Catheter-Based Ultrasound Hyperthermia System for 3D-Targeted Thermal Therapy

描述(申请人提供)：用于30目标热疗的基于导管的超声热疗系统热疗与放射治疗和/或化疗相结合，用于治疗局部晚期或复发的骨盆肿瘤(如前列腺、子宫颈)已被证明显著改善了临床反应。许多此类研究中使用的深度区域加热技术不能有效地定位规定的温度分布，也不能提供一种手段来验证是否提供了足够的热剂量。我们的总体研究计划是开发高度可控的组织间和腔内超声加热技术，将其与HDR近距离放射治疗相结合，作为一种手段，显著提高热疗与标准放疗和化疗相结合的治疗效果，以治疗患有巨大的IB-IllB期(可能是IVA)疾病、复发的前列腺癌和其他持续或晚期盆腔肿瘤的宫颈癌患者。凭借我们开发基于导管的超声加热技术的专业知识，包括以前对骨盆疾病的临床治疗，我们计划迅速完成间质和腔内热疗喷射器和治疗输送系统的高级开发(目标1)。这包括集成超声波敷贴器和内腔式HDR环敷贴器内的温度传感，以便直接从宫颈内加热，以及经尿道敷贴器用于加热前列腺。将开发基于图像的治疗计划程序和热模型，并用于确定治疗策略和施加器配置，从而显著改善治疗输送和加热一致性(目标2)。因此，在HDR治疗之前或之后，用于提供放射治疗的相同导管和设备可以用于提供顺应性热疗和监测肿瘤内温度。将对这种基于导管的超声系统进行临床研究，以提供设计反馈并确定该方法的可行性(目标3)。从这项工作中获得的信息将在必要时用于指导未来的发展和L/11期研究的设计/实施，以确定这种方法在特定地点的安全性和有效性。同样的技术可以被修改并用于将3D适形热疗应用于使用HDR近距离放射治疗的其他部位(例如，头颈部、黑色素瘤、乳房)。

DESCRIPTION (provided by applicant): Catheter-Based Ultrasound Hyperthermia System for 30-Targeted Thermal Therapy Hyperthermia combined with radiotherapy and/or chemotherapy for the treatment of locally advanced or recurrent pelvic tumors (e.g., prostate, cervix) has been shown to dramatically improve clinical response. The deep-regional heating techniques used in many of these studies do not effectively localize a prescribed temperature distribution nor provide a means of verifying delivery of adequate thermal dose. Our overall research plan is to develop highly-controllable interstitial and endocavity ultrasound heating technology to be integrated with HDR brachytherapy as a means to significantly enhance treatment efficacy of combining hyperthermia with standard radiation and chemotherapy for cervical cancer patients with bulky Stage IB-IllB (possibly IVA) disease, recurrent prostate cancer, and other persistent or advanced pelvic tumors. Relying upon our expertise developing catheter-based ultrasound heating technology, including previous clinical treatments of pelvic disease, we plan to expeditiously complete advanced development of interstitial and endocavity hyperthermia applicators and treatment delivery systems (Aim 1). This includes the integration of an ultrasound applicator and temperature sensing within an endocavity HDR ring applicator for heating from directly within the uterine cervix, and a transurethral applicator for heating prostate. Image based treatment planning programs and thermal models will be developed and used to determine treatment strategies and applicator configurations that dramatically improve treatment delivery and heating conformability (Aim 2). Thus, prior to or after the HDR treatment, the same catheters and devices used to deliver radiotherapy can be used to deliver conformable hyperthermia and monitor intratumoral temperatures. A clinical study of this catheter-based ultrasound system will be performed to provide design feedback and determine the feasibility of this approach (Aim 3). The information obtained from this effort will be used to guide future development as necessary and the design/implementation of Phase l/ll studies to determine safety and efficacy of this approach for specific sites. The same technique can be modified and utilized for applying 3D conformal hyperthermia to other sites treated with HDR brachytherapy (e.g., head & neck, melanoma, breast).