Retrospective NCI Phantom-Monte Carlo Dosimetry for Late Effects in Wilms Tumor

回顾性 NCI 幻影蒙特卡罗剂量测定对肾母细胞瘤迟发效应的影响

• 批准号: 9980351
• 负责人: John Andrew Kalapurakal
• 金额: $ 55万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9980351
• 关键词: 3-Dimensional; Abdomen; Address; Adult; Age; Algorithms; Breast; Chest wall structure; Child; Childhood; Cohort Studies; Colon; Congestive Heart Failure; Data; Databases; Dose; End stage renal failure; Exposure to; Family; Female; Fertility; Future; Heart; Heart Ventricle; Height; Hypogonadism; Impairment; Incidence; Infertility; Institution; Kidney; Knowledge; Late Effects; Libraries; Liver; Location; Lung; Lung diseases; Male Infertility; Malignant Neoplasms; Malignant neoplasm of lung; Measurement; Measures; Medical History; Methods; Modeling; Modernization; Myocardium; Nephroblastoma; Normal tissue morphology; Organ; Outcome; Ovary; Patients; Pelvis; Prevalence; Protocols documentation; Questionnaires; Radiation; Radiation Tolerance; Radiation therapy; Recording of previous events; Records; Reporting; Stomach; Study Subject; Survivors; System; Testis; Thyroid Gland; Time; Toxic effect; Uterus; Weight; adverse pregnancy outcome; base; childhood cancer survivor; design; dosimetry; follow-up; improved; male; ovarian failure; phantom model; prospective; reconstruction; reproductive; sex; survivorship; treatment planning

PROJECT SUMMARY Radiation therapy is the most important contributor to late toxicity in children. Unlike in adults, there is not much data on three-dimensional (3D) normal tissue radiation tolerance in children. This retrospective dosimetry study will use the patient-matched NCI computational pediatric phantom model for conducting Monte Carlo dosimetry analysis. This study will be performed on matched phantoms of all 5000 children with Wilms tumor (WT) who received radiation therapy (RT) on five National Wilms Tumor Study (NWTS) protocols during 1969-2002. The high survivorship (90%) of WT and the many advantages of the NWTS late effects database makes this an ideal platform for a detailed dosimetry study of late effects of therapy. One patient-matched phantom based on height, weight, age and sex of each NWTS patient, with already pre-contoured target organs will be selected from the phantom library of Dr. Lee at the NCI. This phantom will be imported into the radiation treatment planning system for reconstruction of NWTS radiation fields. While modern RT treatment planning systems (TPS) are fairly accurate for estimating doses both in-field and near-field locations, this method is not suitable for out-of-field dose measurements. The Monte Carlo (MC) dose calculation algorithm has overcome this deficiency of TPS and measures out-of-field doses more accurately. In this study, both dosimetry models will be used for estimating doses in-field, and MC-based dose calculations will be used for estimating out-of-field doses. For AIM 1 of this study, we will collect target organ 3D dosimetry data for 13 organs including thyroid, heart (total heart, ventricles and myocardium), lungs, kidneys, liver, chest wall, stomach, colon, breasts, uterus, ovaries, pelvis and testicles. For AIM 2 we will review and validate reproductive late effects (hypogonadism and infertility) among males and females recorded in the NWTS database and conduct a prospective questionnaire-based cohort study to determine their prevalence among NWTS survivors. For AIM 3 we will study the association between RT dose to target organs estimated using the NCI Phantom MC dosimetry model and six late effects ascertained by the NWTS including: congestive heart failure (heart, ventricles, myocardium), restrictive pulmonary disease (lungs, chest wall), second malignant neoplasms (lung, thyroid, breasts, liver stomach, colon), end stage renal disease (kidney/s), adverse pregnancy outcomes (ovaries, uterus, pelvis) and additional reproductive outcomes (hypogonadism and infertility – ovaries, uterus in females and testicles in males). A comprehensive knowledge of 3D organ tolerance will help reduce the incidence of RT induced late toxicity and minimize their adverse impact on current and future childhood cancer survivors.

项目摘要 放射疗法是导致儿童晚期毒性的最重要因素。与成年人不同，没有 关于儿童的三维（3D）正常组织辐射耐受性的大量数据。这个回顾 剂量学研究将使用患者匹配的NCI计算小儿幻影模型进行蒙特 卡洛剂量法分析。这项研究将对所有5000名Wilms儿童的匹配幻象进行 在五个国家Wilms肿瘤研究（NWTS）方案中接受放射治疗（RT）的肿瘤（WT） 1969-2002。 WT的高生存率（90％）和NWTS后期效果数据库的许多优点 这是对治疗后期作用进行详细剂量测定研究的理想平台。一个患者匹配 基于每个NWTS患者的身高，体重，年龄和性别的幻影 将从NCI的Lee博士的幻影图书馆中选择器官。此幻影将进口到 NWTS辐射场重建的辐射处理计划系统。而现代RT治疗 规划系统（TPS）非常准确地估算了场地和近场位置的剂量， 方法不适用于场外剂量测量。蒙特卡洛（MC）剂量计算算法 已经克服了TPS的缺乏，并更准确地克服了场外剂量。在这项研究中，两者都 剂量测定模型将用于估算场地剂量，基于MC的剂量计算将用于 估计场外剂量。对于本研究的目标1，我们将收集目标器官3D剂量测定数据13 器官在内包括甲状腺，心脏（全心，心室和心肌），肺，肾脏，肝脏，胸壁， 胃，结肠，乳房，子宫，卵巢，骨盆和睾丸。对于目标2，我们将审查并验证 NWTS中记录的男性和女性的生殖后期作用（性能和不育） 数据库并进行基于前瞻性问卷的同类研究，以确定其患病率 NWTS存活。对于AIM 3，我们将研究RT剂量与使用的目标器官之间的关联 NCI Phantom MC剂量学模型和NWT确定的六个后期​​效果，包括： 心力衰竭（心脏，心室，心肌），限制性肺部疾病（肺，胸壁），第二 恶性肿瘤（肺，甲状腺，乳房，肝脏摊，结肠），终阶段肾病（肾脏），敌人 妊娠结局（卵巢，子宫，骨盆）和其他生殖结果（性腺功能减退和 不育症 - 卵巢，雌性的子宫和男性的睾丸）。 3D器官的全面知识 耐受性将有助于降低RT诱导的晚期毒性的发生，并最大程度地减少其对 当前和未来的儿童癌症存活。