The tasks of the Clinical Core are to a) provide treatment plans, quality assurance and monitoring of treatment delivery for patients treated in the Research Projects (RP), b)gather setup uncertainty data for head and neck patients, c) implement specialized treatment methods to enhance tumor localization and reduce the effects of treatment uncertainty developed in the research projects, and d) work with the Computer/Dosimetry Core and RPs to implement improvements to the treatment planning software. Intensity modulated radiotherapy (IMRT) plans will be designed for the treatment of prostate, nasopharynx and non-small cell lung tumors. For prostate tumors, plans will be created for patients treated with either 86.4 Gy IMRT or 75.6 Gy IMRT plus adjuvant androgen deprivation. The feasibility of image-guided """"""""dose-painting"""""""" using IMRT in prostate cancer will also be evaluated using the image registration and delivered dose calculation methods developed in RP 3. This study will establish the limitations of IMRT to deliver 91.8 Gy to suspected tumor-bearing regions within the prostate. Patients with non-small cell lung tumors will be entered into a dose escalation study and will receive radiation alone or concurrent radiation and chemotherapy. They will be planned and treated with respiratory gated IMRT. Tumor localization will be improved with the use of respiration-gated PET/CT images. Plans will be designed using CT images from the portion of the respiratory cycle showing minimum tumor motion, selected from spiral CT images correlated with respiration. Fifty patients will be treated using megavoltage cone-beam CT imaging (MVCBI) to visualize tumor position during treatment. The IMRT plans for these patients will be designed with explicit consideration of the dose delivered during MVCBI. Patients with nasopharynx cancer will be entered into a Phase I dose escalation study, receiving either 70.2 or 75 Gy using osepainting and IMRT. Plans will deliver a non-uniform dose distribution concurrently treating sites of gross disease to 2.34 or 2.5 Gy per fraction and electively irradiated regions to 1.8 Gy per fraction. MR and PET images will be used to improve target and normal tissue localization. Techniques will be developed using enhanced inverse planning tools designed by the Computer Core to minimize salivary gland and cochlear doses. Setup uncertainty will be measured and incorporated into dose calculations facilitating an analysis of delivered dose to the tumor and normal tissues. Improvements in the inverse planning system will include biophysical models from RP 1b, i.e. improved normal tissue complication probability calculations for rectal bleeding, tumor control probability for nasopharynx tumors, and dose response data for sensorineural hearing loss, etc., applied to plan design as they become available.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Program Projects (P01)
Project #
Application #
Study Section
Subcommittee E - Prevention &Control (NCI)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Sloan-Kettering Institute for Cancer Research
New York
United States
Zip Code
Bakst, Richard L; Lee, Nancy; Pfister, David G et al. (2011) Hypofractionated dose-painting intensity modulated radiation therapy with chemotherapy for nasopharyngeal carcinoma: a prospective trial. Int J Radiat Oncol Biol Phys 80:148-53
Santoro, Joseph; Kriminski, Sergey; Lovelock, D Michael et al. (2010) Evaluation of respiration-correlated digital tomosynthesis in lung. Med Phys 37:1237-45
Liu, Xiaoxiao; Saboo, Rohit R; Pizer, Stephen M et al. (2009) A SHAPE-NAVIGATED IMAGE DEFORMATION MODEL FOR 4D LUNG RESPIRATORY MOTION ESTIMATION. Proc IEEE Int Symp Biomed Imaging 2009:875-878
Santoro, Joseph P; Yorke, Ellen; Goodman, Karyn A et al. (2009) From phase-based to displacement-based gating: a software tool to facilitate respiration-gated radiation treatment. J Appl Clin Med Phys 10:2982
Sura, Sonal; Gupta, Vishal; Yorke, Ellen et al. (2008) Intensity-modulated radiation therapy (IMRT) for inoperable non-small cell lung cancer: the Memorial Sloan-Kettering Cancer Center (MSKCC) experience. Radiother Oncol 87:17-23
Greco, Carlo; Clifton Ling, C (2008) Broadening the scope of image-guided radiotherapy (IGRT). Acta Oncol 47:1193-200
Kriminski, Sergey A; Lovelock, D Michael; Seshan, Venkatraman E et al. (2008) Comparison of kilovoltage cone-beam computed tomography with megavoltage projection pairs for paraspinal radiosurgery patient alignment and position verification. Int J Radiat Oncol Biol Phys 71:1572-80
Lu, Renzhi; Radke, Richard J; Yang, Jie et al. (2008) Reduced-order constrained optimization in IMRT planning. Phys Med Biol 53:6749-66
Zhang, Qinghui; Pevsner, Alex; Hertanto, Agung et al. (2007) A patient-specific respiratory model of anatomical motion for radiation treatment planning. Med Phys 34:4772-81
Crouch, Jessica R; Pizer, Stephen M; Chaney, Edward L et al. (2007) Automated finite-element analysis for deformable registration of prostate images. IEEE Trans Med Imaging 26:1379-90

Showing the most recent 10 out of 121 publications