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Artificial intelligence in radiotherapy: a technological review

Ke Sheng

《医学前沿（英文）》 2020年 第14卷 第4期   页码 431-449 doi: 10.1007/s11684-020-0761-1

摘要： Radiation therapy (RT) is widely used to treat cancer. Technological advances in RT have occurred in the past 30 years. These advances, such as three-dimensional image guidance, intensity modulation, and robotics, created challenges and opportunities for the next breakthrough, in which artificial intelligence (AI) will possibly play important roles. AI will replace certain repetitive and labor-intensive tasks and improve the accuracy and consistency of others, particularly those with increased complexity because of technological advances. The improvement in efficiency and consistency is important to manage the increasing cancer patient burden to the society. Furthermore, AI may provide new functionalities that facilitate satisfactory RT. The functionalities include superior images for real-time intervention and adaptive and personalized RT. AI may effectively synthesize and analyze big data for such purposes. This review describes the RT workflow and identifies areas, including imaging, treatment planning, quality assurance, and outcome prediction, that benefit from AI. This review primarily focuses on deep-learning techniques, although conventional machine-learning techniques are also mentioned.

关键词： artificial intelligence     radiation therapy     medical imaging     treatment planning     quality assurance     outcome prediction    

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Long-term results of suppressing thyroid-stimulating hormone during radiotherapy to prevent primary hypothyroidism

Maura Massimino, Marta Podda, Lorenza Gandola, Emanuele Pignoli, Ettore Seregni, Carlo Morosi, Filippo Spreafico, Andrea Ferrari, Emilia Pecori, Monica Terenziani

《医学前沿（英文）》 2021年 第15卷 第1期   页码 101-107 doi: 10.1007/s11684-020-0752-2

摘要： Primary hypothyroidism commonly occurs after radiotherapy (RT), and coincides with increased circulating thyroid-stimulating hormone (TSH) levels. We tested therefore the protective effect of suppressing TSH with L-thyroxine during RT for medulloblastoma/PNET and Hodgkin lymphoma (HL) in a prospective cohort study. From 1998 to 2001, a total of 37 euthyroid children with medulloblastoma/PNET plus 14 with HL, scheduled for craniospinal irradiation and mediastinum/neck radiotherapy, respectively, underwent thyroid ultrasound and free triiodothyronine (FT3), free thyroxine (FT4), and TSH evaluation at the beginning and end of craniospinal iiradiation. From 14 days before and up to the end of radiotherapy, patients were administered L-thyroxine checking every 3 days TSH to ensure a value<0.3 μIU/mL. During follow-up, blood tests and ultrasound were repeated; primary hypothyroidism was considered an increased TSH level greater than normal range. Twenty-two/37 patients with medulloblastoma/PNET and all the 14 patients with HL were alive after a median 231 months from radiotherapy with 7/22 and 8/14 having correctly reached TSH levels ˂ 0.3 μIU/mL and well matched for other variables. Twenty years on, hypothyroidism-free survival rates differed significantly, being 60%±15% and 15.6%±8.2% in TSH-suppressed vs. not-TSH suppressed patients, respectively ( =0.001). These findings suggest that hypothyroidism could be durably prevented in two populations at risk of late RT sequelae, but it should be confirmed in a larger cohort.

关键词： iatrogenic primary hypothyroidism     late effects of radiotherapy     long-term follow-up     medulloblastoma     Hodgkin lymphoma    

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功能影像检测食管癌放疗过程中再增殖和乏氧以及预测临床疗效研究

于金明

《中国工程科学》 2012年 第14卷 第7期   页码 9-19

摘要：

18F-FLT PET能监测食管鳞癌放疗过程中肿瘤和正常组织的生物学变化，其较18F-FDG PET能较好区分炎症和肿瘤，能检测食管肿瘤放疗过程中的加速再增殖,18F-FETNIM PET能检测食管鳞癌的乏氧状态,18F-FLT PET和18F-FETNIM PET作为一种非创伤性的影像学技术，能为肿瘤医生提供一个早期评价治疗反应，检测放疗过程中的再增殖克隆源细胞、乏氧和评价新辅助治疗疗效的手段。18F-FLT PET和18F-FETNIM PET能为放射治疗确定“再增殖”和“乏氧”生物学靶区，以通过剂量调强放疗提高再增殖和乏氧区域放疗剂量，提高肿瘤的局部控制率和远期生存。

关键词： 食管肿瘤     放射疗法     正电子发射型     再增殖     乏氧    

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Improved local control without elective nodal radiotherapy in patients with unresectable NSCLC treated

YANG Kunyu, LIU Li, ZHANG Tao, WU Gang, CAO Fengjun, WANG Jianhua

《医学前沿（英文）》 2007年 第1卷 第4期   页码 381-385 doi: 10.1007/s11684-007-0074-7

摘要： To investigate the influence of prophylactic elective nodal irradiation on the therapeutic results of definitive radiotherapy for patients with stage IIIA or stage IIIB unresectable non-small-cell lung cancer, 55 patients with clinically inoperable advanced non-small-cell lung cancer were studied. After four cycles of induction chemotherapy, the patients were divided into two groups at random. In one group, the elective nodal irradiation was included in clinical tumor volume (CTV) of definitive radiotherapy (ENI group); and in the other group, elective nodal irradiation was not included in CTV (non-ENI group). For the patients in the ENI group, the mean prescription dose for gross tumor volumes was 58.4 Gy, while for the patients in the non-ENI group, it was 65.8 Gy (<0.05). The responsive rates were 45.8% and 74.0% (<0.05), and the rate of the elective nodal failure (ENF) was 4.2% and 11.1%, respectively. Kaplan-Meier analysis showed that the mean local-progression-free survival time was 11.0 and 15.0 months, and one-year local-failure rates were 51.9% and 24.5% (<0.05). The median overall survival time was 13.0 and 15.0 months, respectively ( = 0.084). The one-year survival rates were 55.7% and 72.5%, and two-year survival rates were 0% and 19.9%. There was no significant difference in the occurrences of radiation-associated complications between the two groups. Our results showed that omitting elective nodal irradiation did not result in a high incidence of elective nodal failure. On the contrary, it decreased local failure by increasing prescription doses to the primary diseases and lymphadenopaphy, and thereby it may further prolong the patients survival.

关键词： significant difference     irradiation     unresectable non-small-cell     induction chemotherapy     influence    

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Neoadjuvant radiohormonal therapy for oligo-metastatic prostate cancer: safety and efficacy outcomes from an open-label, dose-escalation, single-center, phase I/II clinical trial

《医学前沿（英文）》 2023年 第17卷 第2期   页码 231-239 doi: 10.1007/s11684-022-0939-9

摘要： To evaluate the safety and efficacy of neoadjuvant radiohormonal therapy for oligometastatic prostate cancer (OMPC), we conducted a 3 + 3 dose escalation, prospective, phase I/II, single-arm clinical trial (CHiCTR1900025743), in which long-term neoadjuvant androgen deprivation was adopted 1 month before radiotherapy, comprising intensity modulated radiotherapy to the pelvis, and stereotactic body radiation therapy to all extra-pelvic bone metastases for 4‒7 weeks, at 39.6, 45, 50.4, and 54 Gy. Robotic-assisted radical prostatectomy was performed after 5‒14 weeks. The primary outcome was treatment-related toxicities and adverse events; secondary outcomes were radiological treatment response, positive surgical margin (pSM), postoperative prostate-specific antigen (PSA), pathological down-grading and tumor regression grade, and survival parameters. Twelve patients were recruited from March 2019 to February 2020, aging 66.2 years in average (range, 52‒80). Median baseline PSA was 62.0 ng/mL. All underwent RARP successfully without open conversions. Ten patients recorded pathological tumor down-staging (83.3%), and 5 (41.7%) with cN1 recorded negative regional lymph nodes on final pathology. 66.7% (8/12) recorded tumor regression grading (TRG) –I and 25% (3/12) recorded TRG-II. Median follow-up was 16.5 months. Mean radiological progression-free survival (RPFS) was 21.3 months, with 2-year RPFS of 83.3%. In all, neoadjuvant radiohormonal therapy is well tolerated for oligometastatic prostate cancer.

关键词： neoadjuvant     radiotherapy     oligometastatic     prostate cancer     radical prostatectomy    

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标题 作者 时间 类型 操作

Artificial intelligence in radiotherapy: a technological review

Ke Sheng

期刊论文

Long-term results of suppressing thyroid-stimulating hormone during radiotherapy to prevent primary hypothyroidism

Maura Massimino, Marta Podda, Lorenza Gandola, Emanuele Pignoli, Ettore Seregni, Carlo Morosi, Filippo Spreafico, Andrea Ferrari, Emilia Pecori, Monica Terenziani

期刊论文

功能影像检测食管癌放疗过程中再增殖和乏氧以及预测临床疗效研究

于金明

期刊论文

Improved local control without elective nodal radiotherapy in patients with unresectable NSCLC treated

YANG Kunyu, LIU Li, ZHANG Tao, WU Gang, CAO Fengjun, WANG Jianhua

期刊论文

Neoadjuvant radiohormonal therapy for oligo-metastatic prostate cancer: safety and efficacy outcomes from an open-label, dose-escalation, single-center, phase I/II clinical trial

期刊论文