Quantitative Lung Function Imaging to Reduce Toxicity for patients treated with Radiation and Immunotherapy

拟议的项目是在胸部肿瘤学领域。接受治疗的肺癌患者 放射治疗和免疫治疗有出现严重肺部副作用的风险，尤其是， 肺炎。肺炎会导致咳嗽、呼吸急促，并可能致命。肺炎，是一种严重的、 重叠毒性，可作为放射治疗和免疫治疗的函数。肺炎有一种 显著影响患者的生活质量，限制了积极的治疗组合 在临床试验中进行评估。需要采取策略来降低接受以下治疗的患者的肺炎发病率 在临床试验中积极结合放射治疗和免疫治疗。一种新的肺功能成像方法 已经开发出一种使用所获得的数据作为肺癌患者常规临床护理的一部分的模式 以及创新地计算肺功能图的软件技术。新型肺功能成像技术 通过个人化的功能性回避放射治疗，放射治疗模式已被纳入放射治疗 治疗模式。功能性避免的想法是设计放射治疗计划，将剂量减少到 肺的功能部分，假设减少对功能肺的剂量将导致减少 治疗的副作用和生活质量的改善。基于成像的功能性回避提供了 一种有希望的方法，显著降低接受联合治疗的肺癌患者的毒性 放射治疗和免疫治疗。问题是，新的肺功能成像方法还没有被 将免疫疗法添加到治疗范例中进行开发和评估。 我们项目的目的是开发新的方法，使基于成像的评估 参加放射治疗和免疫治疗临床试验的患者的功能回避。我们的研究将 开发提供肺功能全景图的方法(除呼吸外，还可进行灌注成像) 评估最稳定和临床相关的肺功能成像形式，并进行敏感性分析 各种功能参数如何影响接受放射治疗的患者的放射治疗计划 免疫疗法。我们的研究将使用4个临床试验的数据来评估拟议的成像框架 可以在降低肺癌患者毒性的背景下加入免疫治疗的治疗范式。 更激进的放射治疗和免疫治疗的组合将继续发展， 将在临床试验中进行研究。肺部毒性将是这些研究的一个严重的临床限制。我们的项目 提出了一种方便、廉价的成像方式来降低毒性，并有可能显著 提高接受放疗和免疫治疗的肺癌患者的生活质量。我们的影响 影像框架是，它可以1)减少接受放射治疗的患者与治疗相关的副作用 和免疫疗法，以及2)使更具侵袭性的放射治疗和免疫疗法的研究成为可能 肺癌患者的治疗方法。

The proposed project is in the field of thoracic oncology. Lung cancer patients that get treated with radiotherapy and immunotherapy are at risk of developing serious lung side-effects, and in particular, pneumonitis. Pneumonitis results in cough, shortness of breath, and can be fatal. Pneumonitis, is a serious, overlapping toxicity that can results as a function of both radiotherapy and immunotherapy. Pneumonitis has a significant impact on patient quality of life and limits the aggressive combinations of therapies that can be evaluated in clinical trials. Strategies are needed that can reduce pneumonitis rates for patients treated with aggressive combinations of radiotherapy and immunotherapy in clinical trials. A novel lung function imaging modality has been developed that uses data acquired as part of routine clinical care for lung cancer patients along with software techniques to innovatively calculate lung function maps. The novel lung function imaging modality has been incorporated into radiotherapy through a personalized, functional avoidance radiation treatment paradigm. The idea of functional avoidance is to design radiation treatment plans that reduce dose to functional portions of the lung with the hypothesis that reduced dose to functional lung will lead to decreased side-effects from treatment and improved quality of life. Imaging-based functional avoidance provides a promising method for significantly reducing toxicity for lung cancer patients who get treated with combinations of radiotherapy and immunotherapy. The problem is that the novel lung function imaging methods have not been developed and evaluated with immunotherapy added to the treatment paradigm. The purpose of our project is to develop novel methods that enable the evaluation of imaging-based functional avoidance for patients enrolled in radiotherapy and immunotherapy clinical trials. Our study will develop methods that provide a complete picture of lung function (perfusion imaging in addition to ventilation), evaluate the most stable and clinically relevant form of lung function imaging, and perform a sensitivity analysis of how various functional parameters effect radiation treatment plans for patients treated with radiotherapy and immunotherapy. Our study will use data from 4 clinical trials to evaluate whether the proposed imaging framework can reduce toxicity for lung cancer patients in the setting of immunotherapy added to the treatment paradigm. More aggressive combinations of radiotherapy and immunotherapy are going to continue to evolve and be investigated in clinical trials. Pulmonary toxicity will be a serious clinical limitation for these studies. Our project proposes a convenient, inexpensive imaging modality to reduce toxicity and has the potential to significantly improve quality of life of lung cancer patients treated with radiotherapy and immunotherapy. The impact of our imaging framework is that it can 1) reduce treatment-related side-effects for patients treated with radiotherapy and immunotherapy and 2) enable the investigation of more-aggressive radiotherapy and immunotherapy treatment approaches for lung cancer patients.