EP2891171A1 - Radiothérapie des organes saillants et/ou compatibles - Google Patents

Radiothérapie des organes saillants et/ou compatibles

Info

Publication number
EP2891171A1
EP2891171A1 EP13832747.3A EP13832747A EP2891171A1 EP 2891171 A1 EP2891171 A1 EP 2891171A1 EP 13832747 A EP13832747 A EP 13832747A EP 2891171 A1 EP2891171 A1 EP 2891171A1
Authority
EP
European Patent Office
Prior art keywords
radiation source
shield
radiotherapy device
single radiation
radiotherapy
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP13832747.3A
Other languages
German (de)
English (en)
Other versions
EP2891171A4 (fr
Inventor
John J. Munro, Iii
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Source Production and Equipment Co Inc
Original Assignee
Source Production and Equipment Co Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Source Production and Equipment Co Inc filed Critical Source Production and Equipment Co Inc
Publication of EP2891171A1 publication Critical patent/EP2891171A1/fr
Publication of EP2891171A4 publication Critical patent/EP2891171A4/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1077—Beam delivery systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1077—Beam delivery systems
    • A61N5/1081—Rotating beam systems with a specific mechanical construction, e.g. gantries
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N2005/1092—Details
    • A61N2005/1094—Shielding, protecting against radiation

Definitions

  • This application is related to the field of radiation therapy.
  • This approach is the subject of ongoing NSABP/RTOG clinical trials and has been deemed suitable by ASTRO for a limited subset of breast cancer patients outside of the clinical trials.
  • APBI has been tested as the sole method of irradiation following lumpectomy in numerous trials. Five-year results from the majority of these trials have demonstrated local control rates comparable to those observed after conventional WBI. These reports suggest that APBI is comparable to whole-breast irradiation in both safety and efficacy.
  • APBI has been delivered using three broad techniques, and each has its shortcomings.
  • intracavitary balloons and cage-like devices have been extensively used to deliver high dose rate (HDR) brachytherapy.
  • HDR high dose rate
  • MammoSiteTM device with which more than 50,000 patients have been treated, but other devices are also in the marketplace.
  • Intracavitary balloons have been promoted as much easier and technically less demanding than the multicatheter technique.
  • drawbacks and limitations of this technique have emerged, including lack of conformance of the balloon to the cavity and to the asymmetrical target, high rate of balloon explantation, discomfort, wound problems, pain, early skin reactions with moist desquamation, infection, clinically significant and persistent seroma, and high costs, which have served to temper somewhat the enthusiasm of the early experiences.
  • Early local control results are not as favorable as after multicatheter brachytherapy.
  • the third APBI technique is three-dimensional conformal radiation therapy (3D- CRT).
  • Typical 3D-CRT includes 3-5 noncoplanar fields with no beams directed towards the heart, lung or contralateral breast.
  • 3D-CRT eliminates the additional surgical procedure and improves dose homogeneity within the target volume, which may improve cosmetic results and reduce the risk of symptomatic fat necrosis, but does so at the expense of irradiating more normal tissue.
  • brachytherapy which requires additional training
  • most radiation facilities already have the technologic tools required to deliver 3D-CRT.
  • the primary disadvantage is that larger volumes of breast need to be included in the target to account for the intrinsic intra- and interfraction motion, uncertainty in target delineation and setup uncertainties in order to avoid improper target coverage.
  • a delivery system exists to implement this developmental treatment modality using real-time mammographic image guidance for stereotactic applicator positioning and CTV localization.
  • therapeutic dose to the lumpectomy cavity is delivered by externally placing opposing plaque-like applicators at multiple orientations to provide conformity while not exceeding the skin toxicity threshold.
  • the initial assessment of this system determined that dose to lungs, heart, and other critical organs was typically much lower than form 3D-CRT techniques and suggested that this technique may be an attractive APBI option.
  • a drawback to the AccuBoost approach is the non-uniform dose distribution within the target.
  • the dose is delivered to breast tissue that is compressed by a mammography unit.
  • a tungsten shield in the form of a re-entrant cylinder, is positioned on the compression plate of the mammography unit and a typical 192 Iridium (Iridum-192 or Ir-192) high dose rate (HDR) brachytherapy source may be manipulated around the inside circumference of this tungsten shield to deliver the dose.
  • HDR high dose rate
  • a recent applicator design is a reentrant cylinder augmented with an internal truncated cone (frustrum). By placing the truncated cone in the center of the circular applicator, shielding is provided toward much of the skin from each stopping position. This design reduces the skin dose with minimal effect on the dose to the treatment plane.
  • this technique achieves the objective of significantly reducing dose to the non-target volume, skin and chest wall of the ipsilateral breast and virtually no dose to the contralateral breast, lungs, and heart, it delivers a non-uniform dose to the target itself.
  • This non-uniformity can have the result of under-dosing critical target tissue and thereby reducing the therapeutic effect, or, in order to compensate for this reduction, over-dosing other target tissue, and thereby increasing the probability of unacceptable toxicities such as subcutaneous fibrosis and pneumonitis, and unacceptable cosmesis.
  • a radiotherapy system that will significantly reduce the risks of adverse cosmetic outcomes and toxicities by delivering a uniform radiation dose to the target volume with significantly reduced dose to the non-target volume, skin and chest wall of the ipsilateral breast and virtually no dose to the contralateral breast, lungs, and heart. It would further be desirable to irradiate only the breast with an extremely uniform radiation dose, achieve dose distributions that will significantly reduce the risks of adverse cosmetic outcomes and toxicities, and reduce costs (both initial capital outlay and operational). This would have a significant impact on the treatment of breast cancer.
  • a radiotherapy device includes a shield.
  • a single radiation source is disposed within the shield.
  • the single radiation source is movable within a channel of the shield.
  • a collimated opening is disposed in the shield that enables the single radiation source to be moved along the channel and positioned in an exposed position within the shield.
  • a beam modulator component may be disposed adjacent to the collimated opening.
  • the single radiation source may include Se-75 and/or the single radiation source may include Co-56, Co-57, Co-58, Co-60, Zn-65, Pd-103, Cd-109, 1-125, Cs-131, Cs-137, Sm-145, Gd-153, Yb-169, W-187, Ir-192, and/or Au-198.
  • a method of performing radiotherapy includes disposing a single radiation source within a shield.
  • the single radiation source is movable within a channel of the shield.
  • the single radiation source is moved along the channel into an exposed position above a collimated opening of the shield.
  • a uniform radiation dose is delivered from the single radiation source to a target volume.
  • the method may further include flattening the radiation beam before delivery to the target volume using a beam modulator component disposed adjacent to the collimated opening of the shield.
  • the single radiation source may include Se-75 and/or the single radiation source may include Co- 56, Co-57, Co-58, Co-60, Zn-65, Pd-103, Cd-109, 1-125, Cs-131, Cs-137, Sm-145, Gd-153, Yb-169, W-187, Ir-192, and/or Au-198.
  • the collimated opening may have a conical shape.
  • the shield may be made of a material having a density greater than 6 g/cm 3 .
  • the method may further include imaging the target volume and the imaging of the target volume may be performed using the single radiation source.
  • the single radiation source may be a first single radiation source and delivering the uniform radiation dose may include delivering a radiation dose from a second single radiation source located on an opposite side of a target volume with respect to the first single radiation source.
  • a radiotherapy system includes a first radiotherapy device and a second radiotherapy device disposed on an opposite side of a target volume with respect to the first radiotherapy device.
  • Each of the first radiotherapy device and the second radiotherapy device includes a shield; a single radiation source disposed within the shield; and a collimated opening disposed in the shield that enables the single radiation source to be positioned in an exposed position within the shield.
  • the first radiotherapy device and/or the second radiotherapy device may include a beam modulator component disposed adjacent to the collimated opening.
  • the single radiation source of the first radiotherapy device and/or the single radiation source of the second radiotherapy device may include Se-75.
  • One of the first radiotherapy device or the second radiotherapy device may act as a beam catcher for the other of the first radiotherapy device or the second radiotherapy device.
  • An imaging system may further be provided that images the target volume using radiation from the single radiation source of the first radiotherapy device and/or the second radiotherapy device.
  • FIGS. 1A and IB are schematic illustrations showing a shielded radiotherapy device according to an embodiment of the system described herein in which a single radiation source may be positioned with respect to a collimated conical opening within a shield.
  • FIG. 2 is a graph of a relative dose equation for a source located above a reference plane.
  • FIGS. 3A and 3B are schematic illustrations showing a shielded radiotherapy device according to an embodiment of the system having components like that described in connection with FIGS. 1A and IB and further incorporating a beam modulator element.
  • FIG. 4 is a graph of lateral dose rate distribution at a central plane according to an embodiment of the system described herein.
  • FIG. 5 is a graph showing dose rate distributions of an embodiment of the system described herein at other depths.
  • FIG. 6 is a schematic illustration showing the use of two radiotherapy devices according to an embodiment of the system described herein.
  • FIG. 7 is a schematic illustration showing the use of a VMAT apparatus in connection with an embodiment of the system described herein.
  • FIGS. 8A-8C show histograms of dosimetric results of the Monte Carlo simulations in connection with an embodiment of the system described herein.
  • FIG. 9 is a schematic illustration showing that imaging may also be incorporated within the system according to an embodiment of the system described herein.
  • a method for delivering Accelerated Partial Breast Irradiation (APBI) and for delivering a boost to standard whole- breast irradiation (WBI) for the treatment of breast cancer that will significantly reduce the risks of adverse cosmetic outcomes and toxicities.
  • APBI Accelerated Partial Breast Irradiation
  • WBI standard whole- breast irradiation
  • FIGS. 1A and IB are schematic illustrations showing a shielded radiotherapy device 100 according to an embodiment of the system described herein in which a single radiation source 110 may be positioned with respect to a collimated conical opening 120 within a channel of a shield 130.
  • FIG. 1A shows the radiation source 1 10 in a shielded position in the radiotherapy device 100.
  • FIG. IB shows radiation source 1 10 moved by an arm 1 15 in the channel of the shield 130 into an exposed position above the collimated conical opening 120 in the radiotherapy device 100.
  • the collimated opening 120 is shown as a right- circular cone, other shapes are possible and may be appropriately used in connection with the system described herein.
  • the collimated conical opening 120 may have other conical shapes, such as that of a pyramid and/or other volume shape having a polygonal base.
  • the shield 130 may be made of tungsten.
  • Other appropriate shielding materials may be used, such as uranium or lead. More generally, other materials having high densities, such as a density greater than 6 g/cm 3 , may be used for the shield, such as lead, steel, brass, copper, silver, gold and/or tantalum, for example.
  • the dose distribution will vary as a function of radial distance from the axis due to the inverse square behavior of dose (and dose rate) distribution.
  • FIG. 2 is a graph 200 of Equation 1 for a source located above a reference plane.
  • the source is located 30 mm above the reference plane.
  • FIGS. 3A and 3B are schematic illustrations showing a shielded radiotherapy device 300 according to an embodiment of the system having components like that described in connection with FIGS. 1A and IB and further incorporating a beam modulator element 350.
  • a single radiation source 310 may be positioned with respect to a collimated conical opening 320 within a channel of a shield 330.
  • FIG. 3A shows the radiation source 310 in a shielded position in the radiotherapy device 300 with the beam modulator element 350 in position adjacent to the opening 320.
  • FIG. 3B shows radiation source 310 moved in the channel of the shield 330 by an arm 315 into an exposed position in the radiotherapy device 300 with the beam flattener element 350 in position adjacent to the opening 320.
  • the collimated opening 320 is shown as a right-circular cone, other shapes are possible and may be appropriately used in connection with the system described herein.
  • the collimated conical opening 320 may have other conical shapes, such as that of a pyramid and/or other volume shape having a polygonal base.
  • the shield 130 may be made of tungsten.
  • Other appropriate shielding materials may be used, such as uranium or lead. More generally, other materials having high densities, such as a density greater than 6 g/cm 3 , may be used for the shield, such as lead, steel, brass, copper, silver, gold and/or tantalum, for example.
  • the beam modulator component 350 enables control of an intensity of the beam.
  • the beam modular component 350 may be a beam flattener that controls the beam intensity to be uniform in all locations and/or directions.
  • the beam modulator component 350 may enable control of the beam intensity in a non-uniform manner.
  • the beam modulator component 350 may allow a higher radiation intensity in a center of a target volume (tumor) and a lower radiation intensity at the periphery of the target volume.
  • the beam modulator component 350 may be made of a similar material as that of the shield 320.
  • FIG. 4 is a graph 400 of the lateral dose rate distribution at the central plane (at a depth of 30 mm from the surface of the breast) according to an embodiment of the system described herein.
  • the dose rate results are absolute values (Gy/min) and not relative values.
  • the results for the HDR Ir-192source are based on a source of 10 Ci stepping around the entire inner circumference of the conical applicator.
  • results for the system described herein for the embodiment of the device like that shown in FIGS. 3A and 3B are calculated using the maximum proposed activity. These results represent exposure from one side only, and do not include the effects of opposing exposures. As is shown in this graph 400 of FIG. 4, the dose distribution within the target region is significantly flatter, with a sharper demarcation at the edges, as a result of use of the beam modulator component 350. Also, the absolute dose rate is somewhat higher (-10%).
  • FIG. 5 is a graph 500 showing dose rate distributions of an embodiment of the system described herein at other depths.
  • the results show that the flat dose rate distribution is not an anomaly occurring at the depth of 30 mm, but exists at other depths, for example, 5 mm, 15 mm, 25 mm, 35 mm, 45 mm and 55 mm. It is also noted that this is not restricted to a target volume radius of 30 mm. This flat dose rate distribution may be achieved at virtually all target sizes. It is also not restricted to circular targets. This flat dose rate distribution may be achieved in irregularly-shaped volumes as well. In various embodiments, it is noted that the flat dose distribution of the system described herein may be achieved with multiple types of radiation sources.
  • the current AccuBoost system employs an Ir-192 HDR brachytherapy source, and such an Ir-192 source may be used in the system described herein. However, it is noted that the beam-modulating is rendered more efficatious with lower-energy radiation sources.
  • radionuclide(s) of the source(s) may be chosen from the list of commonly recognized and/or available radionuclides.
  • the ideal isotope may have the right combination of half-life, gamma ray energies and ease of production and purification. The half-life has an impact on the shelf life of the product.
  • the x-ray or gamma ray (photon) energies control the depth of the field for dose delivery and may be optimized such that it matches the volume and location of the tumor bed. Higher energy photons are better for more deeply seated targets.
  • the radionuclide may be chosen among available or easily producible species. Example options for radioisotopes capable of meeting these requirements discussed in Sioshansi et al. include Co-56, Co-57, Co-58, Co-60, Zn-65, Pd-103, Cd-109, 1-125, Cs-131, Cs-137, Sm-145, Gd-153, Yb-169, W-187, Ir-192, and Au- 198.
  • another suitable radioisotope that may be beneficially used as the radiation source in the system described herein is 75 Selenium (Selenium-75 or Se-75).
  • Se-75 decays by electron capture accompanied by the emission of gamma rays with energies in the range of 120 keV - 400 keV (average energy: 215 keV).
  • Se-75 is an advantageous choice for a gamma radiation source in connection with the system described herein because high specific activities (up to 1500 Ci/g) can be achieved.
  • the Se-75 source may be delivered in a radiotherapy device, like the radiotherapy devices 100 or 300 that are further discussed elsewhere herein, using tungsten for shielding.
  • the package may have a diameter of ⁇ 75 mm (3 inches) and weigh -5.4 kg (12 lbs) which would be sufficiently light as to be capable of mounting on the compression plate of a mammography system. If the device were limited to 80 Curies, then it would be transported as a Type A container, minimizing the regulatory burden. Using this approach, it would be possible to use two units, mounted in opposing positions, simultaneously to reduce the treatment time in half.
  • Se-75 with its lower photon energies also reduces the room shielding requirements over those of an Ir-192 HDR brachytherapy source. Because of the self- contained storage device and collimator, there is no need for the source to traverse unshielded between the storage device and the exposing position, as is the case with the Ir-192 HDR source technique.
  • FIG. 6 is a schematic illustration 600 showing the use of two radiotherapy devices 610, 620 according to an embodiment of the system described herein.
  • the system described herein enables two radiotherapy devices 610, 620, like that of the devices 100 or 300 described elsewhere herein, to be mounted simultaneously on mammography compression plates on both sides of a target volume 601, such as a breast or other organ. This would permit both exposures to be performed simultaneously, significantly reducing the treatment time.
  • the opposing shielded device may act as a beam catcher for the device on the opposite side, providing shielding for the beam emerging from the opposite source and additionally reducing the room shielding requirement.
  • VMAT volumetric modulated arc therapy
  • VMAT places the patient in a prone position and rotationally irradiate only the breast.
  • FIG. 7 is a schematic illustration 700 showing the use of a VMAT apparatus 710 in connection with an embodiment of the system described herein.
  • a patient 701 is placed in a prone position on the apparatus 710 that rotationally irradiates only the breast and incorporates simultaneous (or near-simultaneous) CT-imaging of the target in exactly the same position as the treatment delivery.
  • the patient 701 would lie on a shielded table 71 1 with the breast protruding below the shielded surface to assure that no direct radiation dose would be delivered to the contralateral breast, lung or the heart.
  • a radiotherapy device 720 like that of the radiotherapy devices 100 or 300 discussed elsewhere herein, causes the radiation source to be directed only at the breast such that no primary radiation would be directed at the patient's chest wall, lung or heart. In those cases where dose needs to be delivered close to the chest wall, proper design of the table 711, including a trough, may achieve good coverage of the breast and axilla.
  • external beam APBI may only be performed using high energy photons, principally because of the need to deliver the beam through long path lengths in the body without creating very high skin/entrance doses.
  • Breast radiation therapy is typically performed with high energy radiation accelerators which deliver photons with energies of many thousands of keV (many MeV).
  • keV machine-derived keV
  • radiation therapy may be applied with a radiation source that may include any of the radionuclide sources identified above, especially including Se-75.
  • An advantage of the delivery approach according to the system described herein is the ability to use low-energy radiation.
  • Earlier considerations of rotational breast therapy have focused on higher energy X-ray sources (320 kV p ortho voltage tubes).
  • the combination of rotation and collimation limits the skin dose; only small areas of the skin are in the near field beam for only very short fractions of the treatment duration. This permits the treatment to be performed using relatively low energies; energies that would not generally be considered for volumetric treatment. As described below, acceptable results have been obtained with energies as low as 120 kV p .
  • variable (multi-leaf) collimators the radiation beam may be adjusted to conform directly to the target volume at all angular positions.
  • a treatment facility may be small and self- contained so that it could be installed in an unshielded treatment room, permitting the therapist to be present in the same room as the patient during treatment.
  • the patient will be able to view her surroundings, avoiding the anxiety resulting from the feeling of being closed in that is so common in MRI and CT examinations and external beam therapy. It will provide the additional benefit of allowing clinical personnel to approach the patient for comfort and care during the procedure, which is now not possible without interruption/termination of the treatment.
  • this treatment facility would be less costly that alternative external beam machines, allowing this procedure to be more widely available.
  • MCNP5 Monte Carlo techniques were used to simulate the dose distribution in a breast under several treatment scenarios.
  • the treatment geometry is similar to that shown in FIG. 7.
  • the breast was postulated to be a hemispherical section with a diameter of 140 mm superimposed onto a cylindrical section with a diameter of 140 mm and a length of 70 mm.
  • a 20 mm radius spherical lumpectomy cavity was located concentric with the hemisphere.
  • the target volume was postulated as a 10 mm thick spherical shell surrounding the lumpectomy cavity. Irradiations were simulated with 120 kV p and 160 kV p X-ray sources, each located at 500 mm from the center of the lumpectomy cavity.
  • FIG. 8A-8C show histograms of dosimetric results of the above-noted simulations.
  • FIG. 8A shows a target dose-volume histogram (DVH) 801.
  • FIG. 8B shows a non-target breast DVH 802.
  • FIG. 8C shows a skin DVH 803.
  • 3D-CRT used in the NSABP B-39 protocol for APBI.
  • recent clinical data has suggested that the current 3D- CRT technique is associated with unacceptable toxicities and unacceptable cosmesis, correlating to the volume of normal tissues being excessively irradiated. Accordingly, the results are also compared with more stringent dose-volume constraints for toxicity avoidance: 120 kV p and 160 kV p .
  • Table 1 The comparison results are presented in Table 1 :
  • FIG. 9 is a schematic illustration 900 showing that imaging may also be incorporated within the system according to an embodiment of the system described herein.
  • the illustration 900 shows VMAT components like that of the illustration 700 described in connection with FIG. 7 and further shows an imaging system 1000.
  • the delivery approach lends itself to simultaneous (or near-simultaneous) imaging of the target, using the imaging system 1000, in exactly the same position as treatment delivery.
  • breast CT may be performed immediately before the therapy, thereby assuring target location and avoiding the difficulties of reliably reproducing the target from fraction to fraction in other external beam techniques.
  • the same radiation source maybe used for imaging and therapy.
  • the imaging may include the addition of an imaging plate to the apparatus 610 to perform cone-beam CT.
  • an additional radiation source can be incorporated for imaging, likely orthogonally to the therapy beam in order to make sequential cone-beam CT images to be very immediately followed by VMAT.
  • the imaging system may further be used in connection with the use of multiple radiotherapy devices like that shown in FIG. 6 and in which, in an embodiment, the imaging system may image the target volume using radiation from the single radiation source of the first radiotherapy device and/or the second radiotherapy device.
  • Partial Breast Irradiation for delivering a boost to standard whole-breast irradiation (WBI) for the treatment of breast cancer and/or for delivering radiation therapy using a VMAT technique.
  • WBI whole-breast irradiation
  • VMAT vacuum-breast irradiation
  • the system described herein may be used with other appropriate treatment regimes. Further, the system described herein may be applied to body parts and organs other than breasts, specifically where it is desirable to deliver a uniform radiation dose to the target volume with significantly reduced dose to the non-target volume and surrounding tissue and organs.
  • the computer-readable medium may include volatile memory and/or non- volatile memory, and may include, for example, a computer hard drive, ROM, RAM, flash memory, portable computer storage media such as a CD-ROM, a DVD-ROM, a flash drive or other drive with, for example, a universal serial bus (USB) interface, and/or any other appropriate tangible or non-transitory computer-readable medium or computer memory on which executable code may be stored and executed by a processor.
  • a universal serial bus USB

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

La présente invention se rapporte à un système permettant d'administrer une dose d'irradiation partielle accélérée du sein (APBI pour Accelerated Partial Breast Irradiation) et d'administrer une stimulation à une irradiation standard de tout le sein (WBI pour Whole Breast Irradiation) pour permettre le traitement du cancer du sein qui réduit de manière significative les risques de résultats cosmétiques défavorables et de toxicités. Cela est possible grâce à un procédé et un dispositif permettant d'administrer une dose de rayonnement uniforme au volume cible, une dose significativement réduite étant administrée au volume non cible, à la peau et à la paroi thoracique du sein ipsilatéral et virtuellement aucune dose n'étant administrée au sein contralatéral, aux poumons et au cœur.
EP13832747.3A 2012-08-29 2013-08-29 Radiothérapie des organes saillants et/ou compatibles Withdrawn EP2891171A4 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201261694313P 2012-08-29 2012-08-29
PCT/US2013/057232 WO2014036225A1 (fr) 2012-08-29 2013-08-29 Radiothérapie des organes saillants et/ou compatibles

Publications (2)

Publication Number Publication Date
EP2891171A1 true EP2891171A1 (fr) 2015-07-08
EP2891171A4 EP2891171A4 (fr) 2016-04-27

Family

ID=50184346

Family Applications (1)

Application Number Title Priority Date Filing Date
EP13832747.3A Withdrawn EP2891171A4 (fr) 2012-08-29 2013-08-29 Radiothérapie des organes saillants et/ou compatibles

Country Status (2)

Country Link
EP (1) EP2891171A4 (fr)
WO (1) WO2014036225A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20200305820A1 (en) * 2016-04-08 2020-10-01 Istituti Fisioterapici Ospitalieri (Ifo)-Istituto Regina Per Lo Studio E La Cura Dei Tumori (Ire) Diagnostic and therapeutic unit

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2849621A (en) * 1955-03-25 1958-08-26 Litton Ind Of California Methods and apparatus for X-ray therapy
US3048701A (en) * 1958-09-12 1962-08-07 Westinghouse Electric Corp Radioactive source holder
US3161776A (en) * 1961-03-20 1964-12-15 Gen Motors Corp Portable radiographic exposure unit
SE522710C2 (sv) * 2002-07-05 2004-03-02 Elekta Ab Strålterapiapparat med flera uppsättningar hål i kollimatorringen där förskjutbara plattor bestämmer vilka håluppsättningar som strålkällorna ska använda, samt metod att variera strålfältet
US20050049508A1 (en) * 2003-08-06 2005-03-03 Michael Forman Treatment of age-related macular degeneration
US20050276377A1 (en) * 2004-06-10 2005-12-15 Carol Mark P Kilovoltage delivery system for radiation therapy
EP2005992A1 (fr) * 2007-06-19 2008-12-24 Nucletron B.V. Dispositif miniature source de rayons X pour radiothérapie ainsi que procédé pour la réalisation d'un traitement de radiothérapie sur une partie anatomique du corps d'un animal utilisant un dispositif miniature source de rayons X

Also Published As

Publication number Publication date
EP2891171A4 (fr) 2016-04-27
WO2014036225A1 (fr) 2014-03-06

Similar Documents

Publication Publication Date Title
US8182410B2 (en) Peripheral radiotherapy of protruding conformable organs
US8519370B2 (en) Modifying radiation beam shapes
US10022565B2 (en) External beam radiotherapy and imaging with radioactive isotope
US20150352373A1 (en) An apparatus to deliver conformal radiotherapy using external beam cobalt 60
US20140066687A1 (en) Radiation therapy of protruding and/or conformable organs
Huang et al. Treatment of multiple brain metastases using stereotactic radiosurgery with single-isocenter volumetric modulated arc therapy: comparison with conventional dynamic conformal arc and static beam stereotactic radiosurgery
Gazda et al. Principles of radiation therapy
Barbiero et al. Single-fraction flattening filter–free volumetric modulated arc therapy for lung cancer: dosimetric results and comparison with flattened beams technique
US8444544B1 (en) Device and method for intensity modulated brachytherapy
EP2891171A1 (fr) Radiothérapie des organes saillants et/ou compatibles
Buzurovic et al. Medical physics and planning in skin radiotherapy and brachytherapy
US20230117131A1 (en) Optimization of Radionuclides for Treatment of Cutaneous Lesions
Luharia et al. The role of physics in modern radiotherapy: Current advances and developments
Baggarley et al. The physics of radiation oncology
Kavak Advanced Treatment Techniques In Radiotherapy
Collins Radiation Therapy Medical Physics Review–Delivery, Interactions, Safety, Feasibility, and Head to Head Comparisons of the Leading Radiation Therapy Techniques
Thornton et al. Technical advances in radiotherapy of head and neck tumors
Ong Volumetric modulated arc therapy for stereotactic body radiotherapy:: Planning considerations, delivery accuracy and efficiency
Potharaju et al. Dosimetric Comparison of Stereotactic Body Radiotherapy and Intensity-Modulated Radiotherapy to Deliver Hypofractionated Radiotherapy in Organ-Confined Prostate Cancer
Todor Physics of APBI
Amestoy et al. Treatment Planning and Treatment Planning System (TPS)
Hidayati et al. Assessment of Modern Radiotherapy Techniques for Breast Cancer Treatment in Indonesia
Cifter Customizable radiotherapy enhancement (CuRE) for prostate cancer using platinum based nanoparticles
Mestrovic Integration of daily imaging, plan adaptation and radiation delivery for near real-time adaptive radiation therapy
Marcu et al. 9 Brachytherapy: Radiobiology and Physics Aspects of Treatment

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20150224

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR

AX Request for extension of the european patent

Extension state: BA ME

DAX Request for extension of the european patent (deleted)
RA4 Supplementary search report drawn up and despatched (corrected)

Effective date: 20160329

RIC1 Information provided on ipc code assigned before grant

Ipc: A61N 5/10 20060101ALI20160321BHEP

Ipc: H01J 35/14 20060101AFI20160321BHEP

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN

18D Application deemed to be withdrawn

Effective date: 20161026