Biologically Targeted Radiation Therapy: Incorporating Patient-Specific Hypoxia Data Derived from Quantitative Magnetic Resonance Imaging

Cancers

Hayley M. Reynolds¹  Angel Kennedy²  Yu Sun³  Annette Haworth³  Martin A. Ebert⁴  Emily J. Her⁴  Scott Williams⁵ 

[1] Auckland Bioengineering Institute, University of Auckland, Auckland 1010, New Zealand;Department of Radiation Oncology, Sir Charles Gairdner Hospital, Perth, WA 6009, Australia;Institute of Medical Physics, University of Sydney, Sydney, NSW 2006, Australia;School of Physics, Mathematics and Computing, University of Western Australia, Perth, WA 6009, Australia;The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC 3000, Australia;

关键词: prostate cancer;    hypoxia;    tumour control probability;    radiogenomics;    multiparametric MRI;   

DOI  :  10.3390/cancers13194897

来源: DOAJ

【 摘 要 】

Purpose: Hypoxia has been linked to radioresistance. Strategies to safely dose escalate dominant intraprostatic lesions have shown promising results, but further dose escalation to overcome the effects of hypoxia require a novel approach to constrain the dose in normal tissue.to safe levels. In this study, we demonstrate a biologically targeted radiotherapy (BiRT) approach that can utilise multiparametric magnetic resonance imaging (mpMRI) to target hypoxia for favourable treatment outcomes. Methods: mpMRI-derived tumour biology maps, developed via a radiogenomics study, were used to generate individualised, hypoxia-targeting prostate IMRT plans using an ultra- hypofractionation schedule. The spatial distribution of mpMRI textural features associated with hypoxia-related genetic profiles was used as a surrogate of tumour hypoxia. The effectiveness of the proposed approach was assessed by quantifying the potential benefit of a general focal boost approach on tumour control probability, and also by comparing the dose to organs at risk (OARs) with hypoxia-guided focal dose escalation (DE) plans generated for five patients. Results: Applying an appropriately guided focal boost can greatly mitigate the impact of hypoxia. Statistically significant reductions in rectal and bladder dose were observed for hypoxia-targeting, biologically optimised plans compared to isoeffective focal DE plans. Conclusion: Results of this study suggest the use of mpMRI for voxel-level targeting of hypoxia, along with biological optimisation, can provide a mechanism for guiding focal DE that is considerably more efficient than application of a general, dose-based optimisation, focal boost.

【 授权许可】

Unknown