Proposed intensity modulated radiation therapy (IMRT) techniques aim to provide higher tumor dose irradiation, and thereby better tumor control, while reducing dose to nearby important normal tissues. The main goal of this project is to use computer simulations to understand the potential benefits of a range of proposed photon and proton IMRT techniques relative to conventional techniques. In the first phase, technical issues relating to IMRT treatment planning will be investigated, including: global vs. local optimization, effects of tumor control probability (TCP) model assumptions, the effect of treatment margins and geometrical uncertainties, number and angles of incident fields needed for optimal irradiation, and type of intensity modulation (full resolution vs. segmental). These questions will be studied in detail using a suite of two- dimensional (2D) test problems, derived from patient CT data sets, which will cover a wide range of potential IMRT planning problems. Results from this phase of 2D simulations will be tested in more limited three-dimensional (3D) simulations. In the second phase, 2D and 3D simulations will be made comparing several proposed IMRT techniques, including: few- and many-field intensity modulated coplanar photon delivery, intensity-modulated arc therapy, and a novel intensity modulated proton beam method. Each plan will be optimized with alternative objective functions, maximum TCP and maximum minimum target dose, but constrained to the same normal tissue dose-volume limits. Those plans will be compared with conventional photon technique plans. At least four different sites will be studied in full 3D for all the IMRT techniques: lung, prostate, head and neck, and abdominal tumors. We will investigate the anatomical and geometrical factors which may indicate a dosimetric superiority of one IMRT technique over another. Proposed IMRT techniques will be difficult to compare directly in clinical trials except on a limited scale. The approach in this project is to conduct computational comparisons of a range of proposed IMRT techniques, using the same radiobiological and dosimetric assumptions, in order to help understand the relative potential benefits of each technique compared with conventional treatment. We hypothesize that IMRT will require more than 3-5 fields, using radiobiologically realistic and fully 3D planning methods, to reach the level of TCP possible using many-field delivery.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29CA085181-02
Application #
6175330
Study Section
Radiation Study Section (RAD)
Program Officer
Stone, Helen B
Project Start
1999-07-01
Project End
2004-06-30
Budget Start
2000-07-01
Budget End
2001-06-30
Support Year
2
Fiscal Year
2000
Total Cost
$109,200
Indirect Cost
Name
Washington University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
062761671
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Deasy, Joseph O; Bentzen, Søren M; Jackson, Andrew et al. (2010) Improving normal tissue complication probability models: the need to adopt a ""data-pooling"" culture. Int J Radiat Oncol Biol Phys 76:S151-4
Marks, Lawrence B; Bentzen, Soren M; Deasy, Joseph O et al. (2010) Radiation dose-volume effects in the lung. Int J Radiat Oncol Biol Phys 76:S70-6
Bentzen, Soren M; Parliament, Matthew; Deasy, Joseph O et al. (2010) Biomarkers and surrogate endpoints for normal-tissue effects of radiation therapy: the importance of dose-volume effects. Int J Radiat Oncol Biol Phys 76:S145-50
Bentzen, Søren M; Constine, Louis S; Deasy, Joseph O et al. (2010) Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC): an introduction to the scientific issues. Int J Radiat Oncol Biol Phys 76:S3-9
Marks, Lawrence B; Yorke, Ellen D; Jackson, Andrew et al. (2010) Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys 76:S10-9
El Naqa, I; Grigsby, P; Apte, A et al. (2009) Exploring feature-based approaches in PET images for predicting cancer treatment outcomes. Pattern Recognit 42:1162-1171
Blanco, Angel I; Chao, K S Clifford; El Naqa, Issam et al. (2005) Dose-volume modeling of salivary function in patients with head-and-neck cancer receiving radiotherapy. Int J Radiat Oncol Biol Phys 62:1055-69
Zakarian, Constantine; Deasy, Joseph O (2004) Beamlet dose distribution compression and reconstruction using wavelets for intensity modulated treatment planning. Med Phys 31:368-75
Deasy, Joseph O; Blanco, Angel I; Clark, Vanessa H (2003) CERR: a computational environment for radiotherapy research. Med Phys 30:979-85
Deasy, Joseph O; Wickerhauser, M Victor; Picard, Mathieu (2002) Accelerating Monte Carlo simulations of radiation therapy dose distributions using wavelet threshold de-noising. Med Phys 29:2366-73

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