December 14, 2022

Cancer Radiomics Targeted by Pencil Beam Scanning Proton Therapy for Deformable Tumours

2nd Call, PM / PH Research

Short Summary

Tumours located in thoracic and abdominal sites present a unique set of challenges for radiotherapy because of their anatomical complexity, biological heterogeneity and non-stationary motion dynamic. Tumour hypoxia has been reportedly correlated with poor prognostic outcome owing to its contribution to radio-resistance. The aim of this project is to improve the quality of radiation therapy for cancer patients by precisely delivering the dose to radio-resistant tumour locations (biologic heterogeneity) by personalized proton therapy that tackles both tumour geometry and motion of a given patient. Medical-related technology applied to advanced delivery of proton pencil beam scanning will consequentially improve the precision of the therapy in the framework of precision- or personalized-medicine.

Goals

To develop accurate and reliable treatment planning tools and methods for predicting the actual delivered dose to mobile tumours, together with the application of biological models for estimating treatment outcomes. The aim is therefore to implement a platform for decision support that presents the different treatment options with the expected therapeutic benefit to the physician taking into account the biological heterogeneity of tumours together with the potential effects of motion.

Significance

The proton therapy facility at PSI is a world leading institute for clinical and research particle therapy. This project will build on this experience, particularly in the area of the treatment of mobile tumours in the thorax, and will deliver a number of tools that will be applicable to both proton and conventional radiotherapy (e.g. incorporation of functional imaging into the treatment planning process, motion models, libraries of 4D motions, etc.). This will help PSI retain its reputation as a leading researcher, developer and provider of state-of-the-art proton therapy. In addition, will provide a unique tool to the Swiss radiotherapy community for assessing, on a patient-by-patient basis, the best, and most personalized approach, to the treatment of lung cancers.

Background

Radiotherapy is a cornerstone of cancer treatment, being used in 40% of all cured malignancies. Although it has been, for most of its history, a heavily personalised treatment modality in the form of individually designed and calculated treatment plans the transition to biologically guided personalisation is more recent. The challenge and priority of radiotherapy is to provide health care provider with models that integrate anatomical and functional-biological information to predict the therapeutic benefit of a treatment for individual patients and therefore select the best therapeutic strategy, including the selection of the best treatment modality such as photon or proton radiotherapy.

Publications

Colvill E et al. “Anthropomorphic phantom for deformable lung and liver CT and MR imaging for radiotherapy”, Phys. Med. Biol., 65, 2020, 10.1088/1361-6560/ab7508
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Fattori G et al. “Technical assessment of the NDI Polaris Vega optical tracking system”. Radiat Oncol 16(87), 2021, 10.1186/s13014-021-01804-7
Fielding A, et al. “Preliminary study of the Intel RealSenseTM D415 camera for monitoring respiratory like motion of an irregular surface”. IEEE Sensors, in-press, 2020
Heule R et al., “Multi-parametric artificial neural network fitting of phase-cycled balanced SSFP data”, Magn. Reson. Med., 2020
Köthe A et al, “Combining Clinical and Dosimetric Features in a PBS Proton Therapy Cohort to Develop a NTCP Model for Radiation-Induced Optic Neuropathy”, IJROBP, 2021, 10.1016/j.ijrobp.2020.12.052
Köthe A et al. “Assessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy”, Cancers 2021, 10.3390/cancers13215327
Köthe A et al., “Investigating the potential of proton therapy for hypoxia-targeted dose escalation in non-small cell lung cancer”, Radiat Oncol. 2021, 10.1186/s13014-021-01914-2
Köthe A et al., “The impact of organ motion and the appliance of mitigation strategies on the effectiveness of hypoxia-guided proton therapy for non-small cell lung cancer”, Radiother Oncol., 2022, 1016/j.radonc.2022.09.021
Schroeder et al. “NTCP modelling for high-grade temporal radionecrosis in a large cohort of patients receiving pencil beam scanning proton therapy for skull base and head and neck tumors International Journal of Radiation Oncology”, IJROBP, 2022 ://doi.org/10.1016/j.ijrobp.2022.01.047
Willers C, “The impact of segmentations on whole-lung functional MRI quantification: repeatability and reproducibility from multiple human observers and an artificial neural network”, Magn. Reson. Med., 2020