We believe therapeutic effect is enhanced when hyperthermia and radiation therapies are delivered simultaneously and when these two modalities are focused efficiently into the target disease. In Phase I, we constructed applicators that combine the uniform heating capabilities of conformal microwave array (CMA) printed circuit board applicators with an improved patient interface that allows positioning of HDR radiation sources for simultaneous brachytherapy of superficial tissue disease. We investigated the feasibility of using these applicators for treatment of large-area chestwall recurrence, studying radiation dosimetry and analyzing interactions between heat and brachytherapy components. While meeting our objectives for Phase I, we identified key improvements needed to reproduce and distribute the device commercially. The goal of Phase II is to complete design optimization and begin clinical evaluation of the combination applicator. To accomplish this, we propose three specific tasks: 1) Refine applicator design based on clinical requirements, 2) Optimize design based on manufacturing considerations, and 3) Evaluate combination applicator performance in both laboratory and clinical use. We will upgrade current CMA designs to include heating arrays that shape power delivery to fit typically contoured anatomy with non-rectangular """"""""vest"""""""" shape applicators . We will refine bolus design to promote rapid flow of cooling water evenly distributed across the treatment surface. We will integrate adjustable air bladders and elastic garments into the structure to insure precise positioning of heating and brachytherapy sources over contoured anatomy. Once clinical needs have been addressed, we will optimize device design for manufacturability. By the end of Phase II, we will have a device that meets all clinical requirements for effective hyperthermia and brachytherapy delivery. We will have established appropriate treatment protocols and verified clinical performance. And we will have manufacturing capability to produce applicators that meet the needs of the cancer treatment community. ? ?
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