Betrouni N, Boukris S, Benzaghou F
INSERM, U1189, 1 Avenue Oscar Lambret, Cedex 08, 59037, Lille, France.
Medical Department, Steba biotech, 32 Boulevard Flandrin, Paris, France.
Lasers Med Sci. 2017 Aug;32(6):1301-1307. doi: 10.1007/s10103-017-2241-7. Epub 2017 Jun 1.
Vascular targeted photodynamic therapy (VTP) with WST11 is a novel non-thermal focal treatment for localized prostate cancer that has shown favorable and early efficacy results in previously published studies. In this work, we investigate the efficiency of automatic dosimetric treatment planning. An action model established in a previous study was used in an image-guided optimization scheme to define the personalized optimal light dose for each patient. The calculated light dose is expressed as the number of optical cylindrical fibers to be used, their positions according to an external insertion grid, and the lengths of their diffuser parts. Evaluation of the method was carried out on data collected from 17 patients enrolled in two multi-centric clinical trials. The protocol consisted of comparing the method-simulated necrosis to the result observed on day 7 MR enhanced images. The method performances showed that the final result can be estimated with an accuracy of 10%, corresponding to a margin of 3 mm. In addition, this process was compatible with clinical conditions in terms of calculation times. The overall process took less than 10 min. Different aspects of the VTP procedure were already defined and optimized. Personalized treatment planning definition remained as an issue needing further investigation. The method proposed herein completes the standardization of VTP and opens new pathways for the clinical development of the technique.
采用WST11的血管靶向光动力疗法（VTP）是一种针对局限性前列腺癌的新型非热聚焦治疗方法，在先前发表的研究中已显示出良好的早期疗效。在这项工作中，我们研究了自动剂量治疗计划的效率。在图像引导优化方案中使用先前研究中建立的作用模型，为每位患者定义个性化的最佳光剂量。计算出的光剂量表示为要使用的光学圆柱形光纤数量、它们根据外部插入网格的位置以及它们的扩散器部分的长度。对从参与两项多中心临床试验的17名患者收集的数据进行了该方法的评估。该方案包括将方法模拟的坏死情况与第7天磁共振增强图像上观察到的结果进行比较。该方法的性能表明，最终结果的估计精度可达10%，对应边缘为3毫米。此外，就计算时间而言，该过程与临床条件兼容。整个过程耗时不到10分钟。VTP程序的不同方面已经得到定义和优化。个性化治疗计划的定义仍是一个需要进一步研究的问题。本文提出的方法完善了VTP的标准化，并为该技术的临床发展开辟了新途径。
