Apparatus for treating solid tumors, treatment plan planning method, device, and system

Abstract

The present disclosure provides a device for treating solid tumors, a treatment plan planning method, equipment and system, relating to the technical field of medical devices, for solving the technical problem that the existing treatment plan has certain limitations. The device for treating solid tumors comprises a low-dose radiotherapy nested stereotactic radiotherapy system; the low-dose radiotherapy nested stereotactic radiotherapy system is used for low-dose radiotherapy on the whole of the solid tumor, and stereotactic radiotherapy on the local solid tumor. The present disclosure can formulate a reasonable treatment plan for a single solid tumor or multiple solid tumors of a patient through the synergistic treatment mode of low-dose radiotherapy and stereotactic radiotherapy.

Description

[0001] This application claims priority to Chinese Patent Application No. 202310612915.7, filed May 29, 2023, the contents of which are incorporated herein by reference in its entirety. TECHNICAL FIELD

[0002] The present application relates to the technical field of medical devices, and in particular to a device for treating solid tumors, a treatment plan planning method, equipment and a system. BACKGROUND

[0003] Immune checkpoint inhibitors (ICI) have shown significant efficacy in the treatment of various tumors, but the efficacy is not ideal for large lesion solid tumors, especially for large lesion solid tumors larger than 7 cm. This is because there are many anoxic necrotic areas in large lesions, and the number and function of infiltrating lymphocytes are not sufficient to effectively control the tumor, often requiring combined radiotherapy and chemotherapy. Such patients often fail multiple-line treatment, and the efficacy of immunotherapy and chemotherapy is limited.

[0004] Stereotactic body radiotherapy (SBRT) is a special radiotherapy method, also known as stereotactic ablative radiotherapy (SABR), which precisely projects high-dose radiation onto tumor lesions, thereby performing targeted treatment on the tumor. SBRT can induce immunogenic cell death and effectively induce anti-tumor immunity. However, SBRT is generally used to treat tumors with a size of no more than 5 cm, especially central lung cancer located within 2 cm of the bronchial tree, which is a "no-fly zone" for SBRT. Due to the limitation of normal tissue dose constraints, whole lesion SBRT is not suitable for treating large lesion solid tumors.

[0005] Low dose radiotherapy (LDRT) refers to radiotherapy using a total dose of ≤10 Gy and a single fraction of ≤2 Gy. LDRT can trigger immune regulation and remodel the tumor microenvironment, thereby enhancing immune infiltration. However, the direct killing effect of LDRT on tumors is small, and the treatment effect is limited.

[0006] Currently, the treatment mode of LDRT and SBRT cooperation is usually applied to the treatment of multiple tumors, that is, LDRT is used to irradiate large tumors, and SBRT is used to irradiate small tumors, which has certain limitations. SUMMARY

[0007] In order to solve the problems in the prior art, the present disclosure provides a device for treating a solid tumor, a treatment plan planning method, equipment and a system, which can formulate a reasonable treatment plan through the cooperative treatment mode of LDRT and SBRT in the treatment scene of a single tumor.

[0008] In a first aspect, the present application provides a device for treating a solid tumor, comprising a low-dose radiotherapy nested stereotactic radiotherapy system.

[0009] The low-dose radiotherapy nested stereotactic radiotherapy system is used for low-dose radiotherapy on the whole solid tumor and stereotactic radiotherapy on the local solid tumor.

[0010] Optionally, the solid tumor is a solid tumor with a diameter greater than or equal to 7 cm.

[0011] Optionally, the solid tumor is any one of the following: lung cancer, liver cancer, thymoma, and metastatic tumor to the lung and / or liver.

[0012] Optionally, the dose of low-dose radiotherapy is 2 Gy / time, the treatment frequency of low-dose radiotherapy is 1 time per day, and the treatment number of low-dose radiotherapy is 1-3 times.

[0013] Optionally, the dose of stereotactic radiotherapy is 8 Gy / time-15 Gy / time, the treatment frequency of stereotactic radiotherapy is 1 time per day, and the treatment number of stereotactic radiotherapy is 1-3 times.

[0014] Optionally, the tumor target area of stereotactic radiotherapy is located in the radiotherapy area of low-dose radiotherapy, and the tumor target volume of stereotactic radiotherapy is less than or equal to the volume of a sphere with a diameter of 3 cm.

[0015] Optionally, the stereotactic radiotherapy has 1-3 tumor target areas.

[0016] Optionally, when the number of tumor target areas of stereotactic radiotherapy is multiple, the mutual distance in the three-dimensional space of any two tumor target areas of stereotactic radiotherapy should not have 50% isodose curve overlap.

[0017] As can be seen from the above, in the present application, stereotactic radiotherapy (SBRT) refers to the use of super large dose fraction irradiation, usually with a fraction number not greater than 5 times, and a single dose greater than 6 Gy; low-dose radiotherapy (LDRT) refers to a total dose ≤10 Gy, and a single fraction ≤2 Gy.

[0018] Compared with the prior art, the present application has the following beneficial effects:

[0019] The present application is aimed at large lesion solid tumors, uses LDRT to treat the entire solid tumor, and uses SBRT to treat the local solid tumor, that is, adopts a treatment mode of LDRT nested SBRT.

[0020] Secondly, SBRT can create an immunogenic cell death zone within a large tumor, where tumor cells undergo immunogenic cell death and release tumor-specific antigens, activating dendritic cells and tumor-specific T cells. LDRT can play an immunomodulatory role throughout the entire large lesion, reshaping the tumor microenvironment and promoting the migration of these activated tumor-specific T cells throughout the entire large lesion. This combined treatment modality not only avoids the toxic side effects of SBRT directly irradiating the entire large lesion, but also fully utilizes the immunoactivating effects of SBRT and LDRT, further enhancing the anti-tumor immunity of PD-1 inhibitors, thus achieving a comprehensive and synergistic anti-tumor therapeutic effect.

[0021] Compared with existing radiotherapy methods combined with immune checkpoint inhibitors for tumor treatment, the low-dose radiotherapy combined with stereotactic radiotherapy method of this application combined with immune checkpoint inhibitors has a better effect on tumor treatment.

[0022] In summary, this application addresses the limitation of existing radiotherapy techniques in treating single large tumor lesions by providing a low-dose radiotherapy combined with stereotactic radiotherapy (SBRT) technique for treating single large tumor lesions. This application combines low-dose radiotherapy (LDRT) of the entire large tumor lesion with stereotactic radiotherapy (SBRT) of a specific area within the lesion; this LDRT-SBRT treatment can synergistically exert the therapeutic effect of immune checkpoint inhibitors, achieving excellent therapeutic results and possessing significant clinical implications for tumor treatment.

[0023] Secondly, a treatment planning method is provided, comprising: acquiring a simulated localization image of a target object; the simulated localization image shows at least one solid tumor of the target object; determining, based on the simulated localization image, a low-dose radiotherapy zone and a stereotactic radiotherapy target zone for each solid tumor of the target object; wherein the stereotactic radiotherapy target zone is located within the low-dose radiotherapy zone; planning a treatment plan for the target object based on the low-dose radiotherapy zone and the stereotactic radiotherapy target zone for each solid tumor of the target object; wherein, in the treatment plan, the dose for the low-dose radiotherapy zone is less than the dose for the stereotactic radiotherapy target zone.

[0024] It can be learned from the above that the treatment plan planning method provided by the present disclosure can obtain a simulation positioning image of a target object, and determine a radiotherapy area of low-dose radiotherapy and a tumor target area of stereotactic radiotherapy of each solid tumor of the target object based on the simulation positioning image. Subsequently, a treatment plan of the target object can be planned based on the radiotherapy area of low-dose radiotherapy and the tumor target area of stereotactic radiotherapy of each solid tumor of the target object. The tumor target area of stereotactic radiotherapy is located in the radiotherapy area of low-dose radiotherapy. In the treatment plan, the dose for the radiotherapy area of low-dose radiotherapy is less than the dose for the tumor target area of stereotactic radiotherapy.

[0025] In this way, the present disclosure can plan different doses for the radiotherapy area of low-dose radiotherapy and the tumor target area of stereotactic radiotherapy, so that the radiotherapy area of low-dose radiotherapy and the tumor target area of stereotactic radiotherapy can be treated cooperatively, a reasonable and effective treatment plan is generated, and the treatment effect is improved.

[0026] Optionally, the tumor target area of stereotactic radiotherapy is a spherical shape with a diameter of 1-2 cm.

[0027] Optionally, the number of the tumor target area of stereotactic radiotherapy is at least one.

[0028] Optionally, when the number of the tumor target area of stereotactic radiotherapy is multiple, the 50% isodose curve in the three-dimensional space of any two tumor target areas of stereotactic radiotherapy does not overlap.

[0029] Optionally, the dose of low-dose radiotherapy is 1 Gy / time-3 Gy / time, the treatment frequency of low-dose radiotherapy is 1 time per day, and the treatment number of low-dose radiotherapy is 1-3 times.

[0030] Optionally, the dose of stereotactic radiotherapy is 8 Gy / time-15 Gy / time, the treatment frequency of stereotactic radiotherapy is 1 time per day, and the treatment number of stereotactic radiotherapy is 1-3 times.

[0031] Optionally, the treatment number of low-dose radiotherapy is the same as the treatment number of stereotactic radiotherapy.

[0032] Optionally, the treatment plan planning method is executed in the case that the maximum diameter of the solid tumor of the target object is greater than or equal to 5 cm.

[0033] Optionally, the target object is injected with an immunosuppression inhibitor.

[0034] In a third aspect, an electronic device is provided, including: a processor; a memory configured to store processor-executable instructions; and wherein the processor is configured to execute the instructions to implement the method of any one of the second aspect.

[0035] In a fourth aspect, a radiotherapy system is provided, comprising: a TPS server and a radiotherapy device; the TPS server is configured to implement the method of any one of the second aspect; and the radiotherapy device is configured to perform radiotherapy on a low-dose radiotherapy zone of each solid tumor of a target object and a tumor target zone of stereotactic radiotherapy.

[0036] In a fifth aspect, a non-transitory storage medium is provided, the non-transitory storage medium storing a computer program, the computer program being read and executed to implement the method of any one of the second aspect.

[0037] Obviously, according to the above content of the present application, according to the ordinary technical knowledge and common means in the art, other various forms of modifications, replacements or changes can be made without departing from the above basic technical idea of the present application.

[0038] The above content of the present application will be further described in detail through the specific embodiments in the form of examples. However, it should not be understood that the scope of the above subject matter of the present application is limited to the following examples. Any technology implemented based on the above content of the present application belongs to the scope of the present application. BRIEF DESCRIPTION OF DRAWINGS

[0039] The accompanying drawings are used to better understand the present application and do not limit the present disclosure. Among them:

[0040] Figure 1 The SBRT target zone definition schematic diagram provided for the embodiments of the present application.

[0041] Figure 2 The radiotherapy system structure schematic diagram provided for the embodiments of the present application.

[0042] Figure 3 The treatment planning method flowchart schematic diagram provided for the embodiments of the present application.

[0043] Figure 4 The result graph of the low-dose radiotherapy nested stereotactic radiotherapy technology for treating large lesion solid tumors provided for the embodiments of the present application.

[0044] Among them, Figure 4 A in is the waterfall chart of the best tumor response of the large nested small radiotherapy lesions; B is the progression-free survival (PFS) and overall survival (OS) curve graph of the patient; C is the response to treatment and treatment duration graph of the 39 patients.

[0045] Figure 5 The result graph of the low-dose radiotherapy nested stereotactic radiotherapy combined with PD-1 inhibitor treatment provided for the embodiments of the present application.

[0046] Figure 6 The mechanism summary graph of the low-dose radiotherapy nested stereotactic radiotherapy provided for the embodiments of the present application.

[0047] Figure 7 A schematic diagram of a treatment process of a mouse provided in an embodiment of the present application.

[0048] Figure 8 A tumor volume and survival rate result diagram of mice in each group provided in an embodiment of the present application after being treated by different radiotherapy methods.

[0049] wherein, Figure 8 A is a tumor volume change diagram of CT26 cell model mice after being treated by different radiotherapy methods; B is a tumor volume change diagram of LLC1 cell model mice after being treated by different radiotherapy methods; C is a survival rate result diagram of CT26 cell model mice after being treated by different radiotherapy methods; D is a survival rate result diagram of LLC1 cell model mice after being treated by different radiotherapy methods.

[0050] Figure 9 A structural schematic diagram of an electronic device provided in an embodiment of the present application. DETAILED DESCRIPTION

[0051] The technical solutions in the embodiments of the present disclosure will be described clearly and completely below with reference to the drawings in the embodiments of the present disclosure. Obviously, the described embodiments are only part of the embodiments of the present disclosure, rather than all the embodiments. Based on the embodiments in the present disclosure, all other embodiments obtained by those skilled in the art without creative labor fall within the scope of protection of the present disclosure.

[0052] In the description of the present disclosure, it should be understood that the orientation or positional relationship indicated by the terms “center”, “longitudinal”, “lateral”, “length”, “width”, “thickness”, “upper”, “lower”, “front”, “back”, “left”, “right”, “vertical”, “horizontal”, “top”, “bottom”, “inner”, “outer” and the like is based on the orientation or positional relationship shown in the drawings, and is only for the convenience of describing the present disclosure and simplifying the description, and does not indicate or imply that the device or element referred to must have a particular orientation, be constructed and operated in a particular orientation, and therefore cannot be understood as a limitation on the present disclosure. In addition, the terms “first”, “second”, “third” are only for the purpose of description, and cannot be understood as indicating or implying relative importance or implicitly indicating the number of the technical features indicated. Therefore, the features limited by “first”, “second”, “third” can explicitly or implicitly include one or more of the features. In the description of the present disclosure, the meaning of “multiple” is two or more, unless otherwise specifically limited.

[0053] In the description of the present disclosure, the word "exemplary" is used to mean "serving as an example, instance, or illustration." Any implementation described as "exemplary" in the present disclosure is not necessarily to be construed as preferred or advantageous over other implementations. The following description is presented to enable any person skilled in the art to make and use the present disclosure. In the following description, for purposes of explanation, specific details are set forth to provide a thorough understanding of the present disclosure. It will be apparent to one skilled in the art, however, that the present disclosure can be practiced without using these specific details. In other instances, well-known structures and processes are not elaborated in detail in order not to obscure the description of the present disclosure. Thus, the present disclosure is not intended to be limited to the embodiments shown, but is to be accorded the widest scope consistent with the principles and features disclosed herein.

[0054] It should be noted that the method of the embodiments of the present disclosure is executed in the server, and the processing objects of the server exist in the form of data or information, such as time, which is actually time information. It can be understood that in subsequent embodiments, if the size, quantity, position and the like are mentioned, they all exist in the corresponding data for the server to process, and specific details are not described here.

[0055] Before introducing the device for treating solid tumors, the treatment plan planning method, the equipment and the system provided by the embodiments of the present application, first, the various concepts involved in the embodiments of the present application are introduced.

[0056] 1. Simulation positioning

[0057] The Computed Tomography (CT) simulation positioning technology is adopted, and a body position fixing device must be used during positioning to ensure the repeatability of radiotherapy positioning and the accuracy of treatment. The acceptable fixing forms include but are not limited to α-bracket, vacuum bag, hard pillow, thermoplastic film and stereotactic frame.

[0058] The clinical standard simulation positioning technology is adopted, CT simulation positioning is performed, image acquisition and target area delineation are performed, including Gross Tumor Volume (GTV), Planning Target Volume (PTV) and normal organs. The tumor target volume is defined as the primary lesion and positive lymph nodes visible in the image. The planning target volume is defined as the range of GTV outside the three-dimensional direction by 0.5-1.0 cm.

[0059] In the present application, enhanced CT can be used for simulation positioning to facilitate target area delineation, but if the electronic density of the enhanced tissue image is too high to affect the radiotherapy plan making, the enhanced CT can be fused with the plain CT for radiotherapy plan making.

[0060] The simulation positioning is the first step in radiotherapy, which can be performed by the method of the present application or by other conventional methods in the art.

[0061] 2. Target volume definition

[0062] The target volume definition, i.e. the target volume delineation, is a necessary step in radiotherapy, which is responsible for the target volume delineation and normal tissue delineation by a radiotherapist. The present application adopts the fludeoxyglucose-positron emission computed tomography (FDG-PET) / CT and / or enhanced CT to guide the target volume delineation. Other conventional methods in the art can also be used.

[0063] 2.1 LDRT target volume definition

[0064] The LDRT target volume of the tumor target volume (Gross Target Volume, GTV) can be named as: GTVldrt.

[0065] The visible tumor (primary tumor, metastatic lymph node, other metastatic lesions, etc.) displayed by CT, PET scan, bronchoscopy or mediastinoscopy, etc. When there is atelectasis of lung lobe or segment, the PET image can be used to distinguish lung atelectasis.

[0066] The LDRT target volume of the planning target volume (Planning Target Volume, PTV) can be named as: PTVldrt

[0067] When the lesion is treated by LDRT, the PTV range is considered as the GTV range with 0.5-1.0 cm outward in three-dimensional direction during the target volume definition.

[0068] 2.2 SBRT target volume definition

[0069] The SBRT target volume (i.e. the tumor target volume of stereotactic radiotherapy) of the tumor target volume (Gross Target Volume, GTV) can be named as: GTVsbrt

[0070] CT, PET scan, bronchoscopy or mediastinoscopy, etc. The visible tumor (primary tumor, metastatic lymph node, other metastatic lesions, etc.) is displayed. The clinical radiotherapy physician combines FDG-PET / CT images and selects the GTVldrt inner region as the SBRT irradiation region (GTVsbrt) according to the three principles of avoiding the central area (SBRT "no-fly zone" within 2 cm of the bronchial tree), crossing the necrotic area, and avoiding the atelectasis area. GTVsbrt can be a spherical volume with a diameter of less than or equal to 3 cm (or a spheroid), which can be a regular spherical volume or a volume approximating a sphere (such as an ellipsoidal sphere, etc.). For example, the diameter of GTVsbrt can be a spherical volume (V = 4 / 3πr 3 ) with a diameter of 1-2 cm. In clinical practice, 1 to 3 GTVsbrt can be set according to the size of GTV. In the target area of each GTVsbrt in three-dimensional space, the mutual distance should not have 50% isodose curve overlap (see Figure 1 ).

[0071] 2.3 Treatment plan

[0072] 2.3.1 SBRT: Stereotactic radiotherapy is also called stereotactic ablative radiotherapy (SABR), which is usually divided into no more than 5 fractions, and the single dose is greater than 6Gy. Under the strict control of the normal tissue dose, stereotactic technology and special radiation devices are used to focus multiple sources, multiple beams or multiple fields of high-energy radiation in three-dimensional space on a target area in the body, so that tumor cells and interstitial cells (such as vascular endothelial cells) are effectively killed.

[0073] 2.3.2 LDRT: Low-dose radiotherapy is defined as a total dose ≤10Gy, and a single fraction ≤2Gy. Intensity modulated radiation therapy (IMRT) is used to achieve conformal radiotherapy for large GTV.

[0074] 2.4 Dose prescription

[0075] The treatment dose calculation software system (TPS) of the radiotherapy equipment is used for target delineation, irradiation field arrangement, and dose calculation. GTVsbrt is embedded in GTVldrt to implement radiotherapy. SBRT starts on the first day, once a day, with a dose of 8Gy / time-15Gy / time, for a total of 1-3 times. LDRT starts on the same day as SBRT, once a day, with a dose of 2Gy / time, for a total of 1-3 times. The LDRT prescription dose covers 95% of PTV.

[0076] 2.5 Radiotherapy machine (i.e. radiotherapy system)

[0077] The radiation implemented by the embodiments of the present application can be X-ray, gamma ray, alpha ray, beta ray, heavy ion (GTVsbrt), neutron, proton, electron, muon, etc. or any combination thereof.

[0078] The energy level of the radiation can be suitable for radiotherapy and can be energy with a megavolt (MV) level. For example only, the energy of the X-ray can be 6 MV.

[0079] 2.6 Treatment indications: This technology is suitable for single tumor large lesions in parallel organs (lungs, liver).

[0080] 2.7 The treatment planning design provided by the embodiments of the present application needs to avoid the organs at risk

[0081] SBRT organs at risk limits:

[0082] Spinal cord: The shape of the spinal canal needs to be drawn to represent the spinal cord. The maximum dose limit of SBRT spinal cord is 18Gy (6Gy / fraction).

[0083] Esophagus: The maximum dose limit is: 27Gy (9Gy / fraction).

[0084] Brachial plexus: The maximum dose limit is: 24Gy (8Gy / fraction).

[0085] Heart / Pericardium: The heart needs to be drawn on all levels. The upper boundary should include the right ventricular infundibulum and the top of the two atria, but large blood vessels should be removed as much as possible, and the lower boundary is the lowest point of the left ventricle and should be separated from the liver. The maximum dose limit is: 30Gy (10Gy / fraction).

[0086] Trachea and proximal bronchus: The maximum dose limit is: 30Gy (10Gy / fraction).

[0087] Ribs: The maximum dose limit is: 30Gy (10Gy / fraction).

[0088] Skin: The maximum dose limit is: 24Gy (8Gy / fraction).

[0089] The impact of LDRT on organs at risk can be superimposed with SBRT, and the specific case is referred to the relevant provisions of NCCN guidelines 2021 edition 1 and RTOG for radiotherapy. The clinical radiotherapy physician should evaluate the dose parameters and equivalent biological dose of each organ at risk in detail and make adjustments according to the actual situation. The limits of the remaining organs at risk are referred to the relevant provisions of NCCN guidelines 2021 edition 1 and RTOG for SBRT radiotherapy.

[0090] The application scenarios of the present application are described below.

[0091] As described in the background, LDRT refers to radiotherapy using a total dose of ≤10 Gy and a single fraction of ≤2 Gy. Studies have found that LDRT can trigger immune regulation, heat remodeling the tumor microenvironment, and enhance immune infiltration.

[0092] That is, at present, the treatment mode of LDRT and SBRT cooperation is usually applied to the scene of treating multiple tumors, that is, LDRT is used to irradiate large volume tumors, and SBRT is used to irradiate small volume tumors, which has certain limitations.

[0093] In view of the above problems, the present application provides a device for treating solid tumors, a treatment planning method, equipment and system, which can formulate a reasonable treatment plan for each of the single solid tumor or multiple solid tumors of the patient in the treatment scene of a single tumor through the treatment mode of LDRT and SBRT cooperation.

[0094] The device for treating solid tumors provided by the present application can include a low-dose radiotherapy nested stereotactic radiotherapy system.

[0095] The low-dose radiotherapy nested stereotactic radiotherapy system is used for low-dose radiotherapy on the whole solid tumor and stereotactic radiotherapy on the local solid tumor.

[0096] Optionally, the above-mentioned solid tumor to be treated is a solid tumor with a diameter greater than or equal to 5 cm, for example, a solid tumor with a diameter greater than or equal to 7 cm.

[0097] Optionally, the above-mentioned solid tumor to be treated is any of the following: lung cancer, liver cancer, thymoma, and metastatic tumor to the lung and / or liver.

[0098] Optionally, the dose of the above-mentioned low-dose radiotherapy is 2 Gy / time, the treatment frequency of the low-dose radiotherapy is 1 time per day, and the treatment number of the low-dose radiotherapy is 1-3 times.

[0099] Optionally, the dose of the above-mentioned stereotactic radiotherapy is 8 Gy / time-15 Gy / time, the treatment frequency of the stereotactic radiotherapy is 1 time per day, and the treatment number of the stereotactic radiotherapy is 1-3 times.

[0100] Optionally, the radiotherapy area of the above-mentioned low-dose radiotherapy is a planned target volume area covering 95% and above.

[0101] Optionally, the tumor target area of the above-mentioned stereotactic radiotherapy is located in the radiotherapy area of the low-dose radiotherapy, the tumor target area of the stereotactic radiotherapy is a spheroid volume or a sphere volume less than or equal to 3 cm in diameter, and the tumor target area of the stereotactic radiotherapy is a spheroid with a diameter of 1-2 cm.

[0102] Optionally, the above-mentioned stereotactic radiotherapy has 1-3 tumor target areas.

[0103] Optionally, when the number of tumor target regions of the above stereotactic radiotherapy is multiple, the mutual distance between any two tumor target regions of the stereotactic radiotherapy in the three-dimensional space of the target region should not have 50% isodose curve overlap.

[0104] In some embodiments, the present application also provides a radiotherapy system capable of implementing low-dose radiotherapy and stereotactic radiotherapy in a nested manner. The radiotherapy system is used to perform low-dose radiotherapy on the whole of a solid tumor and stereotactic radiotherapy on a part of the solid tumor. As shown in the figure, the radiotherapy system 201 can include a radiotherapy device 202 (i.e., the above-mentioned radiotherapy machine) and a TPS server 203. The radiotherapy device 202 and the TPS server 203 can be communicatively connected. Figure 2

[0105] The radiotherapy device 202 performs radiotherapy on the low-dose radiotherapy region of each solid tumor of the target object and the tumor target region of the stereotactic radiotherapy by emitting radiation.

[0106] Optionally, the radiotherapy device 202 can include a radiation source and a treatment bed. The radiation source is used to emit radiation, which can be X-rays, gamma rays, alpha rays, beta ray beams, heavy ions, neutrons, protons, electrons, muons, etc., or any combination thereof. The treatment bed is used to carry the target object (e.g., a patient or a model), and the treatment bed can be a three-dimensional bed or a six-dimensional bed.

[0107] It should be noted that the radiation for performing radiotherapy on the low-dose radiotherapy region of each solid tumor of the target object and the tumor target region of the stereotactic radiotherapy can be the same type of radiation or different types of radiation. In one possible example, the radiation source for emitting radiation on the low-dose radiotherapy region of each solid tumor of the patient and the tumor target region of the stereotactic radiotherapy is the same, for example, a medical linear accelerator that can emit MV-level X-rays. On the one hand, the radiation source can adapt the emitted X-rays to one or more shapes that match the low-dose radiotherapy region, thereby performing low-dose radiotherapy on the low-dose radiotherapy region. On the other hand, the radiation source can also limit the emitted X-rays to one or more narrow X-ray beams, thereby performing stereotactic radiotherapy on the tumor target region of the stereotactic radiotherapy. In another possible example, the radiation source for emitting radiation on the low-dose radiotherapy region of each solid tumor of the patient and the tumor target region of the stereotactic radiotherapy is more than two different radiation sources, for example, one of the radiation sources is a medical linear accelerator that can adapt the emitted MV-level X-rays to corresponding shapes for performing low-dose radiotherapy on the low-dose radiotherapy region, and the other radiation source is a multi-source rotating focused gamma knife that focuses multiple gamma rays emitted by multiple cobalt sources at the isocenter of the radiotherapy device 202 for performing stereotactic radiotherapy on the tumor target region of the stereotactic radiotherapy. ​

[0108] The TPS server 203 is configured to implement the treatment plan planning method provided by the embodiments of the present disclosure to form a treatment plan for each solid tumor of the target object.

[0109] Optionally, the TPS server 203 can be a standalone physical server, or a server cluster or distributed file system composed of multiple physical servers, or at least one of a cloud server providing basic cloud computing services such as cloud service, cloud database, cloud computing, cloud function, cloud storage, network service, cloud communication, middleware service, domain name service, security service, content distribution network, and big data or artificial intelligence platform. The embodiments of the present disclosure do not limit this. In some embodiments, the number of TPS servers 203 can be more or less, and the embodiments of the present disclosure do not limit this. Of course, the TPS server 203 can also include other functions to provide more comprehensive and diversified services.

[0110] The method provided by the embodiments of the present disclosure will be introduced below based on the radiotherapy system composed of the implementation environment shown in Figure 2 The radiotherapy system shown in FIG. 1.

[0111] Figure 3 is a flowchart of a treatment plan planning method shown by the embodiments of the present disclosure. In some embodiments, the treatment plan planning method is applied to the TPS server in the radiotherapy system shown in Figure 2 The method includes the following steps.

[0112] S301, acquiring a simulation positioning image of a target object.

[0113] In the simulation positioning image, the solid tumor of the target object is at least one, for example, 1, 2, 3 or more.

[0114] Optionally, the target object can be a patient to be treated, or an experimental object, or a phantom.

[0115] Optionally, the target object can be injected with an immunosuppressive molecule inhibitor.

[0116] The immunosuppressive molecule inhibitor can be a programmed cell death receptor 1 (PD-1) inhibitor, or a programmed cell death ligand 1 (PD-L1), and the embodiments of the present disclosure do not limit this.

[0117] Optionally, the TPS server can acquire the simulation positioning image of the target object by simulating positioning of the target object by at least one of the following imaging techniques: FDG-PET imaging technique, CT imaging technique, enhanced CT imaging technique, and MR imaging technique.

[0118] In acquiring the simulation positioning image of the target object, the target object needs to be positioned first. During positioning, a body position fixing device needs to be used to ensure the repeatability of radiotherapy positioning and the accuracy of treatment.

[0119] Optionally, the fixable forms of the target object include, but are not limited to, an alpha support, a vacuum bag, a hard pillow, a thermoplastic film, and a stereotactic frame.

[0120] S302, determining a radiotherapy area of low-dose radiotherapy and a tumor target area of stereotactic radiotherapy of each solid tumor of the target object based on the simulation positioning image.

[0121] The tumor target area of stereotactic radiotherapy is located in the radiotherapy area of low-dose radiotherapy.

[0122] Specifically, the TPS server can first acquire a tumor target volume (i.e., GTV) of each solid tumor of the target object based on the simulation positioning image, and then perform externalization on the GTV (e.g., externalization of 0.5-1.0 cm in three-dimensional directions) to obtain a planning target volume (i.e., PTV) of each solid tumor of the target object. Then, the TPS server can determine the radiotherapy area of low-dose radiotherapy and the tumor target area of stereotactic radiotherapy according to the PTV.

[0123] Optionally, the TPS server can perform contouring on the simulation positioning image based on a target area contouring technique to obtain the radiotherapy area of low-dose radiotherapy. Then, the TPS server can arrange at least one target point in the radiotherapy area of low-dose radiotherapy based on an operation of acquiring arrangement of target points (which can also be referred to as a target arrangement operation), so as to obtain the tumor target area of stereotactic radiotherapy.

[0124] The target area contouring technique can be manual contouring by a physician according to experience, automatic contouring of the TPS server according to a preset contouring algorithm, or a combination of the above two contouring techniques, which is not limited in the embodiments of the present application.

[0125] Optionally, the radiotherapy area of low-dose radiotherapy can be a planning target volume area covering 95% or more. For example, the TPS server can determine the entire region of the PTV as the radiotherapy area of low-dose radiotherapy. In this way, most of the region in the planning target volume area can be irradiated.

[0126] Optionally, the tumor target region for stereotactic radiotherapy is a spheroid volume of 3 cm or less in diameter. For example, the tumor target region for stereotactic radiotherapy is a spheroid volume of 1-2 cm.

[0127] In practical applications, the tumor target region for stereotactic radiotherapy can be flexibly modified according to actual conditions, and the embodiments of the present application do not limit this.

[0128] Optionally, the number of tumor target regions for stereotactic radiotherapy can be at least one. In practical applications, the number of tumor target regions for stereotactic radiotherapy is usually 1-3.

[0129] In practical applications, the number and / or size of the tumor target region for stereotactic radiotherapy can be flexibly arranged according to actual conditions, and the embodiments of the present application do not limit this.

[0130] Optionally, when the number of tumor target regions for stereotactic radiotherapy is multiple (for example, 2 or 3), the 50% isodose curve in the three-dimensional space of any two adjacent tumor target regions for stereotactic radiotherapy does not overlap, thereby ensuring the treatment effect of the target object.

[0131] It should be noted that when determining (or arranging) the tumor target region for stereotactic radiotherapy, it is necessary to be away from the atelectasis region, the tumor center region, the necrosis region, and the normal organs, etc.

[0132] S303, based on the low-dose radiotherapy region of each solid tumor of the target object and the tumor target region for stereotactic radiotherapy, planning a treatment plan for the target object.

[0133] Among them, the dose of the low-dose radiotherapy region in the above treatment plan is less than the dose of the tumor target region for stereotactic radiotherapy.

[0134] In one implementation manner, the TPS server can determine the first treatment prescription and the second treatment prescription, and the maximum dose limit acceptable to the critical organ, and plan a treatment plan for the target object according to the first treatment prescription, the second treatment prescription, and the maximum dose limit acceptable to the critical organ.

[0135] Among them, the first treatment prescription is the treatment prescription of the low-dose radiotherapy region. The second treatment prescription is the treatment prescription of the tumor target region for stereotactic radiotherapy.

[0136] The treatment prescription of the low-dose radiotherapy region (i.e. the first treatment prescription) can be: the dose of the low-dose radiotherapy can be 1 Gy / time-3 Gy / time, the treatment frequency of the low-dose radiotherapy can be 1 time per day, and the treatment number of the low-dose radiotherapy can be 1-3 times.

[0137] In practical applications, the dose of the low-dose radiotherapy is usually 2 Gy / time, which can be flexibly modified according to actual conditions, and the embodiments of the present application do not limit this.

[0138] Correspondingly, the treatment frequency and the number of treatments of the low-dose radiotherapy can also be flexibly modified according to actual conditions, and the embodiments of the present application do not limit this.

[0139] The treatment prescription (i.e., the second treatment prescription) of the tumor target region of the stereotactic radiotherapy can be that the dose of the stereotactic radiotherapy can be 8 Gy / time-15 Gy / time, the treatment frequency of the stereotactic radiotherapy can be 1 time per day, and the number of treatments of the stereotactic radiotherapy can be 1-3 times.

[0140] In practical applications, the dose of the stereotactic radiotherapy is usually 10 Gy / time, which can be flexibly modified according to actual conditions, and the embodiments of the present application do not limit this.

[0141] Correspondingly, the treatment frequency and the number of treatments of the stereotactic radiotherapy can also be flexibly modified according to actual conditions, and the embodiments of the present application do not limit this.

[0142] Optionally, the number of treatments of the low-dose radiotherapy is the same as the number of treatments of the stereotactic radiotherapy.

[0143] The organ at risk and the maximum dose limit acceptable to the organ at risk can refer to the detailed description of the organ at risk to be avoided in the treatment plan design in the above 2.7, which is not repeated here.

[0144] In some embodiments, since the treatment plan planning method provided by the present application is usually applied to the scenario of a large solid tumor, the present application can execute the treatment plan planning method provided by the present application when the diameter of the solid tumor of the target object is greater than or equal to 5 cm.

[0145] Optionally, since the solid tumor of the target object can be irregular in shape, the present application can execute the treatment plan planning method provided by the present application when the maximum diameter of the solid tumor of the target object is greater than or equal to 5 cm.

[0146] The device for treating a solid tumor, the treatment plan planning method, the equipment and the system provided by the present application will be described in detail below in combination with a specific clinical treatment example.

[0147] In an implementable manner, the device for treating a solid tumor, the treatment plan planning method, the equipment and the system provided by the present application can be described in detail by taking the example of treating a large-lesion solid tumor by using the low-dose radiotherapy nested in the stereotactic radiotherapy technology.

[0148] The low-dose radiotherapy and stereotactic body radiotherapy combined with PD-1 inhibitor (a comprehensive treatment method, which is used together with the PD-1 inhibitor in the process of low-dose radiotherapy and stereotactic body radiotherapy, to treat tumor patients) has achieved good efficacy in patients with large solid tumors. From May 2020 to January 2023, a total of 39 patients with advanced (37 patients with stage IV) refractory large solid tumors or tumor emergencies who failed standard treatment received this therapy, with an average lesion diameter of 6.8 cm (3-14.7 cm).

[0149] The average target volume of LDRT and SBRT was 173.5 cm 3 (31.5-982.0 cm 3 ) and 0.97 cm 3 (0.5-11.2 cm 3 ), respectively. The objective response rate of the large-in-small irradiated lesions was 48.7% (19 / 39) (as shown in A of Figure 4 ). Among them, 15 cases were evaluated as partial remission (38.5%), and 13 cases were stable disease. The median PFS was 5.6 months, and the median OS had not been reached (as shown in B and C of Figure 4 ). There was no adverse reaction above grade 3.

[0150] In some embodiments, the following introduces a typical case of low-dose radiotherapy and stereotactic body radiotherapy combined with PD-1 inhibitor treatment provided by the present application

[0151] As shown in Figure 5 , case 1, an 84-year-old male, was diagnosed with stage IVB (cT3N3M1c) lung squamous carcinoma. He had orthopnea, elevated PaCO2, and superior vena cava syndrome, with an ECOG score of 3. CT scan showed a 6.1x5.5 cm mass in the right anterior mediastinum and dilated veins (as shown in case 1 of Figure 5 ). PD-L1 expression was negative, and there was no EGFR mutation and ALK translocation. On May 5, 2020, the lung tumor lesion was treated with low-dose radiotherapy and stereotactic body radiotherapy, with a dose of 8 Gy x 1 (GTVsbrt 0.95 cm 3 ), and the LDRT dose was 2.4 Gy x 1 (whole tumor, 109 cm 3 ). The next day, sintilimab was used. Two days after low-dose radiotherapy and stereotactic body radiotherapy, the patient's orthopnea was relieved, and the ECOG score was reduced to 1. On June 16, 2020, the patient's efficacy evaluation was stable disease (SD), and the CT scan showed no dilated veins (as shown in Figure 5(As shown in Case 1). The patient received sintilimab for cycles 2 through 12 until July 26, 2021. The patient maintained stable disease (SD) for 16.3 months until death from a cardiovascular event on October 12, 2021.

[0152] like Figure 5 Case 2 illustrates a 64-year-old male patient with lung adenocarcinoma cT4N3M1 IV, ECOG score 3-4. He was PD-L1 positive (72%) and had no driver gene mutations. In July 2021, the patient was admitted to the emergency department due to dyspnea and underwent low-dose stereotactic radiotherapy (SBRT) with 9 Gy × 1 dose applied to a portion of the tumor (1.07 cm²). 3 LDRT (2 Gy × 1) was administered to the entire tumor (volume 335.58 cm³). 3 The patient was given pembrolizumab the following day. After treatment, the patient's dyspnea significantly improved. Three weeks later, a second and third low-dose stereotactic radiotherapy treatment was administered (completed within two days), with the same fractionation as before, combined with pembrolizumab and pemetrexed. One month later, the patient achieved partial remission (PR) and has since been on maintenance therapy with pembrolizumab and pemetrexed.

[0153] like Figure 5 Case 3 illustrates a 48-year-old female patient with thymoma type B2 and mediastinal lymph node and left pleural metastases who had failed second-line chemotherapy. PD-L1 was unknown, and there were no driver gene mutations. In April 2022, SBRT (10 Gy × 3) was used to irradiate the central tumor region (volume 1.98 cm²). 3 ), LDRT (6 Gy × 3) irradiated the entire tumor (volume 877.21 cm³). 3 The patient was subsequently treated with paclitaxel in combination with sintilimab. Two months later, the patient achieved partial remission (PR) and remains alive to this day.

[0154] The summary diagram of the low-dose radiotherapy-intussusception stereotactic radiotherapy mechanism in this application is shown below. Figure 6 As shown.

[0155] In some embodiments, the effects of different radiotherapy techniques combined with PD-1 antibody therapy provided in this application are described below.

[0156] C57BL / 6 mice were injected with CT26 cells and LLC1 cells to construct colon cancer mouse and lung cancer mouse models, respectively. After 10 days of modeling, the successfully modeled mice were subjected to radiotherapy: (1) LDRT (whole tumor irradiation), 2 Gy each time, once a day, for a total of 3 times; (2) SBRT (tumor central irradiation), 10 Gy each time, once a day, for a total of 3 times; (3) the low-dose radiotherapy stacking stereotactic radiotherapy (LDRT stacking SBRT) of the present application, LDRT 2 Gy each time (whole tumor irradiation), SBRT 10 Gy each time (tumor central irradiation), both once a day, for a total of 3 times. At the same time, starting from the implementation of radiotherapy, each mouse was injected with PD-1 antibody, once every 3 days, for a total of 7 times, 200 μg per mouse each time. The control mice were only modeled and not treated. The schematic diagram of the mouse treatment process is shown in Figure 7 .

[0157] The tumor volumes and survival rates of the four groups of mice were observed, and the results are shown in Figure 8 . It can be seen from Figure 8 that the efficacy of the low-dose radiotherapy stacking stereotactic radiotherapy combined with PD-1 antibody treatment is significantly better than that of low-dose radiotherapy and stereotactic radiotherapy alone in controlling large lesion solid tumors in mice. The use of the low-dose radiotherapy stacking stereotactic radiotherapy of the present application significantly enhances the control of large lesion solid tumor growth Figure 8 (A and B), and prolongs the survival time of mice Figure 8 (C and D).

[0158] The above experiments show that the low-dose radiotherapy stacking stereotactic radiotherapy of the present application is significantly better than low-dose radiotherapy and stereotactic radiotherapy alone, and is suitable for the treatment of large lesion tumors.

[0159] In summary, the present application provides a low-dose radiotherapy stacking stereotactic radiotherapy technique for treating single large lesion tumors in view of the limited treatment effect of existing radiotherapy techniques on single large lesion tumors. The present application found that low-dose radiotherapy (LDRT) for the entire tumor large lesion, combined with stereotactic radiotherapy (SBRT) for part of the large lesion, i.e., LDRT stacking SBRT treatment, can exert a synergistic immune checkpoint inhibitor treatment effect and achieve excellent treatment effect on tumors, which is of great significance for the clinical treatment of tumors.

[0160] The above describes the scheme of the embodiments of the present application mainly from the method aspect. It can be understood that, in order to implement the above functions, the TPS server comprises a hardware structure and / or a software module for executing each function. Those skilled in the art should easily realize that, in combination with the units and algorithm steps of each example described in the embodiments disclosed herein, the embodiments of the present application can be implemented in the form of hardware or a combination of hardware and computer software. Whether a certain function is implemented in the form of hardware or computer software driven hardware depends on the specific application and design constraints of the technical solution. Those skilled in the art can use different methods to implement the described functions for each specific application, but such implementation should not be considered beyond the scope of the embodiments of the present application.

[0161] The embodiments of the present application can divide the functional units of the TPS server according to the above method examples. For example, each functional unit can be divided according to each function, or two or more functions can be integrated in one processing unit. The integrated unit can be implemented in the form of hardware or software functional unit. It should be noted that the division of units in the embodiments of the present application is illustrative, and is only a logical function division. In actual implementation, there can be another division method.

[0162] In some embodiments, the embodiments of the present application provide a treatment plan planning device, which can be applied to a TPS server, comprising: an acquisition unit and a processing unit.

[0163] The acquisition unit is configured to acquire a simulation positioning image of a target object, and the solid tumor of the target object in the simulation positioning image is at least one. For example, the solid tumor can be 1-3.

[0164] The processing unit is configured to determine a low-dose radiotherapy area of each solid tumor of the target object and a tumor target area of stereotactic radiotherapy based on the simulation positioning image, and the tumor target area of stereotactic radiotherapy is located in the low-dose radiotherapy area.

[0165] The treatment plan of the target object is planned based on the low-dose radiotherapy area of each solid tumor of the target object and the tumor target area of stereotactic radiotherapy. In the treatment plan, the dose for the low-dose radiotherapy area is less than the dose for the tumor target area of stereotactic radiotherapy.

[0166] Optionally, the low-dose radiotherapy area is a planned target volume area covering 95% or more.

[0167] Optionally, the tumor target area of stereotactic radiotherapy is a spherical shape with a diameter of 1-2 cm.

[0168] Optionally, the number of tumor target areas of stereotactic radiotherapy is at least one, for example, 3.

[0169] Optionally, when the number of tumor target regions for stereotactic radiotherapy is multiple, 50% isodose curves in a three-dimensional space of any two tumor target regions for stereotactic radiotherapy do not overlap.

[0170] Optionally, the dose of low-dose radiotherapy is 1 Gy / time-3 Gy / time, the treatment frequency of low-dose radiotherapy is 1 time per day, and the treatment number of low-dose radiotherapy is 1-3 times.

[0171] Optionally, the dose of stereotactic radiotherapy is 8 Gy / time-15 Gy / time, the treatment frequency of stereotactic radiotherapy is 1 time per day, and the treatment number of stereotactic radiotherapy is 1-3 times.

[0172] Optionally, the treatment number of low-dose radiotherapy is the same as the treatment number of stereotactic radiotherapy.

[0173] Optionally, the processing unit is specifically configured to:

[0174] determine a first treatment prescription and a second treatment prescription; wherein the first treatment prescription is a treatment prescription of a radiotherapy region of low-dose radiotherapy, and the second treatment prescription is a treatment prescription of a tumor target region of stereotactic radiotherapy;

[0175] determine a maximum dose limit acceptable to an organ at risk;

[0176] plan a treatment plan of the target object according to the first treatment prescription, the second treatment prescription, and the maximum dose limit acceptable to the organ at risk.

[0177] Optionally, the target object is injected with an immunosuppression inhibitor.

[0178] According to the embodiments of the present disclosure, the present disclosure also provides an electronic device, comprising at least one processor; and a memory connected with the at least one processor in communication; wherein the memory stores instructions executable by the at least one processor, and the instructions are executed by the at least one processor to enable the at least one processor to execute the treatment plan planning method provided by the present disclosure.

[0179] According to the embodiments of the present disclosure, the present disclosure also provides a non-transitory computer-readable storage medium storing computer instructions, wherein the computer instructions are used to enable an electronic device to execute the treatment plan planning method provided by the present disclosure.

[0180] According to the embodiments of the present disclosure, the present disclosure also provides a computer program product comprising a computer program, which, when executed by a processor, implements the treatment plan planning method provided by the present disclosure.

[0181] In some embodiments, the electronic device can be a TPS server shown in the above Figure 2 .Figure 9 A schematic block diagram of an example electronic device 900 that can be used to implement embodiments of the present disclosure is shown. Electronic device 900 is intended to represent various forms of digital computers, such as laptop computers, desktop computers, workstations, personal digital assistants, servers, blade servers, mainframe computers, and other suitable computers. Electronic device 900 may also represent various forms of mobile devices, such as personal digital processors, cellular phones, smartphones, wearable devices, and other similar computing devices. The components shown herein, their connections and relationships, and their functions are merely illustrative and are not intended to limit the implementation of the present disclosure described and / or claimed herein.

[0182] like Figure 9 As shown, the electronic device 900 includes a computing unit 901, which can perform various appropriate actions and processes based on a computer program stored in a read-only memory (ROM) 902 or a computer program loaded from a storage unit 908 into a random access memory (RAM) 903. The RAM 903 may also store various programs and data required for the operation of the electronic device 900. The computing unit 901, ROM 902, and RAM 903 are interconnected via a bus 904. An input / output (I / O) interface 905 is also connected to the bus 904.

[0183] Multiple components in electronic device 900 are connected to I / O interface 905, including: input unit 906, such as keyboard, mouse, etc.; output unit 907, such as various types of displays, speakers, etc.; storage unit 908, such as disk, optical disk, etc.; and communication unit 909, such as network card, modem, wireless transceiver, etc. Communication unit 909 allows electronic device 900 to exchange information / data with other devices through computer networks such as the Internet and / or various telecommunications networks.

[0184] The computing unit 901 can be various general and / or special purpose processing components with processing and computing capabilities. Some examples of the computing unit 901 include, but are not limited to, a central processing unit (CPU), a graphics processing unit (GPU), various specialized artificial intelligence (AI) computing chips, various computing units running machine learning model algorithms, a digital signal processor (DSP), and any appropriate processor, controller, microcontroller, and the like. The computing unit 901 performs various methods and processes described above, such as the treatment plan planning method. For example, in some embodiments, the treatment plan planning method can be implemented as a computer software program that is tangibly embodied in a machine-readable medium, such as the storage unit 908. In some embodiments, part or all of the computer program can be loaded and / or installed onto the electronic device 900 via the ROM 902 and / or the communication unit 909. When the computer program is loaded onto the RAM 903 and executed by the computing unit 901, one or more steps of the treatment plan planning method described above can be performed. Alternatively, in other embodiments, the computing unit 901 can be configured to perform the treatment plan planning method by any other appropriate means, such as by means of firmware.

[0185] Various implementations of the systems and techniques described above herein can be realized in digital electronic circuitry, integrated circuitry, a field programmable gate array (FPGA), an application specific integrated circuit (ASIC), an application specific standard product (ASSP), a system on chip (SOC), a complex programmable logic device (CPLD), computer hardware, firmware, software, and / or combinations thereof. These various implementations can include implementation in one or more computer programs that are executable and / or interpretable on a programmable system including at least one programmable processor, which can be special or general purpose, coupled to receive data and instructions from, and to transmit data and instructions to, a storage system, at least one input device, and at least one output device.

[0186] Program code for carrying out methods of the present disclosure can be written in any combination of one or more programming languages. The program code can be provided to a processor or controller of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the program code, when executed by the processor or controller, produces the functions / operations specified in the flowcharts and / or block diagrams. The program code can be executed entirely on a machine, partially on a machine, partially on a machine as a stand-alone software package, partially on a machine and partially on a remote machine or entirely on a remote machine or server.

[0187] In the context of the present disclosure, a machine-readable medium can be a tangible medium that contains or stores a program for use by or in connection with an instruction execution system, apparatus, or device. The machine-readable medium can be a machine-readable signal medium or a machine-readable storage medium. A machine-readable medium can include but is not limited to an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any suitable combination of the foregoing. More specific examples of the machine-readable storage medium would include one or more lines of electrical connections, portable computer disks, hard disk drives, random access memory, read-only memory, erasable programmable read-only memory (EPROM or Flash memory), optical fibers, portable compact disc read-only memories (CD-ROMs), optical storage devices, magnetic storage devices, or any suitable combination of the foregoing.

[0188] To provide for interaction with a user, the systems and techniques described here can be implemented on a computer having a display device, e.g., a Cathode Ray Tube (CRT) or Liquid Crystal Display (LCD) monitor, for displaying information to the user and a keyboard and a pointing device, e.g., a mouse or a trackball, by which the user can provide input to the computer. Other kinds of devices can be used to provide for interaction with a user as well; for example, feedback provided to the user can be any form of sensory feedback, e.g., visual feedback, auditory feedback, or tactile feedback; and input from the user can be received in any form, including acoustic, speech, or tactile input.

[0189] The systems and techniques described here can be implemented in a computing system that includes a back end component (e.g., as a data server), or that includes a middleware component (e.g., an application server), or that includes a front end component (e.g., a user computer having a graphical user interface or a Web browser through which a user can interact with an implementation of the systems and techniques described here), or any combination of such back end, middleware, or front end components. The components of the system can be interconnected by any form or medium of digital data communication (e.g., a communication network). Examples of communication networks include a local area network (LAN), a wide area network (WAN), and the Internet.

[0190] The computer system can include clients and servers. This relationship can be. The servers are typically remote from the clients with the interactions between them occurring over a communication network. The relationship between a client and a server is one of client-server. The server can be a cloud server, a server of a distributed system, or a server incorporating a blockchain.

[0191] It should be understood that the various forms of flow shown above can be re-ordered, added to, or deleted from without departing from the scope of the present disclosure. For example, the steps recited in the present disclosure can be executed in parallel, executed in series, or executed in different orders, as long as the desired results of the technical solutions of the present disclosure are achieved, and the present disclosure is not limited herein.

[0192] The specific implementation described above does not constitute a limitation on the protection scope of the present disclosure. Those skilled in the art should understand that various modifications, combinations, sub-combinations, and substitutions can be made according to design requirements and other factors. Any modifications, equivalent replacements, and improvements within the spirit and principles of the present disclosure should be included in the protection scope of the present disclosure.

Claims

1. A treatment plan planning method applied to a TPS server, characterized in that, The method comprises: acquiring a simulation positioning image of a target object, wherein a solid tumor of the target object in the simulation positioning image is at least one, and a maximum diameter of the solid tumor is greater than or equal to 5 cm; performing a contouring operation on the simulation positioning image based on the simulation positioning image and a preset contouring algorithm to obtain a low-dose radiotherapy radiotherapy zone of each solid tumor of the target object, wherein the low-dose radiotherapy radiotherapy zone is a planned target volume zone covering 95% or more; in response to an operation of arranging a target point, arranging at least one target point in the low-dose radiotherapy radiotherapy zone to obtain a stereotactic radiotherapy tumor target zone of the solid tumor, wherein, for the same solid tumor, the stereotactic radiotherapy tumor target zone is located in the low-dose radiotherapy radiotherapy zone; based on the low-dose radiotherapy radiotherapy zone and the stereotactic radiotherapy tumor target zone of each solid tumor of the target object, determining a first treatment prescription of the low-dose radiotherapy radiotherapy zone and a second treatment prescription of the stereotactic radiotherapy tumor target zone and a maximum dose limit acceptable to an organ at risk, and planning a treatment plan of the target object according to the first treatment prescription, the second treatment prescription, and the maximum dose limit acceptable to the organ at risk; in the treatment plan, a dose for the low-dose radiotherapy radiotherapy zone is less than a dose for the stereotactic radiotherapy tumor target zone; wherein the low-dose radiotherapy dose is 1 Gy / time-3 Gy / time, the low-dose radiotherapy treatment frequency is 1 time per day, and the low-dose radiotherapy treatment number is 1-3 times.

2. The method of claim 1, wherein, The stereotactic radiotherapy tumor target zone is a sphere-like shape with a diameter of 1-2 cm.

3. The method of claim 1, wherein, When the number of stereotactic radiotherapy tumor target zones is multiple, 50% isodose curves in a target zone three-dimensional space of any two stereotactic radiotherapy tumor target zones do not overlap.

4. The method of claim 1, wherein, The stereotactic radiotherapy dose is 8 Gy / time-15 Gy / time, the stereotactic radiotherapy treatment frequency is 1 time per day, and the stereotactic radiotherapy treatment number is 1-3 times.

5. The method of claim 1, wherein, The low-dose radiotherapy treatment number is the same as the stereotactic radiotherapy treatment number.

6. The method of claim 1, wherein, The target object is injected with an immunosuppression molecule inhibitor.

7. An electronic device, comprising: The electronic device comprises: a processor; a memory configured to store processor-executable instructions; wherein the processor is configured to execute the instructions to implement the method of any one of claims 1-6.

8. A radiotherapy system, characterized by, The radiotherapy system comprises a radiotherapy planning system (TPS) server and a radiotherapy device; the TPS server is configured to implement the method of any one of claims 1-6; the radiotherapy device is configured to perform radiotherapy on a low-dose radiotherapy radiotherapy zone and a stereotactic radiotherapy tumor target zone of each solid tumor of a target object.

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