CN111888657A - Radiation therapy system for addiction diseases - Google Patents
Radiation therapy system for addiction diseases Download PDFInfo
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- CN111888657A CN111888657A CN201910366986.7A CN201910366986A CN111888657A CN 111888657 A CN111888657 A CN 111888657A CN 201910366986 A CN201910366986 A CN 201910366986A CN 111888657 A CN111888657 A CN 111888657A
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N2005/0626—Monitoring, verifying, controlling systems and methods
- A61N2005/0627—Dose monitoring systems and methods
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Abstract
An addictive disorder radiation therapy system comprising: plan generating means for generating an initial radiation treatment plan based on a base radiation dose; a radiation therapy device for receiving the initial radiation therapy plan and irradiating a target area of the addict according to the initial radiation therapy plan, wherein the target area at least comprises nucleus accumbens of the brain of the addict, and the radiation beam of the basic radiation dose can reduce the activity of the nucleus accumbens; and an evaluation device for imaging the target region and detecting whether the nucleus accumbens activity is restored after a predetermined period of time in which the radiation therapy device stops emitting the radiation beam, the detection result of the activity serving as a reference for determining a target radiation dose.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to an addiction disease radiotherapy system.
Background
Research shows that long-term use of addictive substances, such as drugs, alcohol, etc., can cause changes in the structure and function of neurons of the reward system of the brain of a human body, and the changes can last for weeks, months or even years, and simultaneously weaken the effects of the drugs and drugs used, so that a user needs to add heavy dose under stronger use desire, thereby causing addiction. Therefore, many expert scholars have studied on these neural changes and hope to find a way to treat addiction. Studies have shown that the reward system plays a key role in the development of addiction, and is inseparable from the mesolimbic dopamine system (mesolimbic dopamine system), which is composed of a population of neurons, the neuronal body of which is located in the Ventral Tegmental Area (VTA) near the base of the brain, dopamine is usually produced by neurons in the ventral tegmental area, and the distal ends of which extend to the frontal cortex and nucleus accumbens (also known as nucleus accumbens), in front of the brain, and dopamine is transmitted from the ventral tegmental area to the nucleus accumbens and is released in the nucleus accumbens, a key element of addiction.
At present, the addiction treatment mainly comprises drug treatment and operation treatment. However, both medical and surgical treatments have drawbacks. Among them, the drug therapy may cause side effects such as nausea and vomiting, vertigo, somnolence, slight headache, dry mouth, sweating (most in the evening), confusion of consciousness, respiratory depression (especially in combination with other central nerve inhibitors), hypotension, collapse and edema, spasm of bile ducts and renal ducts, lack of appetite, nausea and vomiting, change of menstrual period, etc., and the duration of the drug therapy is short, and it is impossible to prevent the addicts from re-using the addictive substance after withdrawal. The operation treatment is mainly stereotactic damage, which can block the transmission of nerve signals by damaging some key parts, thereby achieving the purpose of reducing the use of addictive substances by addicts, and the main damage targets are cingulum and nucleus accumbens. Wherein, the cingulate incision is used for blocking the thinking of the addict of continuing to use the addictive substance; nucleus accumbens destruction blocks the central cortical marginal dopamine conduction pathway to prevent craving of addicts for addictive substances after withdrawal. Although the psychological dependence of the drug can be relieved by the operation, the damage involves ethics and irreversibility, and the addiction can be caused with unpredictable results, so that the addiction is more controversial. In addition, Deep Brain Stimulation (DBS) is to implant electrodes into specific parts of the Brain, stimulate neurons with external stimulators, and adjust parameters such as voltage, frequency and bandwidth, thereby achieving the purpose of treating psychological dependence of addiction. Although the deep brain stimulation surgery has the characteristics of small damage to brain tissues, adjustable parameters, reversible process and the like, the deep brain stimulation surgery still belongs to the research stage at present, and the implanted electrode also causes some limitations on the life of a patient and cannot be used in large quantities in clinic.
Disclosure of Invention
In view of the above, there is a need for an addiction disease radiotherapy device that can successfully abstain from addiction without irreversible damage.
The invention provides an addiction disease radiotherapy system for treating an addiction disease of an addict, which comprises: plan generating means for generating an initial radiation treatment plan based on a base radiation dose; a radiation therapy device for receiving the initial radiation therapy plan and irradiating a target area of the addict according to the initial radiation therapy plan, wherein the target area at least comprises nucleus accumbens of the brain of the addict, and the radiation beam of the basic radiation dose can reduce the activity of the nucleus accumbens; and an evaluation device for imaging the target region and detecting whether the nucleus accumbens activity is restored after a predetermined period of time in which the radiation therapy device stops emitting the radiation beam, the detection result of the activity serving as a reference for determining a target radiation dose.
The invention utilizes the radiation beam to irradiate the nucleus accumbens of the brain and control the radiation dose, thereby inhibiting the activity of the nucleus accumbens and not causing the death of nucleus accumbens cells, leading an addict to be capable of successfully abstaining from the addiction and not causing irreversible damage.
Drawings
FIG. 1 is a functional block diagram of an addiction disease radiation therapy system according to a preferred embodiment of the present invention.
Fig. 2 is a schematic structural view of the radiotherapy apparatus shown in fig. 1.
FIG. 3 is a flow chart of the method for radiation therapy of addiction diseases in accordance with a preferred embodiment of the present invention.
FIG. 4 is a sub-flowchart of steps S3-S4 of the method of addictive disorder radiation therapy shown in FIG. 3.
Description of the main elements
Addiction disease radiation therapy system 100
Plan generating device 10
Evaluation device 30
Addict 200
Target region 201
The following detailed description will further illustrate the invention in conjunction with the above-described figures.
Detailed Description
Referring to fig. 1 and 2, a radiation therapy system 100 for treating an addiction disease of an addict 200 is provided according to a preferred embodiment of the present invention. The addiction disorder includes an addiction to a chemical drug by the individual, and the chemical drug may be ethanol, nicotine, or cocaine, among others. In other embodiments, the addictive disorder can also include an individual's addiction to a behavioral activity, which can be pathological gambling, pathological satiety, pathological use of an electronic device or electronic game, and the like.
The addiction disease radiotherapy system 100 comprises a plan generating device 10, a radiotherapy device 20 and an evaluating device 30. The specific functions of the various parts of the addiction disease radiation therapy system 100 will be described below with reference to fig. 3.
Referring to fig. 3, the preferred embodiment of the present invention provides a radiation therapy method for treating addiction, which is applied to the radiation therapy system 100 for treating addiction. The order of the steps of the method for radiation therapy of addiction diseases can be changed according to different requirements, and certain steps can be omitted or combined. The addiction disease radiotherapy method comprises the following steps:
in step S1, the plan generating device 10 generates an initial radiation therapy plan according to a base radiation dose.
In general, if the radiation dose is too high during the actual treatment, the radiation therapy will produce a cns-damaging disease (i.e., radiation encephalopathy) after a period of incubation, and such nerve damage is usually irreversible. For example, on the third day after radiation therapy, neuronal cells are altered, mainly by chromatin porosity and cellular edema, with obvious apoptotic changes being visible on day seven. Moreover, it will be appreciated that there is typically a difference between the radiation doses applicable to each addict 200. For example, the brain tissue of the young is more sensitive to radiation, and the occurrence of radiation encephalopathy is also related to factors such as physical condition, angiosclerosis, and immune status of the body of the addict 200. Thus, the basal radiation dose is pre-evaluated prior to the actual treatment in order to inhibit the released dopamine content in the nucleus accumbens (i.e. to inhibit and reduce its activity) without causing death or permanent damage to the nucleus accumbens when the radiation beam irradiates the nucleus accumbens in the brain of the addict 200 at the basal radiation dose. Subsequently, whether the basic radiation dose is continuously increased or decreased is evaluated according to the actual condition of the individual, that is, the radiation dose which is correspondingly accepted by each addict 200 is evaluated, so that the problem that the addict 200 is unnecessarily injured and has side effects due to overlarge radiation dose or the problem that the treatment effect is poor due to insufficient radiation dose is avoided.
The base dose may be evaluated based on the experience of medical personnel or past medical data, and the factors to be referred to for evaluation may be the type of tissue to be treated, the physical condition (e.g., body density) of the addict 200, and the like. In the present embodiment, a designated user (e.g., a medical staff) can input the basic radiation dose to the plan generating apparatus 10 by an input device (e.g., a keyboard, a mouse, etc.).
In this embodiment, the plan generating device 10 matches the corresponding initial radiation parameters according to the basic radiation dose and in combination with factors such as the shape of the target region 201 and the activity of cells or tissues, and generates the initial radiation therapy plan according to the initial radiation parameters, so that the radiation beam is irradiated to the target region 201 at the basic radiation dose when the radiation beam is subsequently emitted toward the target region 201 of the addict 200 according to the initial radiation parameters.
In step S2, the radiotherapy device 20 receives the initial radiotherapy plan and irradiates the target region 201 with a radiation beam according to the initial radiotherapy plan, wherein the target region 201 at least includes nucleus accumbens of the brain of the addict 200.
Referring to fig. 2, the radiotherapy device 20 irradiates the target region 201 with a radiation beam by a radiation source 21. In the present embodiment, the radiotherapy apparatus 20 further includes a driving unit 22 and a linear accelerator 23 fixed to the driving unit 22. The radiation source 21 is fixed to the linear accelerator 23. The driving unit 22 is used for driving the radiation source 21 to move to a proper position by the linear accelerator 23. The radiation source 21 emits a radiation beam 24 towards the target area 201 when moved into position. Wherein the drive unit 22 may be a robot. The radiotherapy apparatus 20 may be any Stereotactic Radiosurgery (SRS) device or Stereotactic Radiotherapy (SRT) device. The stereotactic radiosurgery equipment includes an X-Knife (X-Knife), a gamma Knife (Y-Knife), and a radiowave Knife (Cyber-Knife). The stereotactic radiotherapy apparatus includes three-dimensional conformal radiotherapy (3DCRT) and three-dimensional conformal Intensity Modulated Radiotherapy (IMRT).
Further, the radiation source 21 comprises a bulb (not shown), by means of which the radiation source 21 generates a radiation beam 24. The initial radiation parameter includes a tube current or a tube voltage of the bulb. The initial radiation parameters may also include the radiation angle, the number of times the radiation beam 24 is radiated, the duration of the radiation, etc. That is, the radiotherapy device 20 matches initial radiation parameters such as tube current/tube voltage of the bulb, radiation angle of the radiation beam 24, radiation frequency, and radiation duration according to the basic radiation dose, so that the radiation source 21 emits the radiation beam 24 toward the target region 201 according to the initial radiation parameters. In this embodiment, the radiation source 21 controls the radiation beam 24 to be emitted at a plurality of radiation angles towards the target region 201.
In this embodiment, since the therapeutic effect of radiotherapy depends on the radiosensitivity of nucleus accumbens cells, a radiation sensitizer can be injected into the addict 200 by a syringe (not shown) before the radiation source 21 irradiates the radiation beam, so as to increase the radiosensitivity of nucleus accumbens cells. Therefore, the radiation dose used can be reduced on the premise of ensuring the treatment effect, the damage of the radiation beam 24 to the nucleus accumbens cells is reduced, and the survival rate of the nucleus accumbens cells is improved. In this embodiment, the radiosensitizer can include, but is not limited to, one of a base analog of a DNA precursor, an electrophilic radiosensitizer (including nitroimidazoles, nitroaromatics, and nitroheterocycles), a hypoxic cell radiosensitizer, a bioreductive compound, a radiation damage repair inhibitor, a sulfhydryl inhibitor, an oxygen utilization inhibitor, an oxylog compound, a cytotoxic radiosensitizer, a targeted radiosensitizer, a gene-related tumor radiosensitizer, and the like.
In step S3, the evaluation device 30 performs an imaging of the target region 201 and detects whether the nucleus accumbens has recovered activity after a predetermined period of time in which the radiation therapy device 20 stops emitting the radiation beam 24, and the detection result of the activity is used as a reference for determining a target radiation dose.
In the present embodiment, the evaluation device 30 may be a functional magnetic resonance imaging (fMRI) device, which measures the hemodynamic changes caused by the neuron activity by magnetic resonance imaging (mri) to detect whether the nucleus accumbens activity. Wherein the predetermined time period is the theoretical time length of the nucleus accumbens to recover activity after receiving the radiation beam irradiation, and the predetermined time period can be set according to the experience of medical staff. In this embodiment, the predetermined period of time is approximately one week.
Wherein, when the nucleus accumbens does not regain activity, it indicates that the basal radiation dose is high and causes permanent damage to the target region 201; when the nucleus accumbens has regained activity, indicating that the basal radiation dose has not caused permanent damage to the target region 201, the radiation dose may be further increased. Therefore, the doctor or the radiation therapist can determine whether the base radiation dose needs to be increased or decreased to obtain the target radiation dose according to the detection result of the voltaic barrier activity. The target radiation dose is an optimal radiation dose for the addict 200, if the actual radiation dose is larger than the target radiation dose, the target radiation dose may cause permanent damage to the nucleus accumbens of the addict 200, and if the actual radiation dose is small, the target radiation dose may reduce the activity of the nucleus accumbens to a certain extent, but may cause a problem of poor treatment effect due to insufficient radiation dose. In this embodiment, the target radiation dose is less than 30 Gy.
In step S4, the plan generating device 10 generates a target radiation therapy plan according to the target radiation dose determined by increasing or decreasing the base radiation dose according to the detection result.
In this embodiment, the plan generating device 10 divides the target radiation dose into a plurality of radiation fractions, adjusts the initial radiation parameters according to the radiation fractions to obtain target radiation parameters, and generates the radiation therapy plan according to the target radiation parameters, so that when the radiation beam 24 is subsequently emitted toward the target region 201 for a plurality of times according to the target radiation parameters, the total dose of the radiation beam 24 irradiated to the target region 201 is the target radiation dose. Taking the target radiation dose as 5Gy as an example, the plan generating device 10 sets the radiation fraction as 0.05Gy, and plans to subsequently emit the radiation beam 24 toward the target area 201 multiple times according to the target radiation parameters corresponding to the radiation fraction until the total dose reaches 5 Gy. Wherein, when the initial radiation parameter includes the tube current or the tube voltage of the bulb, the plan generating device 10 adjusts the tube current or the tube voltage of the bulb accordingly to obtain the target radiation parameter.
In another embodiment, the plan generating apparatus 10 may also adjust the initial radiation parameters directly according to the target radiation dose to obtain target radiation parameters, and generate the target radiation therapy plan according to the target radiation parameters.
In step S5, the radiotherapy device 20 receives the target radiotherapy plan and re-irradiates the target region 201 of the addict 200 with the radiation beam according to the target radiotherapy plan.
Referring to fig. 4, in the present embodiment, the steps S3-S4 specifically include:
in step S41, the assessment device 30 performs contrast imaging on the target region 201 and detects whether the nucleus accumbens has recovered activity, if so, then step S42 is performed, otherwise, step S45 is performed.
In step S42, the plan generating device 10 generates a reference radiation therapy plan according to a reference radiation dose determined for increasing the base radiation dose.
In step S43, the radiotherapy device 20 receives the reference radiotherapy plan and re-irradiates the target region 201 with the radiation beam according to the reference radiotherapy plan.
Step S44, after the predetermined period of time that the radiotherapy device 20 stops emitting the radiation beam 24, the evaluation device 30 performs imaging on the target region 201 and detects whether the nucleus accumbens recovers activity, wherein when the nucleus accumbens recovers activity, the basal radiation dose is used as the target radiation dose; otherwise, it indicates that the reference radiation dose may cause permanent damage to nucleus accumbens, and the reference radiation dose is continuously increased until the target radiation dose is determined as the previous reference radiation dose after the predetermined time period when the target region 201 is irradiated with the radiation beam again according to the reference radiation dose and the nucleus accumbens does not return to activity.
In step S45, the plan generating device 10 generates a reference radiation therapy plan according to a reference radiation dose determined for reducing the base radiation dose.
In step S46, the radiotherapy device 20 receives the reference radiotherapy plan and re-irradiates the target region 201 with the radiation beam according to the reference radiotherapy plan.
Step S47, the evaluation device 30 detects whether the nucleus accumbens is activated after the radiation therapy device 20 stops emitting the radiation beam 24 for the predetermined period of time, wherein when the nucleus accumbens is activated, the reference radiation dose does not cause permanent damage to the nucleus accumbens, and the reference radiation dose is used as the target radiation dose; otherwise, the reference radiation dose is continuously decreased until the target radiation dose is set to the current reference radiation dose after the predetermined period of time when the target region 201 is irradiated with the radiation beam again according to the reference radiation dose and the nucleus accumbens is reactivated.
In practical applications, the plan generating device 10 and the radiation therapy device 20 may be two independent devices, or may be integrated in the same apparatus.
The invention utilizes the radiation beam to irradiate the nucleus accumbens of the brain and control the radiation dose, thereby inhibiting the activity of the nucleus accumbens and not causing the death of nucleus accumbens cells, leading an addict to be capable of successfully abstaining from the addiction and not causing irreversible damage.
It will be appreciated by those skilled in the art that the above embodiments are illustrative only and not intended to be limiting, and that suitable modifications and variations may be made to the above embodiments without departing from the true spirit and scope of the invention.
Claims (10)
1. An addictive disorder radiation therapy system for treating an addictive disorder of an addict, the system comprising:
plan generating means for generating an initial radiation treatment plan based on a base radiation dose;
a radiation therapy device for receiving the initial radiation therapy plan and irradiating a target area of the addict according to the initial radiation therapy plan, wherein the target area at least comprises nucleus accumbens of the brain of the addict, and the radiation beam of the basic radiation dose can reduce the activity of the nucleus accumbens; and
evaluating means for imaging the target region and detecting whether the nucleus accumbens reactivated after a predetermined period of time during which the radiation therapy device ceases to emit the radiation beam, the detection of the reactivation being used as a reference for determining a target radiation dose.
2. The addictive disorder radiation therapy system of claim 1, wherein:
the plan generating device is further used for generating a target radiation treatment plan according to the target radiation dose, and the target radiation dose is determined by increasing or decreasing the basic radiation dose according to the detection result;
the radiotherapy device is further used for re-irradiating the target area by the radiation beam according to the target radiotherapy plan.
3. The addictive disorder radiation therapy system of claim 2, wherein:
the plan generating device is further used for generating a reference radiation treatment plan according to a reference radiation dose, wherein the reference radiation dose is determined by increasing the basic radiation dose when the nucleus accumbens recovers activity;
the radiotherapy device is further used for receiving the reference radiotherapy plan and re-irradiating the target area by the radiation beam according to the reference radiotherapy plan;
the evaluation device is further configured to visualize the target region and detect whether the nucleus accumbens is reactivated after the predetermined period of time that the radiation therapy device ceases to emit radiation beams;
wherein the target radiation dose is the base radiation dose when the nucleus accumbens is not reactivated, and the reference radiation dose is continuously increased when the nucleus accumbens is reactivated until the target radiation dose is the previous reference radiation dose after the predetermined period of time when the radiation beam irradiation is resumed for the target region according to the reference radiation dose and when the nucleus accumbens is not reactivated.
4. The addictive disorder radiation therapy system of claim 2, wherein:
the plan generating device is also used for reducing the basic radiation dose when the nucleus accumbens recovers activity to obtain a reference radiation dose;
the plan generating device is further used for generating a reference radiation treatment plan according to a reference radiation dose, wherein the reference radiation dose is determined by reducing the basic radiation dose when the nucleus accumbens is not activated;
the radiotherapy device is further used for receiving the reference radiotherapy plan and re-irradiating the target area by the radiation beam according to the reference radiotherapy plan;
the evaluation device is further configured to visualize the target region and detect whether the nucleus accumbens is reactivated after the predetermined period of time that the radiation therapy device ceases to emit radiation beams;
wherein the reference radiation dose is taken as the target radiation dose when the nucleus accumbens is reactivated, and the reference radiation dose is continuously decreased when the nucleus accumbens is not reactivated until the current reference radiation dose is taken as the target radiation dose after the predetermined period of time when the radiation beam irradiation is resumed for the target region according to the reference radiation dose and when the nucleus accumbens is reactivated.
5. The addictive disorder radiation therapy system of claim 1, wherein the plan generating device is further configured to match corresponding initial radiation parameters according to the base radiation dose and generate the initial radiation therapy plan according to the initial radiation parameters, such that when the radiation therapy device emits a radiation beam toward the target region according to the initial radiation parameters, the dose of the radiation beam irradiated to the target region is the base radiation dose.
6. The addictive disorder radiation therapy system of claim 5, wherein the plan generating device is further configured to divide the target radiation dose into a plurality of fractions, adjust the initial radiation parameters according to the fractions to obtain target radiation parameters, and generate the radiation therapy plan according to the target radiation parameters such that a total dose of radiation delivered to the target region is the target radiation dose when radiation beams are subsequently delivered toward the target region a plurality of times according to the target radiation parameters.
7. The addictive disorder radiation therapy system of claim 6, wherein the initial radiation parameters and the target radiation dose each comprise at least one of a tube current, a tube voltage, a radiation angle of a radiation beam, a number of radiations, and a length of radiation of a radiation source bulb.
8. The addictive disorder radiation therapy system of claim 1, wherein the predetermined period of time is one week.
9. The addictive disorder radiation therapy system of claim 1, further comprising a syringe for further injecting a radiosensitizer into the addict prior to radiation beam irradiation.
10. The addictive disorder radiation therapy system of claim 1, wherein the target radiation dose is less than 30 Gy.
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| US20180178042A1 (en) * | 2007-11-01 | 2018-06-28 | M. Bret Schneider | Radiosurgical neuromodulation devices, systems, and methods for treatment of behavioral disorders by external application of ionizing radiation |
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Application publication date: 20201106 |