应的重要性 一个解剖部位对放射治疗的组织反应，以及（5）比较与治疗相关的发病率 这些选定的儿科恶性肿瘤和成人鼻旁窦肿瘤中的光子和质子。这 项目 3 和项目 4 将研究实现这些临床目标所需的物理工具。 在项目 2 中使用许多这些物理工具对于它们以后在项目 1（质子剂量）中的使用非常重要 非小细胞肺癌的升级和质子与光子随机试验。