Recently, a clinical innovation "black technology" uCT-ART online adaptive radiotherapy technology (CT-guided adaptive radiotherapy) developed by Lianying Medical was applied to the Cancer Prevention and Control Center of Sun Yat-sen University for the first time, and took the lead in the field of lung cancer radiotherapy. This technology not only realizes dynamic positioning, installs "satellite navigation" for direct attack cancer, but also uses 4D-CT to completely adjust the radiotherapy plan online adaptively in only 10 minutes and 45 seconds on the basis of 4D-CT; the image quality is also fully innovative, with the application potential of covering the whole body of cancer, which is expected to help the majority of tumor patients get accurate, efficient and personalized radiation therapy.
Dynamically adjust the radiotherapy plan as the tumor changes
In recent years, the incidence and mortality of tumors in mainland China have been rising, of which lung cancer ranks first in China's cancer incidence and mortality rate. Radiation therapy (hereinafter referred to as "radiotherapy") is one of the main means of tumor treatment at present, this technology emits radiation to the tumor through a linear accelerator to kill cancer cells. If the radiation position is not precise and the dose is improper, it is easy to "accidentally injure" the patient's healthy cells and damage the patient's health.
Chen Ming, director of the Department of Radiotherapy of the Cancer Prevention and Control Center of Sun Yat-sen University, said that for lung cancer patients, a radiotherapy cycle often requires 20 to 30 times of radiotherapy, which lasts for more than 1 month. "In this radiation therapy cycle, it is extremely important to formulate a precise radiotherapy plan and dynamically adjust the radiotherapy plan according to changes in tumor size, location and shape."
Professor Chen Ming, Director of the Department of Radiotherapy, and his team implemented the treatment plan for the patients
Usually, the doctor will sketch the patient's tumor target based on the tumor morphology image that the patient has scanned for the first time, and the physicist will calculate the radiation dose based on this to formulate a radiotherapy plan for the patient. Director Chen Ming said that in the process of radiotherapy, lung tumor retreat, changes in lung tissue that originally had inflammation and atelectasis, and physiological movement of the heart and lungs will lead to changes in tumor morphology, location, and size over time, and changes in patient body shape, positioning, and organ shape will also cause changes in tumors. This requires timely adjustment of the radiotherapy plan during the course of radiotherapy.
"Capturing the dynamically changing tumor image is equivalent to chasing the protagonist on the stage with a chasing light, like a shadow, clearly showing the dynamic change of the protagonist." The same is true for idealized adaptive radiotherapy, which requires accurate imaging to accommodate changes in the position and shape of the tumor during treatment. "The images of traditional linear accelerators are not clear enough, the ability to capture tumor displacement and deformation needs to be improved, and patients often need to locate the tumor on another clear imaging device, and then wait for the doctor to re-plan, and the patient's radiotherapy cycle will change." ”
"However, the integrated CT linear accelerator of Lianying Medical has diagnostic-grade clear CT images, and we can obtain high-definition CT images before each radiotherapy for patients, and directly develop high-precision personalized treatment plans for patients online based on the CT images and lesion information of the day." All operations are solved at one time, doctors can be more flexible, real-time dynamic adjustment plan, patients do not have to travel to various departments, greatly simplifying the patient medical process, to maximize the benefit of the majority of tumor radiotherapy patients. ”
Huang Xiaoyan, deputy director of the Department of Radiotherapy, added: "The intelligent TPS of United Pictures Medical has greatly improved the accuracy of our planning. It can quickly and intelligently and accurately identify and outline tumor lesions and normal organs, and can also provide online dose monitoring, making dose calculation more accurate, ensuring that patients can receive the optimal radiotherapy program every time, and truly realizing accurate radiotherapy. Not only that, the work that used to take several days can now be completed in ten minutes, which greatly improves the work efficiency of doctors and physicists. ”
Industry-medical integration innovation tackles the "card neck" problem
It is reported that behind the birth of uCT-ART technology is the collaborative practice of obstetrics and medicine carried out by the R&D team of ONC Oncology and Imaging Medical under in-depth thinking about the pain points of radiotherapy. "We have been groping for the past six months and today we have completed a case of online adaptive radiotherapy for lung cancer from start to finish, and we are satisfied with the performance of this technology and this platform." Director Chen Ming said, "This is a benchmark achievement of the strategic cooperation between CUHK Oncology and United Film Medical, and also confirms the key role of tackling the 'card neck' technology and the linkage between industry, education and research." Large medical institutions are willing to use domestic equipment, and the combination of medical and industrial equipment can continuously improve domestic equipment, which meets the major needs of the current country, and is also the common responsibility of hospitals and enterprises. The hospital puts forward needs and suggestions according to the actual clinical situation, and the enterprise carries out technological innovation and improvement based on this, and the two sides can cooperate with each other to form a virtuous circle and accelerate the transformation of innovative achievements. ”
On April 11, Professor Chen Ming's team from the Department of Radiation Oncology of CUHK performed 4D uCT-ART (4D CT online adaptive radiotherapy) for lung cancer patients.
It is reported that in October 2021, the CT-linac 506c of Lianying Medical officially entered the Cancer Prevention and Control Center of Sun Yat-sen University, which is also the first domestic radiotherapy equipment introduced by the hospital.
Since 2018, As the obstetric and medical partners of Tackling Cancer, United Imaging Medical and Zhongda Cancer have cooperated closely in many fields: Total-Body PET-CT uEXPLORER Explorer, 75cm large aperture magnetic resonance uMR Omega, integrated CT linear accelerator uRT-linac 506c and a series of clinical research equipment have been stationed; with the upgrading of strategic cooperation, the two sides are working together to build a series of clinical research equipment covering precision diagnosis and treatment, precision immunotherapy, The integrated innovation ecology of diagnosis and treatment linked by precise radiotherapy opens up the whole process of prevention,diagnosis,treatment,and continuously optimizes the medical experience and improves the cure rate of cancer.
[Reporter] Yan Huifang
【Author】 Yan Huifang
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