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Targeted Cancer Therapies

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
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MR Molecular Imaging of Prostate Cancer with a Small Molecular CLT1 Peptide Targeted Contrast Agent

MR Molecular Imaging of Prostate Cancer with a Small Molecular CLT1 Peptide Targeted Contrast Agent

Published on: September 3, 2013

Target definition in prostate, head, and neck.

Coen Rasch¹, Roel Steenbakkers, Marcel van Herk

¹Department of Radiation Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoekhuis, Amsterdam. c.rasch@nki.nl

Seminars in Radiation Oncology

|June 29, 2005

Summary

Radiation therapy errors in prostate and head and neck cancers stem from target definition inaccuracies. Improving target delineation with multimodality imaging and standardized protocols can reduce these errors and optimize treatment margins.

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Area of Science:

Radiation Oncology
Medical Imaging
Cancer Treatment

Background:

Target definition is a significant source of errors in external-beam radiation therapy for prostate and head and neck cancers.
Delineation errors are constant throughout treatment, impacting tumor dose and leading to variations due to visibility, disagreement on extent, and protocol interpretation.

Purpose of the Study:

To explore methods for improving target definition accuracy in radiation therapy.
To assess the impact of multimodality imaging and improved guidelines on reducing delineation errors and optimizing treatment margins.

Main Methods:

Utilized multimodality imaging, including computed tomography (CT)-magnetic resonance imaging (MRI) and CT-positron emission tomography (PET) coregistration.
Investigated the impact of improved delineation guidelines and an online anatomical atlas on observer agreement.
Calculated clinical target volume-planning target volume (CTV-PTV) margins incorporating delineation errors.

Main Results:

Multimodality imaging, particularly CT-MRI coregistration, significantly decreases target volume and variability in head and neck and prostate cancer.
CT-PET delineation shows promise for head and neck cancer.
Improved guidelines and coregistration increase observer agreement for target delineation in various cancers (prostate, lung, nasopharynx).

Conclusions:

Delineation errors in radiation therapy require similar margin considerations as setup and organ motion errors.
A calculated CTV-PTV margin incorporating delineation errors for head and neck cancer ranges from 6.1 to 9.7 mm.
Current delineated clinical target volumes may frequently overestimate the actual tumor volume, potentially impacting Intensity-Modulated Radiation Therapy (IMRT) efficacy.