Beskrivelse
Radiotherapy is an important modality in curative management of locally advanced vulvar cancer. Radiotherapy is typically delivered in conjunction with chemotherapy and possibly surgery. Vulvar cancer is a relatively rare disease, and there is therefore very little knowledge about the pattern of loco-regional failures after radiotherapy. This lack of knowledge represents a missed opportunity as it impedes rational risk/benefit assessments when prescribing the radiation; the optimal radiation dose prescription strategy is disputed and many treatment decisions are guided from clinical trials of cervical cancer in the absence of vulvar cancer research.In this PhD project, our research group proposes a systematic analysis of loco-regional recurrences observed in the vulvar cancer patients treated in MD Anderson, Houston and Rigshospitalet, Copenhagen. CT, MR or PET/CT scans of loco-regional recurrences will be extracted from the picture archival systems (PACS) and recurrence volumes will be delineated based on all available clinical information. We will then use mathematical and biostatistical methods to relate the recurrence positions to the original diagnostic scan. Ultimately, the process will lead to a spatial map of the risk of recurrence in the historical cohort, which in turn will inform the treating physician of how to evaluate radiation dose plans and compromises between targets and normal tissues in future patients.
We will use the generated map of failure probability to suggest a modified, data driven dose prescription strategy targeting more of the radiation dose at regions with high risk of recurrence in patients with poor prognosis with current treatment. The potential to test such a strategy in a prospective trial will be assessed using biostatistical methods.
| Periode | 2015 → … |
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