Image Guided Radiation Therapy (IGRT) for Lung Cancer
While small improvements in outcome have occurred for patients with locally advanced non-small cell lung cancer (NSCLC), 5-year survival results remain low, ranging from 5% to 20%. Local-regional progression, along with distant metastases, remains a significant pattern of failure. We hypothesize that one major reason responsible for local failure is the difficulty in targeting radiation beam to a moving lung tumor due to patient breathing. The goal of this project is to develop effective image guidance techniques that can improve targeting precision and thus improve treatment outcome. The developed techniques are usually applicable to other type of mobile tumors in thorax and abdomen too. The following are some active projects at CART.
Image Guided External Gating: Develop an image guidance procedure to improve the accuracy of respiratory gating based on external surrogates
Fluoro Gating: Develop techniques to use fluoroscopic Images for respiratory gating, especially for lung tumor without implanted fiducial markers
Hybrid Gating: Develop techniques that can optimally combine internal and external signals for respiratory gating with minimal imaging dose and maximum accuracy
Treatment Verification and Monitoring: Develop techniques to assure treatment accuracy, especially for external surrogate based respiratory gating and for gated or non-gated hypo-fractionated treatment
Tumor tracking: Develop techniques to track the implanted fiducial markers and tumor mass directly in fluoroscopic images
Patient breath coaching: Develop effective patient breath coaching protocols to achieve reproducible breathing pattern for better simulation and treatment
Other Gating Projects: Various issues related to gated IMRT.
Adaptive Radiation Therapy (ART) for Gynecologic Cancer
Intensity modulated radiation therapy (IMRT) has been used for treating gynecologic cancer, pioneered by Dr. Mundt and his colleagues, to provide excellent coverage of the clinical target volume while significantly sparing the surrounding normal tissues such as small bowel, bladder and areas of active bone marrow. Clinical trials have shown that IMRT can greatly reduce acute gastrointestinal, genitourinary, and hematologic toxicity caused by radiotherapy. The next natural step is adaptive radiotherapy for treating gynecologic cancer. Organs in pelvic region are mobile and their daily position may vary greatly. In addition, tumor geometry may change significantly in response to radiation and chemotherapy. An optimal IMRT treatment plan developed before the treatment may become less optimal later in the treatment course. Therefore, an adaptive therapy scheme is necessary for the management of gynecologic malignancies. In this project, we explore the feasibility of re-optimizing the treatment plan using the updated patient geometry in an on-line fashion.
Quality Control and Quality Assurance for Radiotherapy
Quality assurance and error analysis are built on a mature body of research from other fields. There is much work to do toward implementing these techniques in radiotherapy practices to optimize quality and minimize errors. We will investigate specific techniques of error analysis and reduction such as failure modes and effects analysis (FMEA), root cause analysis (RCA), pareto charts, fishbone diagrams and statistical process control (SPC) as well as total quality management by the six-sigma approach. We are also developing tools that can automatically detect catastrophic errors in treatment plans
This site is a service of the
Radiation Oncology Department at the Moores UCSD Cancer Center. Please read the terms and conditions
of use before using this site. Comments or questions? Please contact
our webmaster. Radiation Oncology faculty and staff site.
