Functional Infrared Imaging Predicts Radiation Mucositis

描述（由申请人提供）：许多局部晚期头颈癌（HNC）患者将接受治愈性放化疗（CRT）治疗。该方法已在若干随机试验中得到验证，是一种公认的护理标准。CRT有相关的毒性，包括辐射领域几乎普遍的粘膜炎。然而，毒性的严重程度差异很大，有些患者仅出现轻微症状，而另一些患者则需要麻醉镇痛、肠内营养和中断治疗。放疗量可以预测不良反应的部位，但不能预测其程度。目前，还没有能够准确预测CRT诱导HNC患者毒性的方法。CRT诱导的组织损伤导致区域温度变化，可以通过红外成像检测到。阿贡国家实验室开发了一种紧凑的计算机控制的高灵敏度红外成像仪，具有特殊的信号检测算法，可以在很小的背景噪声下检测到微小的温度变化。我们假设治疗早期热强度的改变可以预测患者是否会出现严重的粘膜皮肤毒性。通过红外成像检测这些早期变化将确定一组需要更强化的支持性护理的患者，这些患者可能是去强化治疗以避免严重毒性的候选者。大多数头颈癌患者将采用化疗和放疗联合治疗，并以口腔黏膜炎的形式遭受急性毒性。然而，没有办法预测哪些患者在治疗期间会发生严重的黏膜炎，通常需要中断治疗、减少剂量、麻醉镇痛和管饲。我们假设，热成像将赋予预测哪些患者有这种并发症的风险，并随后允许早期干预和预防的能力。这种工具将在这一患者群体中具有广泛的适用性，并将对他们的治疗产生巨大的影响。

DESCRIPTION (provided by applicant): Many patients with locally advanced head and neck cancer (HNC) will be treated with curative intent chemoradiotherapy (CRT). This approach has been validated in several randomized trials and is an accepted standard of care. CRT has associated toxicity including almost universal mucositis in the radiation field. The severity of toxicity, however, varies widely with some patients experiencing only mild symptoms while others require narcotic analgesia, enteral nutrition, and interruption of therapy. Radiotherapy volumes will be predictive of the location of adverse effects but not the degree. At this time, there are no modalities that allow accurate prediction of CRT induced toxicity in HNC patients. Tissue injury induced by CRT results in regional temperature variations that can be detected by infrared (IR) imaging. Argonne National Laboratory has developed a compact computer-piloted high sensitivity IR imager with special signal detection algorithms that would allow detection of small temperature variations with little background noise. We hypothesize that alterations in thermal intensity early in therapy will be predictive of patients who will develop severe mucocutaneous toxicity. Detection of these early changes by IR imaging would identify a group of patients that will require more intensive supportive care and who may be candidates for de-intensification of therapy to avoid serious toxicity. The majority of patients with head and neck cancer will be treated with combination chemotherapy and radiotherapy and will suffer acute toxicity in the form of oral mucositis. However, there is no way to predict which patients will develop severe mucositis during therapy that often requires treatment interruption, dose reduction, narcotic analgesia, and tube feeding. We hypothesize that thermal imaging will confer the ability to predict which patients are at risk for this complication and would subsequently allow for early intervention and prevention. Such a tool would have wide applicability in this patient population and would have tremendous impact on their treatment.