SOFTWARE FOR OPTIMAL COMBINATION OF EXTERNAL BEAM RADIOTHERAPY (XRT) AND RADIOPHARMACEUTICAL THERAPY (RPT)

在20多年的NIH-R01拨款支持下，Frey和Sgouros实验室开发了定量成像和专利剂量学方法，使联合外部放射治疗（XRT）和放射性药物治疗（RPT）的治疗计划成为可能。XRT-RPT组合在毒性方面是正交的。RPT特别适用于播散性癌症，同时对XRT靶向的肿瘤提供剂量增强。整个工作流程是重建和量化来自RPT计划研究的SPECT/CT图像，计算每个时间点的剂量率图，整合剂量率图以创建剂量图，使用放射生物学原理将剂量图转换为与XRT剂量一致，并将其与Sim-CT结合以导入XRT剂量计划系统。目前的实现涉及几个离散的软件包和手动转换步骤，并且繁琐，容易出错，不适合临床实施或商业化。这个第一阶段应用程序的总体目标是为RPT和XRT的结合创建一个单一的流线型的、健壮的、集成的和经过验证的软件包。我们将：(1)创建开发集成软件；(2)利用现有临床数据进行验证；(3)准备提交FDA IDE以准备拟议的产品

With 20+ years of NIH-R01 grant support the Frey and Sgouros labs have developed quantitative imaging and patented dosimetry methods that enable treatment planning of combination external beam radiotherapy (XRT) and radiopharmaceutical therapy (RPT). Combination XRT-RPT is orthogonal in terms of toxicity. RPT is especially suitable for disseminated cancer while providing a dose boost to tumors targeted by XRT. The overall workflow is to reconstruct and quantify the SPECT/CT images from RPT planning study, calculate dose-rate maps at each time point, integrate the dose-rate maps to create a dose map, using radiobiological principles convert the dose map to be consistent with XRT doses and combine this with a Sim-CT for import into an XRT dose planning system. The current implementation involves several discrete software packages and manual conversion steps and is tedious, error prone, and not suitable for clinical implementation or commercialization. The overall objective of this Phase I application is create a single streamlined, robust, integrated, and validated software package for combining RPT and XRT. We will: (1) Create develop the integrated software; (2) validate it using existing clinical data; and (3) prepare to submit an FDA IDE in preparation for the proposed trial in Phase II.