基于PET/CT的功能影像组学引导食管癌个体化放疗的研究

项目名称： 基于PET/CT的功能影像组学引导食管癌个体化放疗的研究

项目编号： No.81502645

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 余雯

作者单位： 上海交通大学

项目金额： 18万元

中文摘要： GTV内的肿瘤控制是食管癌放疗疗效提高的关键，提高剂量强度可能有帮助。如何筛选需要加量的患者及如何确定加量区域，将是个体化放疗面临的主要问题。我们的前期研究证实了18FDG PET/CT在指导食管癌放疗几何靶区勾画的价值，并显示基于治疗前>50%SUVmax区域的加量放疗在食管癌中是可行的且安全。基于PET的影像组学可提取大量18FDG摄取异质性特征，相比简单SUV阈值，其预后及预测价值可能为食管癌放疗提供更丰富的生物学信息。预实验提示食管癌GTV内的肿瘤代谢负荷及不均质程度可能与肿瘤的治疗反应相关。本研究拟基于PET/CT的影像组学研究平台，通过挖掘18FDG摄取异质性特征对食管癌的预后价值和放疗反应的预测价值，建立相应的预测模型，筛选出局部失败风险高的患者并为其个体化确定加量区域，并将在II期临床研究中验证这种个体化放疗的疗效。此工作将为将来功能影像组学引导肿瘤的个体化治疗奠定基础。

中文关键词： 放射治疗；C06_食管肿瘤；影像组学

英文摘要： Improving local control within the GTV may contribute to better outcome of radiotherapy in esophageal cancer and individually modifying the dose intensity of the GTV may be a potential way. But individualization of radiotherapy faces a few problems, such as how to select patients to whom dose boost is necessary and where to boost. Our previous studies have explored the potential value of 18FDG PET/CT in improving the staging and target volume definition in esophageal cancer, and also indicated that selective dose boost to the pre-treatment 50% SUVmax area of the primary tumor has been safely achieved. PET-based radiomics extracts large amounts of complicated features reflecting spatial and temporal heterogeneity of 18FDG uptake, which could be more informative with prognostic and predictive performance, comparing to the SUVmax threshold. Our preliminary experiment has indicated the correlation of the metabolic burden and heterogeneity within the esophageal GTV with the tumor response to radiotherapy. The present study is designed to identify more heterogeneity features of 18FDG uptake with prognostic power and good performance of predicting the response to radiotherapy, using a quantitative PET-based radiomics approach, and then to screen out patients with high risk of local failure who will undergo radiotherapy with dose boost to an individually defined area. A phase II study will be carried out to validate the outcome of this kind of individualized radiotherapy. We believe this study will provide a basis for radiomics-guided personalized treatment in the future.

英文关键词： radiotherapy;esophageal cancer;radiomics