Control of the primary tumor is a major goal of radiotherapy for cancer. Escalating the dose delivered to the tumor provides a method to improve local control. For lung cancer patients in particular, respiratory-induced organ motion has impeded safe dose escalation. Methods to compensate for this motion or to immobilize the tumor have been developed in recent years. However, these new technologies have not been applied in concert with reduced margins that would enable dose escalation due to the lack of data characterizing uncertainty in respiratory-induced organ motion. It is critical to characterize the uncertainties associated with tumor immobilization to enable the use of appropriate margins. It is our hypothesis that the combination of image guidance techniques and integrated active breath hold radiotherapy will enable characterization and reduction of the geometric uncertainties due to respiratory-induced organ motion. Active breathing control (ABC) has been shown to be a safe and effective means of tumor immobilization for breast cancer patients which allows for the reduction of the dose to normal tissue structures such as the heart and lungs. For lung cancer patients, however, the ABC technique must be adapted to increase compliance for patients with pulmonary compliance issues. Furthermore, the integration of image guidance techniques with ABC radiotherapy enables the characterization and reduction of daily setup variation and immobilization uncertainty.
The specific aims of this project are to (1) Measure the random and systematic uncertainties of tumor immobilization for integrated active breath hold radiotherapy. (2) Evaluate a model image-guidance strategy with respect to the presence of these uncertainties and to design a treatment margin to compensate for these uncertainties. (3) Quantify residual setup error in a small population of patients. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
7R01CA116249-03
Application #
7393310
Study Section
Radiation Therapeutics and Biology Study Section (RTB)
Program Officer
Deye, James
Project Start
2006-06-01
Project End
2010-04-30
Budget Start
2008-07-11
Budget End
2009-04-30
Support Year
3
Fiscal Year
2008
Total Cost
$192,423
Indirect Cost
Name
Virginia Commonwealth University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
105300446
City
Richmond
State
VA
Country
United States
Zip Code
23298
Robertson, Scott P; Weiss, Elisabeth; Hugo, Geoffrey D (2012) Localization accuracy from automatic and semi-automatic rigid registration of locally-advanced lung cancer targets during image-guided radiation therapy. Med Phys 39:330-41
Badawi, Ahmed M; Weiss, Elisabeth; Sleeman 4th, William C et al. (2012) Classifying geometric variability by dominant eigenmodes of deformation in regressing tumours during active breath-hold lung cancer radiotherapy. Phys Med Biol 57:395-413
Weiss, Elisabeth; Robertson, Scott P; Mukhopadhyay, Nitai et al. (2012) Tumor, lymph node, and lymph node-to-tumor displacements over a radiotherapy series: analysis of interfraction and intrafraction variations using active breathing control (ABC) in lung cancer. Int J Radiat Oncol Biol Phys 82:e639-45
Hugo, Geoffrey D; Weiss, Elisabeth; Badawi, Ahmed et al. (2011) Localization accuracy of the clinical target volume during image-guided radiotherapy of lung cancer. Int J Radiat Oncol Biol Phys 81:560-7
Badawi, Ahmed M; Weiss, Elisabeth; Sleeman 4th, William C et al. (2010) Optimizing principal component models for representing interfraction variation in lung cancer radiotherapy. Med Phys 37:5080-91
Glide-Hurst, Carri K; Gopan, Ellen; Hugo, Geoffrey D (2010) Anatomic and pathologic variability during radiotherapy for a hybrid active breath-hold gating technique. Int J Radiat Oncol Biol Phys 77:910-7
Hugo, Geoffrey D; Liang, Jian; Yan, Di (2010) Marker-free lung tumor trajectory estimation from a cone beam CT sinogram. Phys Med Biol 55:2637-50
Hugo, Geoffrey D; Campbell, Jonathon; Zhang, Tiezhi et al. (2009) Cumulative lung dose for several motion management strategies as a function of pretreatment patient parameters. Int J Radiat Oncol Biol Phys 74:593-601
Glide-Hurst, Carri K; Hugo, Geoffrey D; Liang, Jian et al. (2008) A simplified method of four-dimensional dose accumulation using the mean patient density representation. Med Phys 35:5269-77
Thompson, Bria P; Hugo, Geoffrey D (2008) Quality and accuracy of cone beam computed tomography gated by active breathing control. Med Phys 35:5595-608

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