ULTRASOUND APPLICATORS FOR THERMOBRACHYTHERAPY

体温过高已被证明可以显著提高 放射治疗和药物治疗在癌症的临床治疗中的反应 肿瘤的联合治疗高度依赖于一致性和 在目标体积内定位加热。最近的研究表明 表明同时施加热量和辐射将会 显著改善肿瘤控制，并在很长一段时间内最引人注目 持续的间质加热与同期的近距离放射治疗。为数不多的 与联合供热兼容的间隙加热技术 治疗显示出无法有效地控制温度 沿种植体长度的分布，这通常转化为 加热均匀性差，最小热剂量低。 本提案描述了一项发展间隙加热的研究计划。 系统将比以前的技术更有效地提供 同时间质热放射治疗对以前难以 治疗脑部等部位。这包括：L)直接的发展 具有动态功能的植入式多元超声喷射器 控制纵向功率沉积，并允许 同时插入放射源；2)研制 立体定向的治疗优化和控制软件预案 与热剂量学和辐射剂量学有关的照射器的放置 考虑因素，并调节功率电平以达到均匀的温度 最大热剂量的分布。 这种方法的影响将对大脑中的目标最显著 其中稀疏注入和源的非平行对准通常 这是必要的。在未来，该系统可能很容易被改装用于 其他部位，如前列腺，优势，如能力 沿每个喷头的长度调整功率沉积，并 精确控制供暖的局部化是至关重要的。初级阶段 目标是生产组织间敷贴器和相关规划 &控制程序将提供更统一和更大的总体 比目前可用的间隙加热的热剂量分布 技术，并促进同时提供 热放射疗法。这种供暖技术的发展将为 一种改进的供暖方式为长时间的I/II期试验做好准备 同步热放射治疗。

Hyperthermia has been shown to substantially increase the effectiveness of radiation and drugs in the clinical management of cancer, but the response of tumors to combined therapy is highly dependent upon the uniformity and localization of heating within the target volume. Recent studies have shown that applying the heat, and radiation concurrently will significantly improve tumor control, and is most dramatic for long duration interstitial heating with concurrent brachytherapy. The few interstitial heating technologies which are compatible for combined therapy exhibit an inability to effectively control the temperature distribution along the length of the implant, which often translates into poor heating uniformity and a low minimum thermal dose. This proposal describes a research plan to develop an interstitial heating system which will be more effective than former technologies in delivering simultaneous interstitial thermoradiotherapy to previously difficult to treat sites such as brain. This includes: l) the development of directly implantable multielement ultrasound applicators that feature dynamic control of the longitudinal power deposition and allow for the simultaneous insertion of radiation sources; 2) the development of treatment optimization and control software to preplan the stereotactic placement of applicators with respect to thermal and radiation dosimetry considerations, and regulate power levels to attain uniform temperature distributions of maximum thermal dose. The impact of this approach will be most significant for targets in brain where sparse implants and non-parallel alignment of sources are often necessary. In the future, this system may be readily adapted for use in other sites such as prostate, where advantages such as the ability to adjust the power deposition along the length of each applicator and precisely control the localization of heating are essential. The primary objectives are to produce interstitial applicators and associated planning & control programs which will provide more uniform and bigger overall thermal dose distributions than currently available interstitial heating technologies, and to facilitate the delivery of simultaneous thermoradiotherapy. The development of this heating technique will provide an improved heating modality ready for Phase I/II trials of long duration simultaneous thermoradiotherapy.