ULICE WP 3 Biologically based expert system for individualised patient allocation

Transcription

1 Union of Light Ion Centres in Europe ULICE WP 3 Biologically based expert system for individualised Michael Baumann Wolfgang Enghardt Alina Santiago OncoRay Center for Radiation Research in Oncology, Medizinische Fakultät Carl Gustav Carus, Dresden, Germany

2 Start Date End Date Beneficiaries M1 M48 TUD, UCL, RUNMC, (AUH, AS), ETOILE, UKL-HD, CNAO, ARC Effort 113 (Feb. 11): 31,4 m/m Deliverables Submitted Milestones D.JRA 3.1, D.JRA 3.2, D.JRA 3.3, D.JRA 3.4, D.JRA 3.5 M10 Report on data of the radiobiological effects of different beams on tumours: Report was produced and consensus achieved Active Delays Reports delayed from March 2011 to April/June 2011

3 TASK STATUS WORK PERFORMED /RESULTS 3.1 Evaluation of the world-wide radiobiological data base for rational decision making in prescription of different hadron beams ongoing 3.1/3.1 List of radiobiological relevant parameters determining tumour control dependent on the beam quality Finished 3.3/3.1 Report on data of the radiobiological effects of different beams on tumours Finished 3.2 Development of unified protocols for measurement of radiobiological relevant parameters in individual patients and generation of exemplary data sets ongoing 3.2/3.2 Report of different methods available for measurement of radiobiological relevant parameters in patients Finished 3.5/3.2 Provision of exemplary molecular imaging data sets to WP5 Finished

4 TASK STATUS WORK PERFORMED /RESULTS 3.3 Development of software prototypes ongoing 3.4/3.3 Structure of the software modules Finished 3.6/3.3 Test version of software modules available Ongoing 3.4 Implementation study ongoing 3.7/3.4 Report on the methodology and the clinical goals of implementation of the radiobiology-driven software prototype Ongoing

5 Goal: Development of a software prototype to support the evaluation of radiation treatments with different radiation modalities, with two different orientations: 1. Research: Multiparameter analysis for comparison of different treatments 2. Clinical application: Optimization of Optimization of existing resources (hadron therapy centers)

6 Conclusion of the literature research The current available data on the action of tumors and normal tissues of different beam qualities defined the approach for the software tool Current, retrospective information not suitable for setting up a systematic for patient selection Not only tumor but also normal tissue have to be included in the analysis, therefore the basis must be treatment planning information

7 Modified goal: 1. Creation of a software platform for plan comparison and as a basis for TCP and NTCP modelling 2. Implementation of radiobiological models for prediction of outcome and RT side effects 3. Possibility of basic, remote planning treatment planning for protons/carbon ions (as an element for treatment decision)

8 WP 3.1 (TUD): Evaluation of the world-wide radiobiological data base for rational decision making in prescription of different hadron beams D.JRA 3.1 List of radiobiological relevant parameters determining tumour control dependent on the beam quality Most RBE data are based on in vitro studies In vivo experimentation on tumor and normal tissue effects scarce Need for research, both preclinical and clinical to confirm the patterns seen in vitro Therefore current information not suitable for setting up a system for patient selection

9 WP 3.1 (TUD): Evaluation of the world-wide radiobiological data base for rational decision making in prescription of different hadron beams Review paper: In vitro RBE-LET dependence for multiple particle types (2011), BS Sorensen et al, Acta Oncologica, Vol 50, Number 6, Aug 2011 RBE-LET dependence on LET for 10% in vitro colony survival, for the V79 cell line Dependence of RBE on particle species cannot be concluded from the spread in the data

10 WP3.2 (UCL): Development of unified protocols for measurement of radiobiological relevant parameters in individual patients and generation of exemplary data sets Joint document: D.JRA D 3.2 Report on data of the radiobiological effects of different beams on tumours and D.JRA D 3.3 Report of different methods available for measurement of radiobiological relevant parameters in patients Summary of the existing basis for patient selection Clinical criteria remain the basis for patient selection for ion treatment Discussion on radiobiological principles (resistance to photons) and existing clinical experience with neutrons, protons and ions. Finally short review on future possibilities for patient selection of functional imaging, and molecular profiling.

11 D.JRA 3.5: Provision of FMISO PET clinical samples to WP 5 for implementation in TRiP of spatial variations of tumor hypoxia FDG WP 5 would require local information FMISO uptake not proportional to local [po ² ] FMISO Suggestion: start with binary model FMISO contouring and full analysis of clinical trial still ongoing in Dresden

12 WP3.3 - Development of software prototypes D.JRA D 3.6 Software modules available According to the exploratory literature research, a new concept for the software modules has been developed. Module for plan comparison for given patients and given clinical scenarios Possibility to generate the required input for the creation of basic particle therapy treatment plans which can be calculated at the regional particle therapy center. This feature will be implemented for the planning with TRiP98. This system must also be able to connect with the modelling tool, to perform later plan analysis through TCP/NTCP modelling.

13 Structure of the expert system:

14 WP 3.4 Implementation study D.JRA 3.7 Report on the methodology and the clinical goals of implementation of the radiobiology-driven software prototype

15 Highlights M24 A concept for the software tool has been developed Consensus has been achieved within the WP that the basic input for an expert system in this field of research must be treatment planning information Consensus has been reached that not only tumor control but also normal tissue reaction has to be included in such expert system in a quantitative probabilistic way Current knowledge in areas relevant to this topic is being summarized in literature reviews. Example images of FMISO PET for clinical assessment of hypoxia have been provided to WP5 together with a report on the current status of quantification of FMISO.

16 Thanks to: Adrian Begg Robert Haase Uwe Just Mario Helm