PROTON RADIATION THERAPY RESEARCH

质子放射治疗研究

• 批准号: 7503801
• 负责人: THOMAS F DELANEY
• 金额: $ 169.28万
• 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 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7503801
• 关键词: PROTON; RADIATION; THERAPY; RESEARCH

DESCRIPTION (provided by applicant): Objectives and Specific Aims Any tumor cell can be eradicated with a sufficiently high dose of radiation; conversely, any normal tissue can be injured with sufficient dose to a given volume. The challenge for clinicians is to deliver the appropriate dose to only those tissues containing tumor. Proton radiation fields, with no exit beyond the target, deliver less radiation to normal tissues than comparable photon (x-ray) fields. This improves the therapeutic ratio (of cure probability to complication risk) because irradiation of normal tissue does not benefit the patient. We have treated nearly 7,000 cancer patients with proton therapy at the Harvard Cyclotron and Francis H. Burr Proton Therapy Center (FHBPTC) since 1974. We have achieved significant gains in clinical outcomes for a number of disease sites including chondrosarcomas and chordomas of the skull base and cervical spine (95% and 50% local control, respectively), paranasal sinus tumors (82% local control), ocular melanoma (97% local control), and prostate cancer (80% biochemically disease-free). At the FHBPTC, we have been able to expand the range of diseases treated to include pediatric malignancies at nearly any anatomic site including craniospinal axis treatment under anesthesia, nasopharyngeal carcinoma, lung and hepatocellular tumors under respiratory gating, and pelvic and retroperitoneal sarcomas. We believe that research in this field can further iimprove our utilization of the proton beam in the clinic to enhance treatment outcome. We hypothesize that, mainly through the use of advanced imaging technology, we can deliver higher precision proton therapy to further improve target coverage and/or reduced dose to nearby critical structures. We propose 3 integrated projects (1)Clinical Utilization of the Physical Advantages of Proton Therapy, (2)Optimizing the Use of Protons in the Clinic, and (3) Morbidity Reduction with Proton Radiation Therapy to test this hypothesis. The specific aims of the projects are to develop dose guided proton therapy techniques including PET/CT imaging to measure the activation of positron emitters through the proton beam, to control range in the presence of organ motion, and to advance beam delivery strategies for intensity modulated proton therapy to further improve therapeutic ratio. In selected clinical sites where tumor closely invests normal tissue, morbidity reduction with targetted biologic agents will also be explored.

描述（由申请人提供）：目标和具体目标 任何肿瘤细胞都可以用足够高剂量的辐射来根除；相反，任何正常组织都可能因给定体积的足够剂量而受到损伤。临床医生面临的挑战是仅向含有肿瘤的组织提供适当的剂量。质子辐射场没有超出目标的出口，与类似的光子（X 射线）场相比，向正常组织传递的辐射更少。这提高了治疗比（治愈概率与并发症风险），因为正常组织的照射对患者没有好处。 自 1974 年以来，我们在哈佛回旋加速器和弗朗西斯·H·伯尔质子治疗中心 (FHBPTC) 已用质子治疗治疗了近 7,000 名癌症患者。我们在许多疾病部位的临床结果方面取得了显着进展，包括颅底和颈椎的软骨肉瘤和脊索瘤（分别为 95% 和 50% 的局部控制）、鼻旁窦肿瘤（82% 的局部控制为 对照）、眼黑色素瘤（97% 局部对照）和前列腺癌（80% 生化无病）。在 FHBPTC，我们已经能够扩大治疗疾病的范围，包括几乎任何解剖部位的儿科恶性肿瘤，包括麻醉下的颅脊髓治疗、鼻咽癌、呼吸门控下的肺癌和肝细胞肿瘤以及盆腔和腹膜后肉瘤。 我们相信，这一领域的研究可以进一步提高质子束在临床中的应用，从而提高治疗效果。我们假设，主要通过使用先进的成像技术，我们可以提供更高精度的质子治疗，以进一步提高目标覆盖范围和/或减少附近关键结构的剂量。我们提出了 3 个综合项目（1）质子治疗物理优势的临床利用，（2）优化质子在临床中的使用，以及（3）质子放射治疗降低发病率来检验这一假设。这些项目的具体目标是开发剂量引导质子治疗技术，包括 PET/CT 成像，通过质子束测量正电子发射器的激活，控制器官运动时的范围，并推进调强质子治疗的射束传输策略，以进一步提高治疗率。在肿瘤密切影响正常组织的选定临床地点，还将探索使用靶向生物制剂降低发病率。