Clinical Cooperation Unit Radiation Oncology
Prof. Dr. Dr. Jürgen Debus (in ch.)
Computer-aided imaging techniques allow for optimal planning of radiation therapy
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Our Unit treats cancer patients with new innovative technologies and explores new strategies to adapt radiotherapy to the patients’ individual situation. This involves approaches from many fields, such as new imaging techniques, medical physics, computer sciences, biology and radiochemistry. In order to push the boundaries of modern radiation oncology we cooperate with many groups within the DKFZ, the University Hospital and other national and international experts. Within the Heidelberg Institute of Radiation Oncology (HIRO) our goal is to provide for every patient the best available therapy option every day. Since 1997 the unit permanently investigates and optimizes ion therapy. One current research focus is the treatment of moving tumors in the lung and upper abdomen. Breathing motion adjusted therapy is applied in so-called gated therapy; here, radiation is only delivered in the optimal breathing phase. To improve imaging of tumor motion necessary for gated or tracked therapy, we evaluate different markers placed invasively around the tumor. This includes gold markers for X-ray based fluoroscopy imaging and electromagnetic markers for online tumor motion tracking. Within the DKTK, molecular stratification of patients is investigated in a multicentric trial with the aim to identify markers to predict outcome after radiotherapy. We also perform analyses of the use of dual energy CT (DECT) with the aim of metal artefact correction, extraction of a virtual native CT and direct measurement of electron density. Evaluation of functional imaging in involving PET and MRI in the planning of radiotherapy is also on our agenda. This includes metabolic and hypoxic tracers and their potential to individualize radiation treatment of non-small cell lung cancer. Strong emphasis is put on the integration of MR imaging into image guided radiotherapy (IGRT). Using MR imaging and shuttle-based patient transport, we investigate the possibility to optimize adaptive radiotherapy by performing daily inter-fractional image guidance. FUTURE OUTLOOK We will continue the individualization of radiotherapy by integrating biomolecular information into therapy planning, as well as into the therapy process. Several clinical trials, e.g. involving the novel biomarker PSMA, assessing tumor hypoxia status or investigating effects of radiotherapy on the immune system are on our agenda. Towards the development of MR guided Radiotherapy, we received funding from the DFG for a combined treatment system that will be installed in 2016/17.
