Medical Physics Seminar – Monday, October 18, 2010
Dose-Escalation by Boosting Radiation Dose within the Primary Tumor on the Basis of Molecular Imaging
Wouter van Elmpt, Ph.D., (guest of Dr. Robert Jeraj)
Research Fellow, Maastricht Radiation Oncology (MAASTRO Clinic), Department of Radiation Oncology, Maastricht University Medical Centre, Netherlands
The role of FDG-PET/CT for radiotherapy dose redistribution in non-small cell lung cancer (NSCLC) will be discussed. Local tumor failure remains high in patients with stage II and III NSCLC, with local progression free survival (LPFS) rates of about 30%, even with concurrent chemo-radiation. For normal tissue toxicity, we have used FDG-PET/CT imaging to predict normal tissue response to radiotherapy. For tumors, molecular imaging using FDG-PET is used to characterize primary lung tumors. High FDG-uptake regions are hypothesized to be the most therapy-resistant regions. At MAASTRO clinic (Maastricht, The Netherlands) we have started a multi-centre randomized phase II trial on selective dose boosting (dose-painting) of regions inside the primary tumor of NSCLC patients: the PET boost trial.