There are several trends in lung cancer patient management, all leading to an increase in the number of patients being treated with stereotactic body radiotherapy (SBRT). The trends are: (1) increased lung cancer detection through screening programs;(2) promising results of lung SBRT trials using current techniques and technology;and (3) comparable results of SBRT to surgery for medically operable patients leading to open phase II and III trials. Lung SBRT is an emerging technique utilizing high precision and large radiation doses to ablate lung tumor tissue. Despite excellent local control in most studies, the cost of using ablative radiation doses with current radiotherapy technology is morbidity, and in some cases mortality. The research proposed for this grant aims to significantly reduce the toxicity of lung SBRT through several technological developments and associated investigations. First we will solve the four-dimensional constrained treatment planning problem in collaboration with optimization experts;improved treatment plans will be created by including anatomic changes with time as an additional degree of freedom in the optimization. Second, we will combine two intra-treatment imaging modalities, external and internal, to obtain a real-time estimate of the target motion throughout the radiation treatment. Third, this position estimate will be used to direct beams of intensity modulated radiation to moving tumors in real time to offer unprecedented treatment conformality and normal tissue dose reduction. Fourth, a respiratory audiovisual biofeedback tool will be developed in collaboration with a musician and design expert. This tool will improve respiratory regularity for lung SBRT patients and thus decreasing PET/CT artifacts and target delineation errors on PET/CT scans and facilitating improved treatment beam-tumor alignment during radiation delivery. Such a comprehensive and multidisciplinary approach to manage tumor motion will offer the radiation oncology team superior radiation beam-tumor targeting and conformality methods to treat early stage lung cancer patients. We expect the research will ultimately result in a measurable improvement in treatment outcome and have a widespread impact on lung cancer management.
Lung stereotactic body radiotherapy (SBRT) is an increasingly used treatment for early stage lung cancer due to promising local control and survival rates. However, morbidity, and in some cases mortality, result using current technology. This comprehensive, multidisciplinary research program will develop improved treatment planning, image guidance and treatment delivery methods to offer unprecedented radiation beam-tumor targeting. Consequently the amount of healthy tissue irradiated and associated treatment toxicity will be reduced, resulting in improved health of lung cancer patients.
|Shepherd, Ray W; Weiss, Elisabeth (2017) Convex Endobronchial Ultrasound-Guided Placement of Fiducial Markers in Central Lung Tumors. J Bronchology Interv Pulmonol 24:e25-e26|
|Kida, Satoshi; Bal, Matthieu; Kabus, Sven et al. (2016) CT ventilation functional image-based IMRT treatment plans are comparable to SPECT ventilation functional image-based plans. Radiother Oncol 118:521-7|
|Yamamoto, Tokihiro; Kabus, Sven; Lorenz, Cristian et al. (2014) Pulmonary ventilation imaging based on 4-dimensional computed tomography: comparison with pulmonary function tests and SPECT ventilation images. Int J Radiat Oncol Biol Phys 90:414-22|
|Ge, Yuanyuan; O'Brien, Ricky T; Shieh, Chun-Chien et al. (2014) Toward the development of intrafraction tumor deformation tracking using a dynamic multi-leaf collimator. Med Phys 41:061703|
|Ravkilde, Thomas; Keall, Paul J; Grau, Cai et al. (2014) Fast motion-including dose error reconstruction for VMAT with and without MLC tracking. Phys Med Biol 59:7279-96|
|Steel, Harry; Pollock, Sean; Lee, Danny et al. (2014) The internal-external respiratory motion correlation is unaffected by audiovisual biofeedback. Australas Phys Eng Sci Med 37:97-102|
|Suh, Yelin; Murray, Walter; Keall, Paul J (2014) IMRT treatment planning on 4D geometries for the era of dynamic MLC tracking. Technol Cancer Res Treat 13:505-15|
|Ravkilde, Thomas; Keall, Paul J; Grau, Cai et al. (2013) Time-resolved dose distributions to moving targets during volumetric modulated arc therapy with and without dynamic MLC tracking. Med Phys 40:111723|
|Pommer, Tobias; Falk, Marianne; Poulsen, Per R et al. (2013) Dosimetric benefit of DMLC tracking for conventional and sub-volume boosted prostate intensity-modulated arc radiotherapy. Phys Med Biol 58:2349-61|
|Rottmann, J; Keall, P; Berbeco, R (2013) Markerless EPID image guided dynamic multi-leaf collimator tracking for lung tumors. Phys Med Biol 58:4195-204|
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