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WO2024201253A1 - Combinaison de champs de traitement de tumeur avec planification de radiothérapie - Google Patents

Combinaison de champs de traitement de tumeur avec planification de radiothérapie Download PDF

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Publication number
WO2024201253A1
WO2024201253A1 PCT/IB2024/052791 IB2024052791W WO2024201253A1 WO 2024201253 A1 WO2024201253 A1 WO 2024201253A1 IB 2024052791 W IB2024052791 W IB 2024052791W WO 2024201253 A1 WO2024201253 A1 WO 2024201253A1
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WIPO (PCT)
Prior art keywords
radiation therapy
dosage
region
therapy
subject
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PCT/IB2024/052791
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English (en)
Inventor
Brian Berger
Nadav SHAPIRA
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Novocure GmbH
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Novocure GmbH
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Publication date
Application filed by Novocure GmbH filed Critical Novocure GmbH
Priority to EP24715885.0A priority Critical patent/EP4651791A1/fr
Priority to CN202480022558.1A priority patent/CN120957653A/zh
Priority claimed from US18/613,280 external-priority patent/US20240325786A1/en
Publication of WO2024201253A1 publication Critical patent/WO2024201253A1/fr
Anticipated expiration legal-status Critical
Pending legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/40—Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/06—Electrodes for high-frequency therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36002—Cancer treatment, e.g. tumour
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/3603—Control systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/103—Treatment planning systems
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00—ICT specially adapted for the handling or processing of medical images
    • G16H30/40—ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/02—Details
    • A61N1/04—Electrodes
    • A61N1/0404—Electrodes for external use
    • A61N1/0472—Structure-related aspects
    • A61N1/0476—Array electrodes (including any electrode arrangement with more than one electrode for at least one of the polarities)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/3603—Control systems
    • A61N1/36034—Control systems specified by the stimulation parameters

Definitions

  • Tumor treating fields are low intensity alternating electric fields within the intermediate frequency range (for example, 50 kHz to 1 MHz), which may be used to treat tumors as described in U.S. Patent No. 7,565,205.
  • TTFields are induced non- invasively into the region of interest by transducers placed on the patient’ s body and applying alternating current (AC) voltages between the transducers.
  • transducers used to generate TTFields include a plurality of electrode elements comprising ceramic disks. One side of each ceramic disk is positioned against the patient’s skin, and the other side of each disc has a conductive backing.
  • FIG. 1 depicts an example method for selecting one or more transducer layouts for delivering the TTFields to a subject.
  • FIGs. 2A-2D depict examples of various therapy regions.
  • FIG. 3 depicts an example apparatus to apply alternating electric fields to the subject’s body.
  • FIG. 4 depicts an example system for attaching transducers to the subject’s head for delivering TTFields.
  • FIGS. 5 A and 5B depict example structures of a transducer array.
  • FIG. 6 depicts one example of an apparatus to determine the locations of transducers for applying TTFields to the head of the subject.
  • This application describes exemplary techniques to computationally select and determine at least one transducer array layout for delivering TTFields to a subject.
  • Radiation therapy is applied to treat where a tumor is identified and located. Radiation therapy usually causes severe side effects and may be difficult to apply. For example, the inherent toxicity of radiation treatment may cause side effects that may outweigh the benefits from treating a tumor. Further, the human body may also have a lifetime maximum limit to the effectiveness of radiation treatment. Moreover, it may be undesirable to apply radiation therapy to certain regions of a subject’s body.
  • TTFields may be delivered to the subject, where TTFields may have much less side effects and have more flexibility in terms of tailoring tumor treatment plan.
  • one or more pairs of transducers are positioned on the subject’s body.
  • at least two pairs of transducers are used.
  • Transducers used to apply TTFields to the subject’s body often include multiple electrode elements coupled together on a substrate.
  • the inventors discovered computational techniques to determine and select one or more transducer layouts for delivering the TTFields to a subject in addition to existing radiation therapy.
  • the inventive techniques are particularly integrated into a practical application. For example, in some embodiments, treatment of more locations on the subject may be provided with less side effects compared to when using radiation alone. For example, in some embodiments, flexible deployment and combination of tumor treatment methods and dosage use may be employed for beneficial treatment of a tumor of the subject. In some embodiments, since the human body may have a lifetime maximum limit to the effectiveness of radiation treatment, a gap in treatment may occur, or may be prevented by using TTFields.
  • TTFields may be used to fill in the gap in coverage for radiation treatment by treating those areas of the subject that cannot receive radiation due to radiation-induced side effects and/or a lifetime maximum of radiation.
  • using TTFields may also simplify and/or speed up radiation treatment planning since a health care provider can use simpler radiation plans/procedures and supplementing with TTFields as needed.
  • FIG. 1 depicts an example computer-implemented method 100 for selecting one or more transducer layouts for delivering the TTFields to a subject.
  • the method 100 may be implemented by a computer, the computer including one or more processors and memory accessible by the one or more processors, the memory storing instructions that when executed by the one or more processors cause the computer to perform the steps of the method 100. Modifications, additions, or omissions may be made to method 100.
  • the method 100 includes, at Step 102, obtaining a three-dimensional (3D) model of the subject.
  • the model comprises voxels.
  • Each voxel of the model may be assigned a type of tissue (e.g., bone, organs, fluid, skin, or tumor) and/or an electrical conductivity associated with the type of tissue.
  • the model of the subject may represent a head of the subject.
  • the model of the subject may represent a torso of the subject. Other body parts of the subject may be represented in the model of the subject in other embodiments.
  • the model may be obtained using image data, for example, via a computer identifying the different types of tissue from the image data.
  • the image data may include one or more medical images of a portion of the subject’s body (e.g., X-ray images, magnetic resonance imaging (MRI), computerized tomography (CT) images, ultrasound images, or any images providing an internal view of the subject’s body).
  • Each medical image may include an outer shape of a portion of the subject and a region corresponding to the region of interest (e.g., tumor) within the subject.
  • the 3D model may be obtained, for example, from computer memory locally or over a network.
  • the method 100 may include identifying a radiation therapy region in the 3D model of the subject for delivering radiation therapy to a tumor of the subject.
  • the radiation therapy region may have a first radiation therapy region to receive a first dosage of radiation therapy and a second radiation therapy region to receive a second dosage of radiation therapy.
  • the first radiation therapy region may be unable to safely absorb the second dosage of radiation therapy, for example a spinal region, optic chasm, optic tract, pituitary gland, brain stem, hypothalamus, parotid, bowel, or skin.
  • the first dosage of radiation therapy may be based on user input.
  • the first and second dosages of radiation therapy may be in energy/mass units.
  • the first radiation therapy region may correspond to a region of the subject that is more sensitive to radiation therapy than a region of the subject corresponding to the second radiation therapy region. In some embodiments, the first radiation therapy region may correspond to a spinal region of the subject. In some embodiments, the first radiation therapy region may correspond to a region of the subject that is more difficult to apply radiation therapy than a region of the subject corresponding to the second radiation therapy region.
  • the first dosage of radiation therapy may be below a first threshold for the first radiation therapy region, wherein the first threshold is based on minimizing radiation therapy side effects for the subject and/or based on a limit of radiation therapy that may be applied to the first therapy region. In some embodiments, the first dosage of radiation therapy may be based on a region of the subject corresponding to the first radiation therapy region.
  • the first dosage of radiation therapy may be up to 50% less than, or up to 50% greater than, the second dosage of radiation therapy, or any amount in between. In some embodiments, the first dosage of radiation therapy is 50% or less than and greater than 0% of the second dosage of radiation therapy. In some embodiments, the first dosage of radiation therapy is 20% or less than and greater than 0% of the second dosage of radiation therapy. As an example, a first dosage of radiation therapy may be 45 Gray (“Gy”) and the second dosage of radiation therapy may be 75 Gy. The first dosage of radiation therapy may be 35, 40, 45, 50, 55, 60, 65, 70, or 75 Gy, or any value therebetween. The region receiving the first dosage of radiation therapy may overlap, partially overlap, or not overlap the region receiving the second dosage of radiation therapy.
  • the first and second dosages of radiation therapy may depend on the location of the tumor in the subject with respect to other tissue and/or organs of the subject.
  • the dosages of radiation therapy may be limited by predetermined radiation tolerances for tissue and/or organs of the subject.
  • predetermined radiation tolerances for tissue and/or organs of a subject are discussed in, for example: Emami B., “Tolerance of Normal Tissue to Therapeutic Radiation,” Reports of Radiotherapy and Oncology, Spring 2013, Vol. 1, No. 1, pages 35-48 (hereinafter “Emami 2013”); Bisello S.
  • predetermined radiation tolerances for tissue and/or organs of a subject are discussed in, for example: Table 2 of Emami 2013, which is reproduced as Table 1 below; Table 1 of Bisello 2022; Table 1 of Emami 1991; and Table 1 of Marks 2010.
  • the terms “first” and “second” as discussed herein with regards to dosages designate separate dosage amounts and do not necessarily indicate an order of application of the dosages.
  • the first dosage of radiation therapy may be applied in one, two, or more portions at separate times to obtain the first dosage of radiation therapy.
  • the second dosage of radiation therapy may be applied in one, two, or more portions at separate times to obtain the second dosage of radiation therapy.
  • a portion of the first dosage of radiation therapy and a portion of the second dosage of radiation therapy may be applied at the same time or at different times to the subject.
  • more than two radiation therapy regions may be needed.
  • the number of radiation therapy regions may depend on the number of tumor locations and/or their locations with respect to tissue and/or organs of the subject.
  • the method 100 may include identifying a TTFields therapy region in the 3D model of the subject for delivering the TTFields therapy to the tumor of the subject.
  • the TTFields therapy region may at least partially include the first radiation therapy region.
  • the TTFields therapy region may at least partially include the second radiation therapy region.
  • the method 100 may include identifying a first dosage for the TTFields therapy for the first radiation therapy region to compliment the first dosage of radiation therapy to achieve a cumulative dosage.
  • the cumulative dosage may be a predetermined therapeutic amount of dosage sufficient to treat or remove a tumor or cancerous tissue.
  • the cumulative dosage may be substantially equal to or greater than the second radiation dosage.
  • the first dosage for the tumor treating fields therapy for the first radiation therapy region may be based on the first dosage of radiation therapy for the first radiation therapy region.
  • the first dosage for the TTFields therapy may be in energy/volume units.
  • identifying the first dosage for the tumor treating fields therapy for the first radiation therapy region may include determining an approximate equivalent first dosage of radiation therapy for the first radiation therapy region in energy/volume units, and determining the first dosage for the tumor treating fields therapy for the first radiation therapy region based on the approximate equivalent first dosage of radiation therapy for the first radiation therapy region.
  • a combination (cumulative dosage) of the first dosage for the TTFields therapy for the first radiation therapy region and the first dosage of radiation therapy for the first radiation therapy region may meet or exceed a therapeutic dosage threshold for treating the tumor in the first radiation therapy region using radiation therapy alone.
  • the first dosage of radiation therapy for the first radiation therapy region may be less than a therapeutic dosage threshold for treating the tumor in the first radiation therapy region using radiation therapy alone.
  • a combination (cumulative dosage) of the first dosage for the TTFields therapy for the first radiation therapy region and the first dosage of radiation therapy for the first radiation therapy region may be less than a therapeutic dosage threshold for treating the tumor in the first radiation therapy region using the radiation therapy alone.
  • a combination (cumulative dosage) of the first dosage for the TTFields therapy for the first radiation therapy region and the first dosage of radiation therapy for the first radiation therapy region may be approximately equivalent to the second dosage of radiation therapy.
  • a therapeutic dosage threshold for treating a tumor in a radiation therapy region may be 45 Gy, because a higher dosage may perforate the bowel of the subject located next to the pancreas.
  • a dosage for the TTFields therapy for the first radiation therapy region may be applied in addition to a dosage of 45 Gy of radiation therapy for the first radiation therapy region, resulting a combination of dosage exceeding a therapeutic dosage threshold of using radiation therapy alone.
  • the method 100 may include identifying a second dosage for the TTFields therapy for the second radiation therapy region based on the second dosage of radiation therapy for the second radiation therapy region.
  • the method may include identifying a second dosage for the tumor treating fields therapy for the second radiation therapy region without regard to the second dosage of radiation therapy for the second radiation therapy region.
  • more than two dosages of tumor treating therapy may be needed.
  • the number of tumor treating therapies may depend on the number of tumor locations, the radiation dosages, the radiation therapy regions, and/or locations of the radiation therapy regions with respect to tissue and/or organs of the subject.
  • the method 100 may include determining a plurality of transducer layouts for delivering TTFields to the subject.
  • the transducer layouts in the plurality of transducer layouts may differ by at least one of location on the subject, size of the transducer, shape of the transducer, number of electrodes of the transducer, size of electrodes of the transducer, shape of electrodes of the transducer, or applied material and/or structure of the transducer.
  • the method 100 may include selecting one or more transducer layouts from the plurality of transducer layouts from the plurality of transducer layouts for delivering the TTFields to the subject.
  • the selection may be based on the first dosage for the TTFields therapy for the first radiation therapy region.
  • the selection may be further based on the second dosage for the tumor treating fields therapy for the second radiation therapy region.
  • At least one of the selected transducer layouts may be capable of providing the first dosage for the tumor treating fields therapy for the first radiation therapy region and a second dosage of the tumor treating fields therapy for the second radiation therapy region. In some embodiments, at least one of the selected transducer layouts may be capable of providing the first dosage for the tumor treating fields therapy for the first radiation therapy region and capable of providing a different dosage for the tumor treating fields therapy to at least one other region of the subject. In particular, the first dosage of the tumor treating fields therapy and the second dosage of the tumor treating fields therapy may be different.
  • the method 100 may include applying transducers to the subject using the selected transducer layout.
  • FIGs. 2A-2D depict examples of various therapy regions.
  • FIG. 2A shows a radiation therapy region 202 having therapy regions 204 and 206 and a TTFields therapy region 208 having therapy regions 206 and 210.
  • Therapy regions 204 and 206 may receive different radiation therapies, and therapy regions 206 and 210 may receive different TTFields therapies.
  • Therapy region 204 may only receive radiation therapy, and may correspond to a section of a tumor away from a sensitive or hard to reach area.
  • Therapy region 206 may receive both radiation therapy and TTFields therapy, and may correspond to a section of a tumor within or adjacent to a sensitive or hard to reach area.
  • 210 may only receive TTFields therapy.
  • FIG. 2B shows a radiation therapy region 212 that includes a full overlap with a TTFields therapy region 214.
  • a radiation therapy region 212 that includes a full overlap with a TTFields therapy region 214.
  • Such a region may correspond to a tumor fully situated within or adjacent to a sensitive or hard to reach tissue.
  • FIG. 2C shows a radiation therapy region 216 having a therapy region 218 that undergoes radiation alone, and may correspond to a section of a tumor away from a sensitive or hard to reach area.
  • a region 220 that receives both radiation and TTField therapies.
  • Region 220 may correspond to a section of a tumor within or adjacent to a sensitive or hard to reach area.
  • FIG. 2D shows a TTFields therapy region 222 having a therapy region 224 that undergoes TTFields therapy alone, and may correspond to a section of a tumor within or adjacent to a sensitive or hard to reach area and/or a section including potential locations for a tumor.
  • TTFields therapy region 222 Within the TTFields therapy region 222 are three radiation therapy regions 226, 228, and 230 that receive both radiation and TTFields therapies. Regions 226, 228, and 230 may correspond to a section of a tumor away from sensitive or hard to reach area. In some embodiments, the number of the radiation therapy regions may not limited to three and may be one, two, four, five, or more.
  • a tumor may be adjacent to normal tissue and/or may abut one or more organs of the subject.
  • the interplay between the TTFields therapy and the radiation therapy may effectively enable a reduction in radiation dosage when applying treatment to the subject.
  • FIG. 2A may represent applying treatment to a tumor adjacent an organ, for example, a tumor adjacent the bowel of a subject.
  • the TTFields therapy in region 208 may increase or compensate therapeutic dosage applied to the therapy region 206 only, so that the radiation dosage applied to the therapy region 206 may be reduced and/or does not exceed the corresponding therapeutic dosage threshold using radiation therapy alone.
  • FIG. 2B may represent applying treatment to a tumor in the middle of an organ or area, such as a tumor in spine area of the subject.
  • the TTFields therapy in region 214 may increase or compensate the therapeutic dosage applied to the entire therapy region 212, so that the radiation dosage applied to the therapy region 212 may be reduced and/or may not exceed the corresponding therapeutic dosage threshold using radiation therapy alone.
  • FIG. 2B may also represent applying treatment to a tumor in an organ that limits radiation dosage.
  • a lung (or both lungs) of the subject may have a limit of receiving radiation dosage based on size of the lung.
  • radiation dosage may need to be applied to the entire lung area at a certain minimum level while higher dosage is required for the tumor area. This may cause the entire radiation dosage for the lung to exceed the limit of receiving radiation dosage.
  • the TTFields therapy may be applied to the entire therapy region 212 to compensate for the radiation dosage applied to the entire lung area, so that the entire radiation dosage does not exceed the radiation limit.
  • FIG. 2C may represent another example of applying treatment to a tumor in an organ that limits radiation dosage.
  • the TTFields therapy may be applied to the TTFields therapy region 220 to compensate for the therapeutic dosage applied to the tumor, so that the entire radiation dosage does not exceed the radiation limit.
  • FIG. 2C may also represent applying treatment to the tumor about an organ of the subject.
  • the radiation therapy region 218, such as adjacent to and/or within the bowel of the subject the
  • TTFields therapy may be applied to the TTFields therapy region 220 only within the bowel area, so that the region 220 may receive additional therapeutic dosage.
  • FIG. 2D may represent applying treatment when not all of the tumor locations are detectable, for example, a spindly tumor in the brain of a subject.
  • the whole brain of the subject may include more than one tumor location, and there may be concern that not all locations of the tumor were detected in the medical image.
  • the whole brain may need to receive radiation treatment; however, an entire necessary dosage of radiation therapy may cause neuro toxicity.
  • tolerance radiation dosage of the whole brain may be 60 Gy, while a minimum dosage of 60 Gy may be needed to treat each individual tumor location.
  • radiation therapy may be applied to local areas 226, 228, and 230, which are determined to be the tumor locations, with lower dosage, such as 10 Gy for each local area 226, 228, and 230.
  • the TTFields therapy may be applied to the TTFields therapy region 224, such as the whole brain, to compensate the therapeutic dosage to the whole brain, including local areas 226, 228, and 230 determined to have the tumor and areas of the brain where no tumor is yet detected.
  • FIG. 3 depicts an example apparatus to apply alternating electric fields (e.g., TTFields) to the subject’s body.
  • the first transducer array 301 includes thirteen electrode elements 303, which are positioned on the substrate 304, and the electrode elements 303 are electrically and mechanically connected to one another through a conductive wiring 309.
  • the second transducer array 302 includes thirteen electrode elements 305, which are positioned on the substrate 306, and the electrode elements 305 are electrically and mechanically connected to one another through a conductive wiring 310.
  • the first transducer array 301 and the second transducer array 302 are connected to an AC voltage generator 307 and a controller 308.
  • the controller 308 may include one or more processors and memory accessible by the one or more processors.
  • the memory may store instructions that when executed by the one or more processors, control the AC voltage generator 307 to implement one or more embodiments of the invention.
  • the AC voltage generator 307 and the controller 308 may be integrated in the first transducer array 301 and the second transducer array 302 and form a first electric field generator and a second electric field generator.
  • the structure of the transducers may take many forms.
  • the transducers may be affixed to the subject’s body or attached to or incorporated in clothing covering the subject’s body.
  • the transducer may include suitable materials for attaching the transducer to the subject’s body.
  • the suitable materials may include cloth, foam, flexible plastic, and/or a conductive medical gel.
  • the transducer may be conductive or non- conductive.
  • a target region may be in the subject’s brain, and the TTFields may be delivered to the subject’s head via the two pairs of transducer arrays positioned on a head of the subject’s body (such as, for example, as shown in FIG. 4, which has four transducer arrays 400).
  • the target region may be in the subject’s lung, and the TTFields may be delivered to the subject’s body via two pairs of transducer arrays positioned around chest and back of the subject’s body.
  • the transducer may include any desired number of electrode elements. Various shapes, sizes, and materials may be used for the electrode elements. Any constructions for implementing the transducer (or electric field generating device) for use with embodiments of the invention may be used as long as they are capable of (a) delivering TTFields to the subject’s body and (b) being positioned at the locations specified herein.
  • at least one electrode element of the first, the second, the third, or the fourth transducer can include at least one ceramic disk that is adapted to generate an alternating electric field.
  • at least one electrode element of the first, the second, the third, or the fourth transducer comprises a polymer film that is adapted to generate an alternating field.
  • FIG. 5A depicts one example of an alternative design of the transducer array.
  • the transducer array 501 includes twenty electrode elements 502, which are positioned on the substrate 503, and the electrode element 502 are electrically and mechanically connected to one another through a conductive wiring 504.
  • the electrode elements 502 can include a ceramic disk.
  • FIG. 5B depicts one example of an alternative design of the transducer array.
  • the transducer 505 can include substantially flat electrode elements 506.
  • the electrode elements 506 are non-ceramic dielectric materials positioned over a plurality of flat conductors. Examples of non-ceramic dielectric materials positioned over flat conductors may include polymer films disposed over pads on a printed circuit board or over flat pieces of metal.
  • the electrode elements 506 are ceramic elements.
  • the electrode elements 502 and 506 can have various shapes.
  • the electrode elements can be triangular, rectangular, circular, oval, ovaloid, ovoid, or elliptical in shape or substantially triangular, substantially rectangular, substantially circular, substantially oval, substantially ovaloid, substantially ovoid, or substantially elliptical in shape.
  • FIG. 6 depicts an example computer apparatus for use with the embodiments herein.
  • the apparatus 600 may be a computer to implement certain inventive techniques disclosed herein, such as selecting at least one transducer layout for delivering the TTFields to a subject according to FIG. 1.
  • Steps 102 to 114 of FIG. 1 may be performed by a computer, such as computer apparatus 600.
  • the apparatus 600 may be used as the controller 308 of FIG. 3, or as a separate computer apparatus located remote from the controller 308.
  • Step 118 of FIG. 1 may be performed by a controller, such as controller 308.
  • the apparatus 600 may include one or more processors 602, a memory 604, and one or more output devices 606.
  • the one or more processors 602 generate control signals to control the voltage generator.
  • the input 608 is user input from one or more input device(s) (not shown).
  • the input 608 may be from another computer in communication with the controller apparatus 600.
  • the memory 604 is accessible by the one or more processors 602 (e.g., via a link 603) so that the one or more processors 602 can read information from and write information to the memory 604.
  • the memory 604 may store instructions that when executed by the one or more processors 602 implement one or more methods of the present disclosure.
  • the one or more output devices 606 may provide the status of the operation of the invention, such as transducer layout selection, voltages being generated, and other operational information.
  • the output device(s) 606 may provide visualization data according to certain embodiments of the invention.
  • the invention includes other illustrative embodiments (“Embodiments”) as follows.
  • Embodiment 1 A computer- implemented method for selecting at least one transducer layout for delivering tumor treating fields to a subject, the method comprising: obtaining a three-dimensional model of the subject, the model comprising voxels; identifying a radiation therapy region in the three-dimensional model of the subject for delivering radiation therapy to a tumor of the subject, the radiation therapy region comprising a first radiation therapy region to receive a first dosage of radiation therapy and a second radiation therapy region to receive a second dosage of radiation therapy, the first dosage of radiation therapy being smaller than the second dosage of radiation therapy; identifying a tumor treating fields therapy region in the three-dimensional model of the subject for delivering tumor treating fields therapy to the tumor of the subject, the tumor treating fields therapy region comprising the first radiation therapy region; identifying a first dosage for the tumor treating fields therapy for the first radiation therapy region to compensate for the first dosage of radiation therapy being smaller than the second dosage of radiation therapy; and selecting one or more transducer layouts for delivering tumor treating fields to the subject based on the first dosage for the
  • Embodiment 2 The computer-implemented method of claim 1, wherein the first radiation therapy region corresponds to a region of the subject that is more sensitive to radiation therapy than a region of the subject corresponding to the second radiation therapy region.
  • Embodiment 3 The computer- implemented method of claim 2, wherein the first radiation therapy region corresponds to a spinal region of the subject.
  • Embodiment 4 The computer-implemented method of claim 1, wherein the first dosage of radiation therapy is below a first threshold for the first radiation therapy region, wherein the first threshold is based on minimizing radiation therapy side effects for the subject.
  • Embodiment 5 The computer-implemented method of claim 1, wherein the first radiation therapy region corresponds to a region of the subject that is more difficult to apply radiation therapy than a region of the subject corresponding to the second radiation therapy region.
  • Embodiment 6 The computer-implemented method of claim 4, wherein the first radiation therapy region corresponds to a brain or lung region of the subject.
  • Embodiment 7 The computer-implemented method of claim 1, wherein the first radiation therapy region is unable to safely absorb the second dosage of radiation therapy.
  • Embodiment 8 The computer-implemented method of claim 1, wherein the first dosage of radiation therapy is based on a region of the subject corresponding to the first radiation therapy region.
  • Embodiment 9 The computer-implemented method of claim 1, wherein the first dosage of radiation therapy is 50% or less than and greater than 0% of the second dosage of radiation therapy.
  • Embodiment 10 The computer-implemented method of claim 1, wherein the first dosage of radiation therapy is 20% or less than and greater than 0% of the second dosage of radiation therapy.
  • Embodiment 11 The computer-implemented method of claim 1, wherein the first dosage of radiation therapy is based on user input.
  • Embodiment 12 The computer-implemented method of claim 1, wherein the first dosage for the tumor treating fields therapy for the first radiation therapy region is based on the first dosage of radiation therapy for the first radiation therapy region.
  • Embodiment 13 The computer-implemented method of claim 1, wherein the tumor treating fields therapy region in the three-dimensional model of the subject comprises a portion or all of the second radiation therapy region, wherein the method further comprises identifying a second dosage for the tumor treating fields therapy for the second radiation therapy region based on the second dosage of radiation therapy for the second radiation therapy region, and wherein selecting one or more transducer layouts for delivering tumor treating fields to the subject is further based on the second dosage for the tumor treating fields therapy for the second radiation therapy region.
  • Embodiment 14 The computer- implemented method of claim 1, wherein the tumor treating fields therapy region in the three-dimensional model of the subject comprises a portion or all of the second radiation therapy region, wherein the method further comprises identifying a second dosage for the tumor treating fields therapy for the second radiation therapy region without regard to the second dosage of radiation therapy for the second radiation therapy region, and wherein selecting one or more transducer layouts for delivering tumor treating fields to the subject is further based on the second dosage for the tumor treating fields therapy for the second radiation therapy region.
  • Embodiment 15 The computer-implemented method of claim 1, wherein a combination of the first dosage for the tumor treating fields therapy for the first radiation therapy region and the first dosage of radiation therapy for the first radiation therapy region meets or exceeds a therapeutic dosage threshold for treating the tumor in the first radiation therapy region using radiation therapy alone, wherein the first dosage of radiation therapy for the first radiation therapy region is less than a therapeutic dosage threshold for treating the tumor in the first radiation therapy region using radiation therapy alone.
  • Embodiment 16 The computer-implemented method of claim 1, wherein a combination of the first dosage for the tumor treating fields therapy for the first radiation therapy region and the first dosage of radiation therapy for the first radiation therapy region is less than a therapeutic dosage threshold for treating the tumor in the first radiation therapy region using the radiation therapy alone.
  • Embodiment 17 The computer-implemented method of claim 1, wherein the first dosage of radiation therapy is in energy/mass units, wherein the first dosage for the tumor treating fields therapy is in energy/volume units, and wherein identifying the first dosage for the tumor treating fields therapy for the first radiation therapy region comprises: determining an approximate equivalent first dosage of radiation therapy for the first radiation therapy region in energy/volume units; and determining the first dosage for the tumor treating fields therapy for the first radiation therapy region based on the approximate equivalent first dosage of radiation therapy for the first radiation therapy region.
  • Embodiment 18 The computer-implemented method of claim 1, wherein the first and second dosages of radiation therapy are in energy/mass units, wherein a cumulative dosage of the first dosage for the tumor treating fields therapy for the first radiation therapy region and the first dosage of radiation therapy for the first radiation therapy region is approximately equivalent to or greater than the second dosage of radiation therapy.
  • Embodiment 19 The computer-implemented method of claim 1, wherein at least one of the selected transducer layouts is capable of providing the first dosage for the tumor treating fields therapy for the first radiation therapy region and a second dosage of the tumor treating fields therapy for the second radiation therapy region, wherein the first dosage of the tumor treating fields therapy and the second dosage of the tumor treating fields therapy are different.
  • Embodiment 20 The computer-implemented method of claim 1, wherein at least one of the selected transducer layouts is capable of providing the first dosage for the tumor treating fields therapy for the first radiation therapy region and capable of providing a different dosage for the tumor treating fields therapy to at least one other region of the subject.
  • Embodiment 21 The computer-implemented method of claim 1, further comprising determining a plurality of transducer layouts for delivering tumor treating fields to the subject, wherein the at least one transducer layout is selected from the plurality of transducer layouts, wherein the transducer layouts in the plurality of transducer layouts differ by at least one of location on the subject, size of the transducer, shape of the transducer, number of electrodes of the transducer, size of electrodes of the transducer, or shape of electrodes of the transducer.
  • Embodiment 22 An apparatus for selecting at least one transducer layout for delivering tumor treating fields to a subject, the apparatus comprising: one or more processors; and memory accessible by the one or more processors, the memory storing instructions that when executed by the one or more processors, cause the apparatus to: obtain a three-dimensional model of the subject, the model comprising voxels; identify a radiation therapy region in the three-dimensional model of the subject for delivering radiation therapy to a tumor of the subject, the radiation therapy region comprising a first radiation therapy region to receive a first dosage of radiation therapy, the first dosage of radiation therapy being smaller than a therapeutic threshold for treating the tumor in the first radiation therapy region; identify a tumor treating fields therapy region in the three-dimensional model of the subject for delivering tumor treating fields therapy to the tumor of the subject, the tumor treating fields therapy region comprising the first radiation therapy region; identify a first dosage for the tumor treating fields therapy for the first radiation therapy region, wherein combining the first dosage of radiation therapy and the first dosage for the tumor treating fields therapy in the first
  • Embodiment 23 A non-transitory processor readable medium containing a set of instructions thereon that when executed by a processor cause the processor to: obtain a three- dimensional model of the subject, the model comprising voxels; identify a radiation therapy region in the three-dimensional model of the subject for delivering radiation therapy to a tumor of the subject, the radiation therapy region comprising a first radiation therapy region to receive a first dosage of radiation therapy and a second radiation therapy region to receive a second dosage of radiation therapy, the first dosage of radiation therapy being less than the second dosage of radiation therapy; identify a tumor treating fields therapy region in the three-dimensional model of the subject for delivering tumor treating fields therapy to the tumor of the subject, the tumor treating fields therapy region comprising the first radiation therapy region; identify a first dosage for the tumor treating fields therapy for the first radiation therapy region based on the first dosage of radiation therapy for the first radiation therapy region; and select one or more transducer layouts for delivering tumor treating fields to the subject based on the first dosage for the tumor treating fields therapy for the
  • Embodiments illustrated under any heading or in any portion of the disclosure may be combined with embodiments illustrated under the same or any other heading or other portion of the disclosure unless otherwise indicated herein or otherwise clearly contradicted by context.
  • embodiments described in dependent claim format for a given embodiment e.g., the given embodiment described in independent claim format
  • other embodiments described in independent claim format or dependent claim format

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  • Life Sciences & Earth Sciences (AREA)
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  • Urology & Nephrology (AREA)
  • Pathology (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

L'invention concerne un procédé mis en œuvre par ordinateur consistant à : obtenir un modèle tridimensionnel d'un sujet ; identifier une région de radiothérapie dans le modèle pour l'administration d'une radiothérapie à une tumeur du sujet, la région de radiothérapie comprenant une première et une seconde région de radiothérapie pour respectivement recevoir une première et une seconde dose de radiothérapie ; identifier une région de thérapie par champs de traitement de tumeur dans le modèle pour l'administration d'une thérapie par champs de traitement de tumeur à la tumeur, la région de thérapie par champs de traitement de tumeur comprenant la première région de radiothérapie ; identifier une première dose pour la thérapie par champs de traitement de tumeur pour la première région de radiothérapie pour compenser le fait que la première dose de radiothérapie est inférieure à la seconde dose de radiothérapie ; et sélectionner une ou plusieurs dispositions de transducteur pour l'administration de champs de traitement de tumeur au sujet sur la base de la première dose pour la thérapie par champs de traitement de tumeur pour la première région de radiothérapie.
PCT/IB2024/052791 2023-03-31 2024-03-22 Combinaison de champs de traitement de tumeur avec planification de radiothérapie Pending WO2024201253A1 (fr)

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CN202480022558.1A CN120957653A (zh) 2023-03-31 2024-03-22 组合肿瘤治疗电场与放射治疗计划

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070239213A1 (en) * 2006-04-05 2007-10-11 Yoram Palti Treating cancer using electromagnetic fields in combination with other treatment regimens
US7565205B2 (en) 2000-02-17 2009-07-21 Standen Ltd. Treating a tumor or the like with electric fields at different orientations
US20180160933A1 (en) * 2016-12-13 2018-06-14 Novocure Limited Treating Patients with TTFields with the Electrode Positions Optimized Using Deformable Templates
US20210292741A1 (en) * 2020-03-23 2021-09-23 The Board Of Regents Of The University Of Texas System Combination therapeutics using tumor treating fields (ttfields)

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7565205B2 (en) 2000-02-17 2009-07-21 Standen Ltd. Treating a tumor or the like with electric fields at different orientations
US20070239213A1 (en) * 2006-04-05 2007-10-11 Yoram Palti Treating cancer using electromagnetic fields in combination with other treatment regimens
US20180160933A1 (en) * 2016-12-13 2018-06-14 Novocure Limited Treating Patients with TTFields with the Electrode Positions Optimized Using Deformable Templates
US20210292741A1 (en) * 2020-03-23 2021-09-23 The Board Of Regents Of The University Of Texas System Combination therapeutics using tumor treating fields (ttfields)

Non-Patent Citations (5)

* Cited by examiner, † Cited by third party
Title
BISELLO S. ET AL.: "Dose-Volume Constraints fOr oRganS At risk In Radiotherapy (CORSAIR): An ''All-in-One'' Multicenter-Multidisciplinary Practical Summary", CURRENT ONCOLOGY, vol. 29, 2022, pages 7021 - 7050
EMAMI B ET AL.: "Tolerance of Normal Tissue to Therapeutic Irradiation", INT J RADIAT ONCOL BIOL PHYS, vol. 21, 1991, pages 109 - 122, XP026844473
EMAMI B.: "Reports of Radiotherapy and Oncology", vol. 1, 2013, SPRING, article "Tolerance of Normal Tissue to Therapeutic Radiation", pages: 35 - 48
MARKS L.B. ET AL.: "Use of Normal Tissue Complication Probability Models in the Clinic", INT. J. RADIATION ONCOLOGY BIOL. PHYS., vol. 76, no. 3, 2010, pages S10 - S19, XP026917155, DOI: 10.1016/j.ijrobp.2009.07.1754
YUNHUI JO: "Tumor treating fields (TTF) treatment enhances radiation-induced apoptosis in pancreatic cancer cells", INTERNATIONAL JOURNAL OF RADIATION BIOLOGY., vol. 96, no. 12, 1 December 2020 (2020-12-01), GB, pages 1528 - 1533, XP093160987, ISSN: 0955-3002, Retrieved from the Internet <URL:https://dx.doi.org/10.1080/09553002.2020.1838658> DOI: 10.1080/09553002.2020.1838658 *

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