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Direct and Repeated Clinical Measurement of pO2 for Enhancing Cancer Therapy
2014 Norris Cotton Cancer Center
Comprehensive Thoracic Oncology Program (CTOP) Retreat
Benjamin B. Williams, Ph.D.
The Geisel School of Medicine at Dartmouth, Departments of Medicine (Radiation Oncology) and Radiology
May 22, 2014
Clinical EPR at Dartmouth
Clinical problem
Parameter to be measured
Status of measurements in human subjects
Rationale for using in vivo EPR
Cancer
pO2 in tumors
Numerous measurements performed in patients with superficial tumors.
FDA IDE submitted for application of implantable oxygen sensors for application at increased depth and with increased sensitivity
NCI PPG proposal in review
Established collaborations with external academic institutions
The response of tumors to cytotoxic therapy, especially ionizing radiation, is critically dependent on pO2. Anti-tumor therapies are given repeatedly and often change pO2. Knowledge of the changes in individual patients would significantly optimize the timing of the therapy
Potential exposure to clinically significant doses of radiation
Radiation-induced EPR signals in teeth (magnitude is proportional to dose)
Underway in unirradiated volunteers and patients receiving significant doses to teeth from radiation therapy.
Measurements at remote locations possible using transportable device.
Established collaborations with external academic institutions
Exposures may occur from terrorism, war, or accident. In vivo EPR is the only physical method capable of making measurements ‘after-the-fact
Peripheral vascular disease
Oxygen at sites of likely pathologies
Measurements underway in normal volunteers.
The pO2 in the tissues is the most significant pathophysiological variable; no other method available to make such direct measurements.
Radiation Induced Fibrosis
pO2 in irradiated tumor beds and peripheral normal tissue
Recruitment and measurements underway
Radiation-induced hypoxia may play a critical role in the signaling
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