Perfusion modulated tumor dose sculpting with single dose radiotherapy

A system comprising:

• a) a radiation source;
• and
• b) an electronic device, the electronic device including at least a memory and a processor operatively coupled to the memory and configured to execute instructions stored on the memory, the processor configured to:
• i) define a total planning target volume (PTVTOTAL) comprising the tumor's total volume, wherein said PTVTOTAL comprises a first planning target sub-volume (PTVHD) and a second planning target sub-volume (PTVPMDS), wherein the PTVPMDS comprises at least 5% of the tumor's total volume;
• ii) define a radiotherapy treatment plan for said PTVTOTAL;
• and
• iii) send, to the radiation source, a signal indicative of an instruction to deliver radiation doses to the PTVTOTAL, wherein the dose of radiation delivered to the PTVPMDS is less the dose of radiation delivered to the PTVHD;
• wherein the dose of radiation delivered to the PTVPMDS is insufficient to treat the tumor when delivered to the entirety of the PTVTOTAL, optionally wherein
• the tumor is adjacent to a dose limiting organ at risk (OAR), optionally wherein the OAR is a serial OAR.

A method of treating a tumor in a subject in need thereof comprising:

• defining, at a processor, a total planning target volume (PTVTOTAL) of the tumor;
• dividing, at the processor, the PTVTOTAL of the tumor into at least a first planning target sub-volume (PTVHD) and a second planning target sub-volume (PTVPMDS), wherein the PTVPMDS comprises at least 5% of the tumor's total volume;
• sending, from the processor and to a radiation source, a signal associated with a perfusion modulated dose sculpting (PMDS) radiotherapy plan;
• and
• delivering, from the radiation source, a dose of radiation to each of the PTVHD and the PTVPMDS based on the PMDS radiotherapy plan,
• wherein the dose of radiation covering 95% of the PTVPMDS is lower than the dose of radiation covering 95% of the PTVHD and wherein the dose of radiation covering 95% of the PTVPMDS is lower than the dose of radiation covering 95% of the total PTV required to treat the tumor, optionally wherein
• the method reduces incidence of local relapse compared to fractionated radiotherapy methods or
• the tumor is adjacent to a dose limiting organ at risk (OAR), optionally wherein the OAR is a serial OAR.

A method of defining a perfusion modulated dose sculpting (PMDS) radiotherapy plan for treating a tumor in a subject in need thereof, the method comprising:

• defining, at a processor, a total planning target volume (PTVTOTAL) of the tumor;
• dividing, at the processor, the PTVTOTAL of the tumor into at least a first planning target sub-volume (PTVHD) and a second planning target sub-volume (PTVPMDS), wherein the PTVPMDS comprises at least 5% of the tumor's total volume;
• defining a dose of radiation for each of the PTVHD and the PTVPMDS;
• and
• defining the PMDS radiotherapy plan for treating the tumor wherein the dose of radiation covering 95% of the PTVPMDS is lower than the dose of radiation covering 95% of the PTVHD and wherein the dose of radiation covering 95% of the PTVPMDS is lower than the dose of radiation covering 95% of the total PTV required to treat the tumor.