Computergestützte Assistenz zur Verbesserung der Therapie-Planung in der Kopf-Hals-Onkologie

 

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Zusammenfassung

Die Weiterentwicklungen in der Therapie von Patienten mit Kopf-Hals-Tumoren haben sich in den letzten Jahren differenziert. Durch die komplexen chirurgischen Verfahren, verschiedenste multimodale Therapieansätze, veränderte Techniken in der Bestrahlung (intensitätsmodulierte Radiotherapie – IMRT) und den zahlreichen neuen „targeted therapies“ kommt der präzisen Therapieplanung unter Berücksichtigung relevanter Parameter eine zunehmend zentrale Bedeutung zu. Daneben hat auch die Bildgebung z. B. mit der Implementierung der PET/CT Kombinationsgeräte zusätzlich zum gerätespezifischen Fortschritt deutliche Verbesserungen erfahren. Diese Erhöhung des prätherapeutischen Datenvolumens, einhergehend mit der Diversifikation der therapeutischen Optionen zwingt zu einer intensiveren Auseinandersetzung mit den Grundlagen von Therapieentscheidungen. Um diese Entscheidungen zu unterstützen, können computer­assistierte Systeme zur sinnvollen Aufarbeitung planungsrelevanter Daten hilfreich sein. Diese Arbeit beschreibt den Ist-Stand computerassistierter Systeme in der ersten Prüfung zur Kopf-Hals-Tumortherapieplanung. Hierbei spielt die Integration von 3-dimensionalen Patientenmodellen eine zentrale Rolle. Dieses Planungstool stellt die integrale Grundlage für den weiteren Ausbau von Bestrahlungsplanung, Tumordokumentation und Studienmanagement dar.

Abstract

Computer Assistance to Improve Therapy Planning for Head Neck Oncology

The ongoing development in therapies of head and neck malignomas has led to a further differentiation of treatment options. Complex surgical procedures, a wide variety of multi modal therapy options, changing radiation technologies (IMRT – Intensity-modulated radiation therapy) and numerous “targeted therapies” emphasize the need for a precise treatment plan. Beside this, imaging has seen significant improvements beyond the technical ones, e. g. with the implementation of PET/CT scanners. This increase in pre-therapeutic data volume, together with a diversification of treatment options calls for a further discussion of the basics of therapeutic decisions. Planning relevant data processing by computer assisted systems can aid in these decisions. This work describes the current status of relevant computer assisted systems undergoing first testing for head and neck cancer therapy planning. Here, the integration of 3-dimensional patient data plays a central role. This planning tool forms the integrated base for a further development in the areas of radiation planning, documentation and study management.

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