Our long term goal is to maximize the benefits of hyperthermia by developing systems capable of inducing therapeutic thermal doses in entire tumor volumes (to maximize hyperthermic cytotoxicity) and that allow simultaneous delivery of ionizing radiation (to maximize thermal radiosensitization). This application seeks to translate into the radiotherapy clinic a superficial ultrasound hyperthermia system designed for sequential and simultaneous thermoradiotherapy and to evaluate its performance in a human clinical trial. The system (SURLAS for Scanning Ultrasound Reflector Linear Array System) will be based on device developments, numerical modeling and laboratory studies performed under the current funding period. Simultaneous irradiation using electron beams will be tested clinically for the first time.
The specific aims are: (1) Develop a SURLAS suitable for superficial sequential/simultaneous thermoradiotherapy clinical trials with human subjects, compatible with electron/photon beam irradiation, and with 3D heating pattern control. Pre-clinical testing is also part of this aim. (2) Develop a Linac-SURLAS-Patient portable interface to minimize the utilization time of the linear accelerator (linac). The goal is to start the hyperthermia treatment outside the linac room; then midway through the heat treatment the patient and the SURLAS are transported into the room and interfaced with the linac. The radiation fraction is then given without interruption of hyperthermia. The final step is to transport the Linac- SURLAS-Patient portable interface out of the linac room to complete the hyperthermia. (3) Develop a practical hyperthermia treatment planning tool to select initial insonation parameter for the SURLAS depending on target volume characteristics, and to assist the physician in evaluating ultrasound isopower contours with respect to radiation isodoses. We will incorporate ultrasound power deposition distributions into treatment planning tools/programs (CT/MRI-based) developed in our department for 3D radiotherapy. And (4), perform a simultaneous hyperthermia and external beam radiation clinical trial with human patients to: (i) Evaluate the thermal performance of the SURLAS against that of the presently used commercial ultrasound hyperthermia system. (ii) Establish quantitatively, using thermal dosimetry indicators, that heating with the SURLAS is better than with the current device. (iii) Demonstrate that the simultaneous administration o hyperthermia and radiation can be more cost effective by permitting the bulk of the patient's hyperthermia to take place outside the linac room. (iv) Establish feasibility of simultaneous hyperthermia and electron beam radiotherapy. This proposal represents the translation of new hyperthermia technology and decades of biological studies into the human clinic. The benefits to patients e.g., greater likelihood of local tumor control outweigh potential risks.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA063121-10
Application #
6835164
Study Section
Radiation Study Section (RAD)
Program Officer
Deye, James
Project Start
1995-07-01
Project End
2005-08-05
Budget Start
2005-01-01
Budget End
2005-08-05
Support Year
10
Fiscal Year
2005
Total Cost
$140,768
Indirect Cost
Name
Washington University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Varma, Sumeeta; Myerson, Robert; Moros, Eduardo et al. (2012) Simultaneous radiotherapy and superficial hyperthermia for high-risk breast carcinoma: a randomised comparison of treatment sequelae in heated versus non-heated sectors of the chest wall hyperthermia. Int J Hyperthermia 28:583-90
Moros, Eduardo G; Peñagaricano, Jose; Novàk, Petr et al. (2010) Present and future technology for simultaneous superficial thermoradiotherapy of breast cancer. Int J Hyperthermia 26:699-709
Parry, J J; Sharma, V; Andrews, R et al. (2009) PET imaging of heat-inducible suicide gene expression in mice bearing head and neck squamous cell carcinoma xenografts. Cancer Gene Ther 16:161-70
Penagaricano, Jose A; Moros, Eduardo; Novak, Petr et al. (2008) Feasibility of concurrent treatment with the scanning ultrasound reflector linear array system (SURLAS) and the helical tomotherapy system. Int J Hyperthermia 24:377-88
Novak, Petr; Penagaricano, Jose A; Nahirnyak, Volodymyr et al. (2008) Influence of the SURLAS applicator on radiation dose distributions during simultaneous thermoradiotherapy with helical tomotherapy. Phys Med Biol 53:2509-22
Myerson, Robert J; Singh, Anurag K; Bigott, Heather M et al. (2006) Monitoring the effect of mild hyperthermia on tumour hypoxia by Cu-ATSM PET scanning. Int J Hyperthermia 22:93-115
Novak, P; Moros, E G; Parry, J J et al. (2005) Experience with a small animal hyperthermia ultrasound system (SAHUS): report on 83 tumours. Phys Med Biol 50:5127-39
Novak, Petr; Moros, Eduardo G; Straube, William L et al. (2005) Treatment delivery software for a new clinical grade ultrasound system for thermoradiotherapy. Med Phys 32:3246-56
Novak, Petr; Moros, Eduardo G; Straube, William L et al. (2005) SURLAS: a new clinical grade ultrasound system for sequential or concomitant thermoradiotherapy of superficial tumors: applicator description. Med Phys 32:230-40
Singh, A K; Moros, E G; Novak, P et al. (2004) MicroPET-compatible, small animal hyperthermia ultrasound system (SAHUS) for sustainable, collimated and controlled hyperthermia of subcutaneously implanted tumours. Int J Hyperthermia 20:32-44

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